Graduate Nurse Experience Research Articles

A case study of new nurses’ transition from university to work

AimTo explore the experiences of new graduate nurses enrolled in a hospital-based transition to practice program, to gain insight into what new graduate nurses thought about their university training and preparedness for practice. BackgroundNursing transition programs are challenging but are fundamentally about ensuring new graduate nurses are provided the necessary opportunities to allow them to successfully transition into autonomous practice. Understanding the ‘lived’ experiences of new graduate nurses may improve transition programs by considering the difficulties new graduate nurses experience around the rigors and reality of practice. MethodThe researchers used a self-developed Graduate Nurse Workplace Preparation Survey to explore the perceptions of new graduate nurses undertaking a Transition to Professional Practice Program in an Australian metropolitan hospital to investigate the experiences of transition readiness in relation to new graduate nurses’ satisfaction with their undergraduate degree preparation. ResultsA total of 69 new graduate nurses were enrolled in the Transition to Practice Program and 23% (n = 16) completed the New Graduate Nurse Workplace Preparation Survey. Survey responses were analyzed using descriptive statistics and Leximancer was used for thematic analysis of participant comments. The study found that a successful transition from undergraduate nurse to new graduate nurse can be made if undergraduate nurses experience variation during their university clinical placements in terms of patient acuity, complexity, workload, and clinical setting. Successful transition from undergraduate nurse to new graduate nurse is enhanced by Transition to Practice Programs building upon the new graduate nurses’ previous undergraduate nursing clinical experiences. ConclusionTransition to practice and readiness for the role of newly Registered Nurse (new graduate nurse) is an important stage in the professional development of a Registered Nurse and the transition issues related to university preparation made by new graduate nurses in this study corresponded with issues raised in similar preparation and transition literature suggesting that continued work in undergraduate training and clinical placement is required. However, by understanding new graduate nurses’ university preparation satisfaction levels and issues faced during the transition to practice period both universities and clinical placement staff can work together to improve new graduate nurses’ success in Transition to Professional Practice Programs.

A review: Developing an ecological model approach to co-worker incivility experiences of new graduate nurses.

To explore how an ecological approach be used to explore relationships among workplace empowerment, authentic leadership, trust in management, areas of work life and co-worker incivility experiences of new graduate nurses. Key concepts related to new graduate nurses' incivility experience informed the research question building on the findings of our first author's integrative review. Second, relevant theories and concepts were identified by conducting a literature review. Third, the themes build on prior theories and factors to propose a hypothetical model. (2016-2019) CINAHL, OVID, PSYCINFO, PUBMED, EBSCO, ERIC, SCOPUS, Cochrane Library; PROQUEST and Google Scholar. (a) Constructs identified in an IR (Blackstock et al., 2018) guided a literature review on predictive variables linked to new graduate nurse's co-worker incivility experiences; (b) an ecological approach was explored; and (c) we demonstrate how multidimensional organizational factors related to incivility experiences of new graduate nurses can be situated in an ecological model. Structural and organizational factors, and nurse leaders influencing new graduate nurses' experiences are situated in an ecological model. Placing new graduate nurses' co-worker incivility experiences in the microsystem and close to the mesosystem (nurse supervisor) and exosystem (workplace empowerment) of our ecological model provides new insights into their incivility experiences and informs future research. The ecological approach and operational definition of incivility help to clarify incivility behaviours as not merely individual behaviours observed by others needing corrective cognitive behaviours, nor support in a graduate transition program, but rather a symptom of work environment factors contributing to multidimensional work environments of new graduate nurses' and influence incivility behaviours. New graduate nurse co-worker incivility research could measure change across time and across system domains informed by this ecological approach and can shape new ways of thinking about how to prevent and mitigate incivility.

The lived experience of new graduate nurses successfully completing NCLEX-RN

Background and objective: The NCLEX pass rate is considered the primary indicator of program quality. Much literature exists regarding pre-graduation efforts aimed at aiding students to prepare for the NCLEX-RN exam, while there is little available on post-graduation efforts. This project was conducted to identify the post-graduation experiences of successful NCLEX-RN test takers as they prepared to complete the exam.Methods: This was a qualitative descriptive study utilizing a phenomenological framework to determine the lived experience of new graduates preparing to complete the NCLEX-RN exam.Results: Four main themes were identified as relevant to post graduation experiences including: (a) Finding Motivation, (b) Study Tactics, (c) Taking a Break, and (d) The Testing Experience. Additionally, few of the participants took it for granted that they were going to pass the exam, they reported wishing they had spent more time preparing, and with regard to studying, several described wishing they had started earlier.Conclusions: It will be beneficial for faculty to discuss potential strategies for success to utilize after graduation, including expectations of testing day, setting a realistic timetable to test, overcoming lack of motivation to preparation for the exam, and careful scheduling of coaching and study sessions.

The experiences of new graduate nurses and midwives going through a virtual interview recruitment process during the COVID-19 crisis: a cross-sectional study

BackgroundThe annual recruitment of new graduate nurses and midwives is key to recruiting large numbers of staff with the right attitude, skills and knowledge who are the best fit for the organisation. Virtual interviews were undertaken in 2020 due to the surge worldwide in the COVID-19 crisis. This study evaluates those virtual interviews and explores the sustainability of the model.MethodsA cross-sectional study was conducted at a large health organisation in New South Wales, Australia. Data were collected over 3 weeks using two online surveys, one for interviewees (n = 512) and the other for interviewers (n = 68). Quantitative data were analysed using descriptive statistics and frequency distributions, and additional free-text comments were analysed using content analysis.ResultsResponse rates were 55% (n = 280) interviewees and 54% (n = 37) for interviewers. The majority of interviewees (58%, n = 184) and interviewers (78%, n = 29) stated the interview was seamless or very seamless and 55% (n = 156) of interviewees and 73% (n = 27) of interviewers agreed interviewees conveyed themselves well during interviews. Over half of interviewees (65%, n = 182) and interviewers (51%, n = 18) agreed the virtual interview was fair or very fair for interviewee performance, regardless of age, race, or socio-economic status. However, many expressed a need for better internet access, equipment, and support, and a longer interview time to personally connect. Both new graduate interviewees (60%) and interviewers (75%) agreed virtual interviews are a suitable model for future use. However, some respondents indicated they preferred face-to-face interviews.ConclusionsThe use of virtual interviews to select new graduates is considered acceptable, cost-effective and sustainable, as well as fair by the majority of participants. Study findings inform policy development, future planning, support the use of flexible selection practices and provide other health care professionals with a virtual recruitment model to consider when developing strategies to grow their future health workforce.

A qualitative descriptive study of new graduate nurses’ experiences supporting breastfeeding women in neonatal settings

AimThe aim was to explore the experiences of new graduate nurses who provide support to breastfeeding women in neonatal care settings. The objective of this study was to explore the enablers and barriers that influenced new graduate nurses’ self-efficacy. BackgroundNurses have important roles in promoting and educating breastfeeding women in neonatal care settings. Although there are many studies that focused on nursing students and registered nurses’ experiences in supporting breastfeeding women, there is limited research about the experiences of new graduate nurses during their transition from universities to neonatal care settings as a registered nurse where they learn how to educate and support breastfeeding women. DesignA qualitative descriptive study. MethodsNine new graduate nurses who support breastfeeding women in neonatal care settings within Australia were recruited. Data was collected through semi-structured interviews via videoconference or telephone. Braun & Clarke’s thematic analysis was used to analyse the data. ResultsThis study found four themes: Preparedness, Emotions, Ongoing Learning, and Confidence. Barriers and enablers included support, time, consistency of information, and impact of stereotyping. The new graduate nurses did not initially feel prepared to support breastfeeding women due to their lack of knowledge. Participants’ self-efficacy enhancing strategies to help build knowledge and confidence supporting breastfeeding women included: a) frequent practice, b) having role models and seeking support, c) receiving encouragement and positive feedback, and d) interpreting their emotional feelings as a normal reaction to the learning process. ConclusionAdditional education should be provided during pre-registration education and on commencement of employment in neonatal settings to improve new graduate nurses’knowledge supporting breastfeeding women. Self-efficacy enhancing strategies can be used in partnerships between educational institutions and hospitals to support new graduate nurses to feel more confident providing breastfeeding support in neonatal care settings.

The lived experiences of graduate nurses transitioning to professional practice during a pandemic

BackgroundGraduate nurses face challenges during their transition to professional practice. Understanding these experiences during a pandemic has not been explored. PurposeThe purpose of this study is to describe the lived experiences of graduate nurses transitioning to practice during a pandemic. MethodsUsing a hermeneutic phenomenological approach, focus groups were conducted with fifteen nurses who were at three different stages of transition and participating in a 12-month Graduate Nurse Residency Program. FindingsSeven themes emerged: 1) being new is overwhelming, even more so during COVID-19, 2) need to be flexible, 3) pandemic knowledge and practice disconnect, 4) communication barriers worsened with masks, 5) being a “COVID nurse,” 6) no self-care, and 7) gratitude: still glad to be a nurse. DiscussionFindings emphasize the important focus on graduate nurse support and educational foundation for role transition into professional practice, especially during a pandemic. Participants expressed lack of preparedness for practice but remain excited about being a nurse.

Effect of Transition Training Program on Novice Nurses' Working at University Hospitals

Background: Transition is the period of learning, adjustment and socialization, when the nurse applies, consolidates and increases their existing knowledge, gaining competence (knowledge, skill, and attitude) that is applicable to the nursing practice of the clinical setting or patient population in which they are expected to perform. Aim: investigating effect of effect of transition training program on novice bachlors' degree nurses' working at Minia University Hospitals. Research design: Quasi-experimental research design was utilized in this study. Setting: The study was carried out at Minia University Hospitals. Subject: A convenient sample the study subjects were include all novice nurses (bachelor's degree) in University Hospitals. They are working in the field of nursing practice less than one year (no=110). Tools: Two tools were used in this study; nurse's transition training program knowledge questionnaire, and The Casey-Fink Graduate Nurse Experience Survey. Results: There were statistical significance differences in knowledge test scores as well as mean scores of transition role among new graduate nurses. Conclusions: There was a positive effect of transition training program on Novice Nurses. Recommendations: Further attention to academic preparation of nursing new graduate nurses to promote their perceptions about role transition.

Graduate nurse views on patient safety: Navigating challenging workplace interactions with senior clinical nurses.

To explore and understand the negative experiences of graduate nurses' interaction with senior nurses and the implications for safe patient care. Patient safety is dependent on the nursing care they receive. Working in environments where there is reduced collegial support and increased emotional distress, increases the likelihood of nurses making errors that may negatively impact on patient outcomes. Insights drawn from graduate nurses' negative interactions with senior nurses may provide an understanding of the impact of nurse-to-nurse interactions on patient safety outcomes. A qualitative exploratory descriptive design was used. A purposive sample of 18 graduate registered nurses participated in this study. Semi-structured interviews were conducted, audio-recorded and transcribed verbatim. Data were thematically analysed. The COREQ checklist was followed. The overarching theme, 'Navigating workplace challenges' was identified with two sub-themes: Processing unsupportive nurse behaviour and responding to nurse deviations from best practice. Common deviations in practice included erosion of safe medication practice, wound care and non-compliance with universal precautions. Graduate nurses also observed unsafe workplace practice, however, were hesitant to speak up due to fear of retribution. Unsupportive behaviours impacted on their critical thinking ability, follow-up interactions with other nurses and subsequent delivery of patient care. Quality and safety strategies should not ignore and/or overlook the impact of interpersonal relationships on patient safety and risk. Strategies for delivering evidence-based, safe and quality care to patients go beyond the establishment of standards and technically focussed management strategies. It is vital to examine the quality of working relationships between all levels of healthcare professionals including graduate nurses and their supervisors to ensure supportive behaviours prevail in advancing delivery of quality care within the practice environment. The study alludes to the fact that disruptive workplace behaviours are more hierarchical than horizontal (i.e., graduate nurse-to-graduate nurse).

Group mentoring and nurse residents

Group mentoring and nurse residents

Revisions to the Casey-Fink Graduate Nurse Experience Survey Reflect Current Healthcare Trends.

Revisions to the Casey-Fink Graduate Nurse Experience Survey Reflect Current Healthcare Trends.

New graduate nurses and dementia care in acute care: A qualitative study

With the increasing older adult population, new graduate nurses will be providing care for patients with dementia more frequently. The purpose of this qualitative study was to explore the experiences of new graduate nurses when providing care for patients with dementia in acute care environments. We conducted semi-structured interviews with eleven new graduate nurses in Ontario, Canada. Three themes emerged from the thematic analysis: (1) building of vision and values; (2) clashing of vision and values; and (3) making do with what you have. Barriers to providing dementia care in acute care were similar to barriers experienced by non- new graduate nurses reported in the literature, such as challenges with responsive behaviours, maintaining safety and providing psychosocial care. Facilitators identified were supportive colleagues and early exposure to dementia care.

Experiences of Registered Nurses in the Transition to Healthcare Professionals: A Study from Military and Civilian Hospitals in Saudi Arabia

Registered nurses (RNs) often experience substantial job dissatisfaction and stress during the transition from a student to a healthcare professional. However, multicenter studies in this area are limited, and little is known whether the transition experience of RNs in a military hospital (MH) is different from that in civilian hospitals (CH). This study presents a multicenter survey on the transition experiences of RNs and compares of transition experiences of RNs in CH and MH. A multicenter survey was conducted in military and civilian hospitals in Saudi Arabia, using a modified version of the validated Casey-Fink Graduate Nurse Experience Survey. In the survey, 278 RNs participated. Of these, 71.2%were under 25 years of age, and 56% were women. Approximately 36% of the respondents were from MH. A majority of RNs (89.9%) cited fears related to patients' safety as a difficulty in the successful transition. When compared with RNs from CH, a higher number of RNs from MH believed that improved orientation could be a support in transition (OR: 2.05, 95% CI 1.23-3.43, P=0.008); conversely, a significantly lower number of respondents from MH believed that an improved work environment could be a support in transition (OR: 0.30, 95%CI 0.16-0.55, P=0.001). Most RNs consider their fear for patients’ safety as a difficult aspect of their transition experience. RNs in MH and CH have a different perception of the least satisfying aspect of their job. Keywords: Transition experience, nurses, orientation, and work environment DOI: 10.7176/JBAH/11-6-03 Publication date: March 31 st 2021

Registered Nurses’ experiences of psychological well‐being and ill‐being in their first year of practice: A qualitative meta‐synthesis

To synthesize Registered Nurses' self-reported perceptions and experiences of psychological well-being and ill-being during their first year of practice. Qualitative meta-synthesis. Databases included Cumulative Index of Nursing and Allied Health Literature, Excerpta Medica database, Medical Literature Analysis and Retrieval System Online and Psychological Information. Qualitative studies were considered for inclusion if published in English, from 2009-2019, reporting primary data analysis including psychological well-being and ill-being experiences of graduate nurses in first year of practice. Qualitative studies were systematically identified and critically appraised. A meta-synthesis was applied using an open card sort technique to organize empirical data into a matrix of graduate nurses' voices of psychological well-being and ill-being. Twenty-two studies were included. Analysis revealed patterns of positive experiences and emotions. These included feeling valued and part of the team and learning from and feeling supported by other nurses. Negative experiences and emotions such as feeling overwhelmed, stressed, alone and inadequately prepared were also identified. Graduate nurses' perceptions and experiences of their psychological well-being and ill-being revealed both positive and negative dimensions during this transition period. Specific examples of strategies that may promote transition nurses' well-being and prevent ill-being were identified such as social connection and support. Increasing the numbers of new nursing graduates world-wide is required to strengthen health systems. Developing strategies to retain these graduates in the workforce is paramount. This review found some graduate nurses experience the transition period as a time of personal growth and fulfilment, for others this period was a stressor. These findings were illustrated in a model of 'ways to well-being'. The potential for knowledge translation of this model extends from graduate nurses as individuals, to nurse entry to practice programs and graduate nurse programs, to organizational policy targeting future health workforce. CRD42020148812.

Shaping clinical imagination as new graduate nurses in maternal-child simulation

BackgroundCombined with traditional placement, simulation has been used as an experiential learning opportunity to integrate theory and practice in maternal-child nursing. Methodvan Manen’s phenomenology of practice uncovered the lived experience of new graduate nurses adopting maternal-child simulation in their practice. Narrative methods included a three-phased approach to phenomenological interviews to capture the new graduate's entry into practice. ResultsThematic analysis revealed four main themes: acting like a nurse, forming a clinical imagination, embodying the role of the novice nurse, and embracing in-situ simulation. DiscussionThe essence of being a nurse required immersion into the ethics of caring and creation of an optimal simulation debriefing using a skilled and thoughtful approach to trigger imaginative thinking. While an inventory of simulation in nursing education was deemed necessary to understand the current blend of traditional placement and simulation in practice education, the new graduate nurses in the study looked for specialty training, and exposure to advanced roles in the simulation experiences. ConclusionAn integrated traditional placement with the use of simulation fostered clinical imagination where the new graduate nurse visualized and embodied the role of the novice nurse. Future research is required to describe the impact of simulation on practice readiness.

Corrigendum

Journal of Clinical NursingVolume 30, Issue 1-2 p. 307-307 CORRIGENDUM Free Access Corrigendum This article corrects the following: Corrigendum Volume 30Issue 1-2Journal of Clinical Nursing pages: 307-307 First Published online: November 10, 2020 Correction(s) for this article Corrigendum Volume 30Issue 1-2Journal of Clinical Nursing pages: 307-307 First Published online: November 10, 2020 First published: 10 November 2020 https://doi.org/10.1111/jocn.15536 AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat In Salem Alghamdi and Baker (2020), the Acknowledgement section was incomplete. The Acknowledgement section should read as follows: The authors acknowledge the support provided by the Deanship of Scientific Research at King Saud University, through the Research Center at College of Nursing. Furthermore, the authors are very thankful to all the associated personnel in any reference who have contributed to the purpose of this research. Reference Salem Alghamdi, M., & Baker, O. G. (2020). Identifying the experiences of new graduate nurses during the transition period to practice as a professional nurse. Journal of Clinical Nursing, 29, 3082– 3088. https://doi.org/10.1111/jocn.15344 Wiley Online Library PubMed Web of Science®Google Scholar Volume30, Issue1-2January 2021Pages 307-307 ReferencesRelatedInformation

Assessing Stressors for Interns: Using the Casey-Fink Graduate Nurse Experience Survey.

New graduate nurses experience stress when transitioning from the student role to the RN role. The Casey-Fink Graduate Nurse Experience Survey tool (CFGNES) was used to evaluate new graduate nurse stressors. The CFGNES study looked at the effect that a nurse intern program and simulation had on their anxiety. Understanding and identifying stressors can aid transition to practice programs in assisting new graduate transition into the practicing nurse role. [J Contin Educ Nurs. 2020;51(11):516-521.].

Transition to Practice Experiences of New Graduate Nurses From an Accelerated Bachelor of Science in Nursing Program: Implications for Academic and Clinical Partners.

This study explored the transition to practice experiences of new graduate nurses and the effects of their education on their readiness to practice. This phenomenological study used two focus groups to gain an in-depth understanding of the lived experiences of these graduate nurses during their first year of practice, their perceptions of the effectiveness of their academic experience in preparing them for professional nursing practice, and clinical agency support. Three themes emerged from the focus group analysis: Practice Readiness, Work-Related Environmental Influences, and Being a Nurse. This study provides insight into the key issues surrounding the transition process experienced by new nurses and suggests ways to educate and successfully transition them into professional practice. Information gained from this study provides a beginning evidence base for other educators in both the academic and clinical settings interested in supporting successful transition to practice for new graduate nurses. [J Contin Educ Nurs. 2020;51(9):433-440.].

Reported Levels of Exhaustion by the Graduate Nurse Midwife and Their Perceived Potential for Unsafe Practice: A Phenomenological Study of Australian Double Degree Nurse Midwives.

The experiences of graduate nurses and midwives transitioning into the clinical environment as beginning practitioners has been reported as a time period of great challenge. For the graduate double degree nurse midwife, often transitioning into two disciplines of practice concurrently, their experiences have the potential to be heightened. The aim of this research was to explore the transition to practice experiences of double degree graduate nurse midwives practicing in either or both nursing and midwifery in the Australian health care system. This research used a Husserlian descriptive phenomenological approach to understand the experiences of 23 double degree graduate nurse midwives working in 20 different health care facilities across Australia. The findings showed that most participants experienced exhaustion from an emotional, physical, and mental perspective during their first year of practice. These experiences were linked with cognitive saturation, professional loneliness, sleep deprivation, and an inability to achieve a work-life balance. The data also highlighted the graduate nurse midwife's concerns for safe practice when feeling mentally, physically, and emotionally depleted. Safe practice is paramount for both patient and health care worker. The levels of exhaustion described by the participants in this study influenced their perceived ability to practice safely. As a result, it should be recognized that the graduate nurse midwife's health and well-being is central to their perceptions of safe practice and is fundamental to a positive transition to practice experience.

Identifying the experiences of new graduate nurses during the transition period to practice as a professional nurse.

To assess the impact of orientation programmes on new graduate nurses' transition periods. The transition of graduate nurses from students to the practising professional nurse is often found to be stressful. The study has employed a descriptive correlational design. The data were collected from 95 participants who were working as registered nurses in public hospitals in Al-Bahah region. Questionnaire was used for collecting data which was based on the Casey-Fink graduate nurse experience survey. SPSS software was used to analyse the results. The methods of this study are in line with the STROBE checklist. The findings indicated statistically significant relationship between preceptor's support and communication leadership, professional satisfaction and job satisfaction, whereas an insignificant relationship was observed between preceptor's support and organising patient safety. The results also indicated that new graduate nurses were uncomfortable while performing different procedures/skills independently. The study implied instigation of the structured orientation programme to overcome the challenges faced by the new graduate nurses in their transition period. The upsurge in the nurses' demand across Saudi Arabia makes this study highly relevant. It helps in optimising the transition experience of the nurses who are required to provide service in the acute sector.

Casey-Fink Graduate Experience Survey for Nurses and Preceptors in the Kingdom of Saudi Arabia

Background: Preceptors play an essential role in supporting new nurses during the transitional period in professional roles. Moreover, graduate nurses experience several challenges during their transitional role from students to professional nurses, despite the considerable relationship between nurses and preceptors.Purpose: The study aims to evaluate the relationship between the experiences of nurses using Casey-Fink Graduate Nurse Experience Survey and the number of preceptors in Saudi hospitals.Methods: A cross-sectional study design was adopted, and Casey-Fink Graduate Nurse Experience Survey was used to collect data from 84 newly graduated nurses. Descriptive and regression analysis was used for data analysis.Results: Results showed that there was no statistically significant relationship between the responses of 5 factors of the Casey-Fink Graduate experience survey and the number of preceptors. Based on the survey, (33.8%) had to stress whereas significant causes of stress were student loans (41.9%), personal relationships (13.5%), living situation (27%), and finances (10.8%).Conclusion: No statistically significant relationship was found between variables including; support, patient safety, communication/leadership, professional satisfaction, and job satisfaction. The significance of preceptorship programs should be considered by the primary health care corporation to support and prepare preceptors of newly graduated and recruited nurses.