Experiences Of New Graduate Nurses Research Articles

Coming ready or not! An integrative review examining new graduate nurses' transition in acute care.

To synthesize the scientific evidence about new graduate nurses' transition to practice in the acute care setting and consider implications for nurses and nursing practice. Despite the vast amount of literature on new graduate nurses' transition to practice, the transition of new graduate nurses is a global issue and remains at the forefront of discussions within the nursing community. An integrative review. A search of evidence-based research from seven electronic databases (CINAHL, MEDLINE, ProQuest, Cochrane, JBI, Wiley, and Scopus) was conducted for the period of 2006-2016. Eligible articles were critically reviewed and scored using the Mixed Methods Appraisal Tool (MMAT). Twenty-six articles were reviewed, which included 19 qualitative, five quantitative, and two mixed methods studies. "The Experiences" are described in three themes: Dominated by fear but feeling a sense of accomplishment and satisfaction; Reality vs Idealism; and Adjusting to nursing life. "The Factors" are described under three themes: Personal, Professional, and Organizational. The transition experience of new graduate nurses is complex and multidimensional and highlights that "it takes a village" to grow and support new graduate nurses.

The experiences of new graduate nurses hired and retained in adult intensive care units

BackgroundIt is a common practice that new graduate Registered Nurses are hired into adult intensive care units as initial entry into practise. There exists a practice readiness gap between nursing curricula and actual clinical practise expectations at adult intensive care settings; this has led to negative consequences and subsequent nurse turnover, a concern nationwide. Nonetheless, some new graduate nurses survived their initial transition and continue to practise in adult settings. The purpose of this study was to explore the experiences of nurses who were hired into adult intensive care as a new graduate and survived their transition from novice to competent, starting the third year of practise. MethodologyThe study used the hermeneutic phenomenology research approach. FindingsData analysis revealed the overall meaning of the experience: coming to terms with being comfortable with being uncomfortable. The six themes associated with being comfortable with being uncomfortable were: confidence and uncertainty, gaining experiences and forever learning, intuitive knowing and intuition, difficult and stressful, being courageous and assertive, and the team and support people. ConclusionNew graduate nurses can survive to become competent adult intensive care nurses. This study reveals the need to promote exposure to a variety of clinical situations early, to promote resilience and self-care, and to foster unit teamwork and mentoring to ensure successful transition and overall retention of new nurses hired into in adult intensive care.

Protocol for a Case Study to Explore the Transition to Practice of New Graduate Nurses in Long-Term Care.

A qualitative case study protocol for an exploration of the transition to practice of new graduate nurses in long-term care is presented. For the new graduated nurse, the transition to professional practice is neither simple nor easy. This time of transition has been examined within the hospital setting, but little work has been done from the perspective and context of long-term care. As the global population continues to age and the acuity of persons accessing services outside of hospital continues to increase, there is a need to better understand the transition experience of new graduate nurses in alternative, tertiary settings such as long-term care. Therefore, the purpose of this report is to situate a study and describe a protocol that explored the transition to practice experience of seven new graduate nurses in long-term care using Yin’s case study methodology. The case or phenomenon being explored is new graduate nurse transition to practice. This report presents an overview of the literature in order to situate and describe the case under study, a thorough description of the binding of the case as well as the data sources utilized, and ultimately reflects upon the lessons learned using this methodology. The lessons learned include challenges related to precise case binding, the role and importance of context in conducting case study research, and difficulties in disseminating study findings. Overall, this report provides a detailed example of the application of the case study design through description of a study protocol in order to facilitate learning about this complex and often improperly utilized study design.

The transition challenges faced by new graduate nurses in their first year of professional experience

Though nurses form the largest group of healthcare professionals in most of the healthcare systems, the transition from an academic to a real-world setting is characterized by high stress and reality shock, which contributes to a high turnover rate during the first year of practice. This qualitative study aimed to illustrate the transition experience of new graduate nurses and to identify the factors affecting their adaptation processes. Registered nurses who had completed university nursing training program and possessed about a year of professional nursing experience in Hong Kong were recruited for semi-structured, face-to-face individual interviews. The data was saturated after 14 new graduate nurses had been interviewed. The participants experienced complicated perceptions with fluctuating feelings ranging from frustration to a sense of accomplishment during the transition period. Four interrelated human and work related factors were illuminated to influence their adaptation to transition: 1) professional accountability and competency, 2) personal adaptation attitude and ability, 3) interpersonal relationships with colleagues and 4) institutional/workplace support and orientation. The findings demonstrated a close link between perceptions and the interrelated factors affecting transition experiences and adaptation processes. Education and healthcare institutions should provide more training and support in the promotion of emotional well-being, the improvement of professional knowledge and skills, and in-service adaptation enhancement programs before and during the transition. Further comprehensive studies with longitudinal designs are recommended to explore the perceptions of new graduate nurses. Keywords

Dealing with end of life-New graduated nurse experiences.

This article explores the perceptions of new graduate nurses around their readiness for practice when faced with death and dying within the workplace, particularly in rural hospital and community nursing settings. An essential consideration for nurses in the care of people with life-limiting illness is the extent of their preparation for this area of practice. Nurses need to be aware of a multitude of compounding factors that will influence how and where the person is cared for. Despite significant literature about how to provide end of life education to undergraduate nurses there is little in the literature that explores the experiences of new graduate nurses. This paper reports on a qualitative interpretative study with data collected in seven semi-structured interviews. Participants were invited to be interviewed with an online mail-out to Alumni who had graduated between 1-2years earlier. A thematic analysis of the interviews was then conducted. Four themes emerged from the thematic analysis of the interviews. These were; the role of the new graduate in palliative care, preparation for palliative care in undergraduate nursing curricula, readiness for dealing with death and dying, and gaps in educational preparation. While palliative care is viewed as an important aspect of undergraduate nursing education, it is recognised as an area of practice that undergraduate nurses feel they are not adequately prepared for. This study identifies the need to incorporate skills such as having conversations and communicating effectively with patients and families experiencing end of life issues. Graduate nurses feel they are not adequately prepared for end of life care which demonstrates the need for quality end of life care education in undergraduate nursing curricula.

New graduate nurses' experiences about lack of professional confidence

Professional confidence is an essential trait for new graduate nurses to possess in order to provide quality patient care in today's complex hospital setting. However, many new graduates are entering the workforce without it and this remains to be explored. This study describes how new graduate nurses accounted for their lack of professional confidence upon entry into professional practice and how it developed during their first year of practice in the hospital setting. Two face-to-face, individual interviews of 12 participants were utilized to capture the lived experiences of new graduate nurses to gain an understanding of this phenomenon. After manual content analysis seven themes emerged: communication is huge, making mistakes, disconnect between school and practice, independence, relationship building, positive feedback is important, and gaining experience. The findings indicate that the development of professional confidence is a dynamic process that occurs throughout the first year of practice. New graduate nurses must experience both positive and negative circumstances in order to move toward the attainment of professional confidence. Knowing this, nurse educators in academia as well as in the hospital setting may better support the development of professional confidence both before and during the first year of practice.

Graduate nurses' experiences of mental health services in their first year of practice: An integrative review

New graduate nurses have reported negative experiences in mental health settings, particularly during the transitional period of practice. Previous research has focused on addressing the undergraduate preparation of nurses for practice instead of the experiences and outcomes of the transitional period. Recently, there has been growing interest in exploring the experiences of graduate nurses in transition and the implementation of promising interventions to facilitate new graduates' assimilation to practice. Despite these initiatives, the overall shortage of mental health nurses continues to rise, and graduates still report negative experiences in the mental health setting. The purpose of this study was to identify and explore the experiences of new graduate nurses in mental health services in their first year of clinical practice. An integrative review was conducted with 22 studies sourced from the CINAHL, PubMed, Scopus, and PsychINFO electronic databases, as well as through hand-searching the literature. Literature review findings have highlighted negative clinical experiences and increased attrition from mental health services for graduate nurses. These experiences were closely linked with the changes in the training of mental health nurses, role ambiguity, inadequate clinical preceptorship, encountering the reality of mental health services, and the role of health services in transitioning graduate nurses into clinical practice. Established research into organizational cultures demonstrates that negative organizational outcomes result from negative workplace experiences. Therefore, further research into new graduate nurses' experiences of mental health nursing and its culture might clarify the reasons why they might not be attracted to the discipline and/or are leaving early in their career.

Experiences of new graduate nurses working in a neonatal intensive care setting: a systematic review protocol of qualitative evidence.

The overall objective of this systematic review is to identify, critically appraise and synthesize the experiences of new graduate nurses in the neonatal intensive care unit (NICU). The specific review question is: what are the experiences of new graduate nurses working in a NICU setting?

The experiences of newly graduated nurses during their first year of practice in the Sultanate of Oman – A case study

BackgroundStudies have demonstrated that the transition experience of new graduate nurses is complex and frequently negative, leading to dissatisfaction with nursing and increased attrition. Existing studies of new graduate nurses’ transition experiences tend to be concerned with the experiences of new graduate nurses in the West. To date, no study has been conducted examining the transition experience in any Middle Eastern country where the cultural context surrounding nursing education and practice is different. AimTo explore the experiences of new graduate nurses during their transition period in the Sultanate of Oman. MethodA qualitative case study utilising an embedded single case design was conducted to investigate the transition experience of new nursing graduates from one university in the Sultanate of Oman. Data were collected from the perspective of new graduate nurses and also from the perspective of other key informants who are key organisational actors such as clinical instructors, managers and preceptors. As is characteristic of case study design, this study employed triangulated methods including individual and focus group interviews, observation and documentary analysis. Data collected were thematically analysed using Microsoft Access. ResultsThis study showed that nursing is not an attractive choice for Omani students to study and pursue as a future career. During the transition period, new graduate nurses experienced reality shock resulting mainly from a theory–practice gap. They found themselves with limited practical experience but a high level of theoretical knowledge that was difficult to utilise in practice. They experienced many competing priorities in their working environment which resulted in task-orientation and compromised patient care. Many new graduate nurses resented their involvement in basic nursing care, which they believed should not be part of their role as degree nurses. ConclusionOmani new graduate nurses’ transition experiences are complex and highly affected by the working conditions and the status of nursing in Oman. Basic nursing care was believed by new graduate nurses to negatively affect the status of nursing.

The lived experience of new graduate nurses working in an acute care setting.

The high attrition rate of graduate nurses will exacerbate the current nursing shortage as Baby Boomer nurses (born between 1946 and 1964) retire, negatively affecting the quality of patient care and increasing employer costs. The purpose of this phenomenological study was to explore the lived experiences of new graduate nurses employed in an acute care setting in southwest Florida. This information provides further guidance to nurse educators as they develop curricula, support graduate nurses to transition into professional practice, and create strategies to increase retention. Ten participants who were traditional students in generic baccalaureate nursing programs, selected through purposeful and snowball sampling, were interviewed via open-ended questions. Using Colaizzi's classic phenomenological method of data analysis and NVivo 10 software, three over-arching themes emerged-knowledge, skills, and environment-which were interpreted in relation to graduates' lived experience. Recommendations include implementation of innovative initiatives that address new graduates' experience and increase retention.

The experiences of new graduate nurses working in a paediatric setting: a systematic review protocol of qualitative evidence.

Review question/objective The overall objective of this systematic review is to identify, critically appraise and synthesize the literature regarding the experiences of new graduate nurses working in a pediatric setting. The specific review question is: what are the experiences of new graduate nurses working in a paediatric setting? Inclusion criteria Types of participants This systematic review will consider studies involving new graduate nurses of any age, gender and cultural background working for 12 months or less in a pediatric setting. A new graduate nurse is a person who has completed a baccalaureate course, associate degree, diploma or equivalent course in nursing, has qualified for registration and is working within the first year post registration as a registered nurse. Phenomena of interest This systematic review will consider studies that investigate the experiences of new graduate nurses working in a pediatric setting. The experiences include new graduate nurses’ perceptions, perspectives, views, challenges, feelings, beliefs and thoughts of working within the first year post registration in a pediatric setting. The experiences may include, but are not limited to, communication, advocacy, education and minimization of distress in dealing with patients and their families. Context Any pediatric setting including, but not limited to, hospitals of any size and within the community in any country, excluding neonatal intensive care units and special care nurseries. A pediatric setting is a place where care is provided to sick infants, children and adolescents.

The Impact of Psychosocial Health and Self-nurturance on Graduate Nurse Experience

Purpose: The purpose of this study was to identify the effect of Psychosocial health and Self-nurturance on the experience of new graduate nurses. Methods: A cross-sectional survey design was used. The participants in this study were 149 nurses who had less than 12 months of nursing experience and were working at one of 4 general hospitals. The data were collected by a self-administered questionnaire from Nov. 2012 to Oct. 2014. Results: The total mean score for Psychosocial health was 3.07±0.60, Self-nurturance, 3.38±0.44, and graduate nurse experience, 2.59±0.27. The effect of Psychosocial health and Self-nurturance predicted 23% of variance in graduate nurse experience. Conclusion: These results indicate that Psychosocial health and Self-nurturance have a positive relationship to graduate nurse experience. Therefore, further studies including approaches that support Psychosocial health and Self-nurturance are recommended to help in the adaptation of newly graduated nurses to clinical settings.

“They have no idea of what we do or what we know”: Australian graduates' perceptions of working in a health care team

Globally it has been suggested that interprofessional education can lead to improvements in patient safety as well as increased job satisfaction and understanding of professional roles and responsibilities. In many health care facilities staff report being committed to working collaboratively, however their practice does not always reflect their voiced ideologies. The inability to work effectively together can, in some measure, be attributed to a lack of knowledge and respect for others' professional roles, status and boundaries. In this paper, we will report on the findings of an interpretative study undertaken in Australia, focussing specifically on the experiences of new graduate nurses, doctors and pharmacists in relation to ‘knowing about’ and ‘working with’ other health care professionals. Findings indicated there was little understanding of the roles of other health professionals and this impacted negatively on communication and collaboration between and within disciplines. Furthermore, most new graduates recall interprofessional education as intermittent, largely optional, non-assessable, and of little value in relation to their roles, responsibilities and practice as graduate health professionals. Interprofessional education needs to be integrated into undergraduate health programs with an underlying philosophy of reciprocity, respect and role valuing, in order to achieve the proposed benefits for staff and patients.

New Graduate Nurse Experience: A Qualitative Study in an Acute Cardiac Specialty Area

Research has suggested that the transition from student nurse to new graduate nurse is a challenging time in a nurse's career, with one in five nurses leaving the profession within the first year of practice. However, the majority of these studies have been conducted in general practice areas, such as medicine and general surgery, with limited research examining the transition experience in acute specialty areas. A study is underway to explore the transition experience of new graduate nurses in an acute cardiac specialty area.

Lived Experiences of New Graduate Nurses

Lived Experiences of New Graduate Nurses

Meeting the Needs of New Graduates in the Emergency Department: A Qualitative Study Evaluating a New Graduate Internship Program

The purpose of this study was to explore the experiences of new graduate emergency nurses participating in a structured internship program. In order to meet the needs of new graduate nurses in emergency departments, these departments have developed a variety of orientation programs, some more successful than others. One type of program involves a combination of didactic content and hands-on clinical experience. This study examines the experiences of new graduate nurses in an internship program at a 200-bed community hospital. A qualitative design was used. Interviews with 8 of 9 nurses who participated in the new graduate internship program between 2006 and 2007 were conducted. Content analysis was used to analyze the data. Three themes were identified from the experiences and expectations reported in the interviews: (1) the acquisition of new knowledge and skills in a specialty area, (2) becoming more proficient, and (3) assistance with role transition. The significant role and importance of the unit-base clinical nurse specialist (CNS) and the nurse preceptors were also identified. The findings of this study suggest that a structured internship program is helpful to new graduate nurses when orienting to a critical care area such as the emergency department. Furthermore, the combination of didactic and clinical content, and the roles of the preceptor and unit-base CNS appear to be key factors in the successful transition from new graduate to emergency nurse.

Socialisation of new graduate nurses to practising nurses

The aim of this study was to explore the socialisation experiences of new graduate baccalaureate nurses to practising nurses. How nurses contend with the stress of their professional role has been of interest to both researchers and healthcare administrators over the past 30 years. Work stress of clinical nurses comes mainly from organisational and professional factors. However, few studies have explored the professional and organisational socialisation experiences of new graduate nurses. A qualitative descriptive approach was adopted. Participants were graduates of a baccalaureate nursing programme and employed full time at four medical centres in Taiwan, their first full-time work experience. Data were collected through semi-structured, open-ended, in-depth interviews, which were transcribed verbatim and analysed by content analysis. Three themes were identified: overwhelming chaos, learning by doing and being an insider. Although the professional socialisation process was hard for the new graduate nurses, they needed much time to increase their knowledge and clinical skills to fulfil clinical needs. However, the hardest work was the organisational socialisation process, which involved fitting into the bureaucratic system, such as maintaining interpersonal relationships with colleagues and familiarising themselves with the ward rules and culture. Neophyte nurse participants were also frustrated by the conflict between professional and organisational values. The study findings show that the transition from new graduate nurse to practising nurse was stressful for these participants, particularly due to the clash between the professional value of patient-oriented nursing care and the organisational value of task-oriented nursing. Senior clinical nurses can consider this study's descriptions of new graduate nurses' experiences to help them become insiders and provide quality care.

Workplace Experiences of New Graduate Nurses

Many new graduate nurses find the first year of work stressful and, because of this, consider leaving their employer early in their career. The purpose of this study is to describe new graduate nurses' experiences during their first year of practice and to explore factors that may lead them to consider leaving their employer. We held semi-structured interviews with 23 new graduate nurses in New Brunswick. Five themes emerged from the data: surviving the first months; induction into the hospital culture; struggling to maintain a balance; being a nurse: assuming a professional role; and strategic choices: looking at the future. The findings suggest that the first year at work continues to be difficult for new graduates. Several participants changed jobs during their first year, and several others were seriously considering leaving. This study provides a more comprehensive understanding of the reasons new graduate nurses decide to leave and describes strategies that may assist in retaining this important group of healthcare providers.

Orientation to Emergency Nursing: Perceptions of New Graduate Nurses

Emergency nursing is one of the most challenging and understaffed areas of professional nursing. Currently, little is known about how new graduate nurses perceive their experiences as novice emergency nurses. The purpose of this study was to gain an understanding of how new graduate nurses who are oriented to emergency nursing as their first professional area of nursing employment perceive the orientation program and emergency nursing at the beginning and end of a 6-month program. This descriptive study incorporated qualitative and quantitative methods consisting of interviews and a survey. Study participants included 15 women and 3 men. Their mean age was 32 years. All were employed full time in their first position as a graduate nurse. They were asked their perceptions of the program at 3 and 6 months. Participants shared their perceptions of why they had been attracted to the program, characteristics of the emergency department and emergency nursing, being in a new job and role, reflections on their performance, the classroom and clinical components of the program, and their recommendations for future orientation programs. Results of the quantitative survey on participants' perceptions of their first job as a registered nurse indicated that they found the work of the orientation program to be stressful. Understanding the experience of new graduate nurses to the emergency setting provides crucial information for orientation program design. Incorporating active teaching and socialization strategies early in the program may facilitate the transition from novice to beginning competent emergency nurse.

The strengths and weaknesses of transitional support programs for newly registered nurses

Objective: The transition experiences of new graduate nurses from university to the workplace have not changed since the transfer of nurse education to the tertiary sector despite the implementation of transition support programs. This study aimed to determine the strengths and weaknesses of transition support programs for newly registered nurses. Design: A qualitative descriptive design using face-to-face interviews was chosen. Theme extraction was used to analyse the data and quotes from the interviews were chosen to illustrate and support the themes. Setting: The study was carried out in seven hospitals in area health services in and around Sydney, representing both small and large facilities with bed numbers ranging from 195 to 530. Subjects: Nine newly graduated registered nurses and 13 experienced registered nurses participated in the study. Main outcome measures: This was an evaluative study designed to gather data about established transition support programs for newly graduated nurses working in New South Wales. Results: Three themes arose from the analysis; Programs operate in a clinical environment which results in unsupportive behaviour toward new graduate nurses; Nurse unit managers influence the experiences of new graduate nurses in their workplace; and, Transition support programs are provided to redress the perceived inadequacy of university preparation for registered nurses. Conclusions: The support afforded and the experience gained by the new graduates was an obvious strength of the programs. Weaknesses of the programs included the times when new graduates worked without support and the unrealistically high expectation of what can reasonably be expected of newly registered nurses.