Nurse Transition Programs Research Articles

New graduate nurse transition programs: Relationships with bullying and access to support

New graduate nurses are often targets of bullying and horizontal violence. The support offered by new graduate nurse transition programs may moderate the effects of bullying and limit its negative impact on new graduate nurse transition. This study examined the relationships between access to support, workplace bullying and new graduate nurse transition within the context of new graduate transition programs. As part of a mixed methods study, an online survey was administered to new graduates (N = 245) approximately a year from starting employment. Bullied new graduate nurses were less able to access support when needed and had poorer transition experiences than their non-bullied peers. Participation in a formal transition program improved access to support and transition for bullied new graduate nurses. People supports within transition programs positively influenced the new graduate nurse transition experience. Formal transition programs provide support that attenuates the impact of bullying on new graduate nurses and improves transition.

The theory of organisational socialisation and its potential for improving transition experiences for new graduate nurses

Graduate nurse transition continues to remain a difficult time for many new graduate nurses, with significant numbers of graduates being dissatisfied, ultimately considering leaving or exiting the profession. Currently, many graduate nurse programs within Australia and internationally reflect a homogeneous nature pertaining to content and program delivery. A refinement of graduate nurse transition programs through an adaptation of a model of organisational socialisation supports a more individualised approach to transition, improving graduate outcomes and addressing attrition rates. To propose a model which supports the accommodation of new graduates within a health service improving both new graduate and health service outcomes through; greater levels of job satisfaction, increased commitment to an organisation and decreased turnover of new staff. Theoretical paper based on a program of research. An adaptation of a model of organisational socialisation was applied to the process of transition for newly qualified graduate nurses. This adaptation was informed by a larger 2012 Australian study (findings reported extensively elsewhere) with 459 newly qualified graduate nurses reporting their transition experiences of the first year of practice. Newly qualified graduate nurses reported effective socialisation with transition based on the following; enduring and continuous orientation throughout the first year of practice, allocation of patient responsibilities reflecting a level of acuity commensurate with a beginning skill set to meet care needs, and feedback of a respectful nature to improve confidence and competence in practice. Negative transition experiences were noted by many new graduates if these factors were not considered. Graduate nurse turnover is costly and destabilising for health services. One means of addressing this is the creation of positive working environments which appropriately socialise new graduates into health services. Accommodating new employees through; individual recognition, modelling of behaviours and developing positive transition outcomes will improve graduate nurse satisfaction and importantly retention.

A patient safety focused registered nurse transition to practice program

New graduate registered nurses (NGRN’s) have an expectation of clinical support as they make the transition from novice to advanced beginner. In this 2008–2009 study of three rural transition to practice programs we found that clinical support did not eventuate. Consequently, NGRN’s reported feeling underprepared for practice, overwhelmed by responsibility and often abandoned. Against this background, many were concerned that their inexperience had implications for safe patient care. Graduate nurse transition programs need to have the physical and human resources necessary to deliver the clinical support as promised in their prospectus, to ensure patient safety. This grounded theory study identified three essential core elements – leadership support, clinical supervision, and effective interprofessional relationships. Recommendation is made to address these deficits by mandating their inclusion in all transition to professional practice programs.

New Graduate Transition Programs: Relationships With Access to Support and Bullying.

Abstract New graduate nurses are often targets of bullying and horizontal violence. The support offered by new graduate nurse transition programs may moderate the effects of bullying and limit its negative impact on new graduate nurse transition. This study examined the relationships between access to support, workplace bullying and new graduate nurse transition within the context of New Graduate Transition programs. As part of a mixed methods study, an online survey was administered to new graduates (n=245) approximately a year from starting employment. Bullied new graduate nurses were less able to access support when needed and had poorer transition experiences than their non-bullied peers. Participation in a formal transition program improved access to support and transition for bullied new graduate nurses. People supports within transition programs positively influenced the new graduate nurse transition experience. Formal transition programs provide support that attenuates the impact of bullying on new graduate nurses and improves transition.

A patient safety focused registered nurse transition to practice program.

Abstract As undergraduate rural nursing students approach completion of their degree and become eligible for registration as a nurse they anticipate becoming part of a transition to practice program. Promises of clinical support, guidance and being welcomed into the profession are provided. Unfortunately the reality for new graduate registered nurses is often quite different. Promised clinical support does not eventuate and patient safety is often compromised. Graduate nurse transition programs need to have the physical and human resources to deliver the clinical support that was promised in their prospectus. This paper describes the nature of professional support experienced by participants of transition to practice programs. Three core elements are recommended to ensure patient safety.

A patient safety focused registered nurse transition to practice program.

Abstract New graduate registered nurses (NGRN's) have an expectation of clinical support as they make the transition from novice to advanced beginner. In this 2008-2009 study of three rural transition to practice programs we found that clinical support did not eventuate. Consequently, NGRN's reported feeling underprepared for practice, overwhelmed by responsibility and often abandoned. Against this background, many were concerned that their inexperience had implications for safe patient care. Graduate nurse transition programs need to have the physical and human resources necessary to deliver the clinical support as promised in their prospectus, to ensure patient safety. This grounded theory study identified three essential core elements - leadership support, clinical supervision, and effective interprofessional relationships. Recommendation is made to address these deficits by mandating their inclusion in all transition to professional practice programs.

Assessing Performance Outcomes of New Graduates Utilizing Simulation in a Military Transition Program

This multi-site, quasi-experimental study examined the performance outcomes of nurses (n = 152) in a military nurse transition program. A modified-performance instrument was used to assess participants in two high-fidelity simulation scenarios. Although results indicated a significant increase in scores posttraining, only moderate interrater reliability results were found for the new instrument. These findings have implications for nurse educators assessing performance-based outcomes of new nurses completing transition programs.

Transition Within a Graduate Nurse Residency Program

As evidence of the effectiveness of these programs grows, nurse leaders feel the pressure to establish high-quality, yet cost-effective graduate nurse transition programs. In 2009, the authors developed an innovative program by incorporating transition theory, research results, stakeholder involvement, and the recommendations of the National Council of State Boards of Nursing. The graduate nurse residency program yielded positive outcomes, including stakeholder satisfaction and high retention rates.

A Model of New Nurse Transition

The progression from nursing student into the RN role remains difficult, despite over 30 years of effort to ease the transition for new graduates. We review the research on programs designed to help new graduates move into practice and propose a model for new nurse transition that starts during nursing education and continues 2 years into practice. The model illustrates the frequent detachment between efforts taken by nursing schools and employers to facilitate this transition. We offer recommendations for the design of future research to capture all transition efforts, from student to functioning RN, and better identify the critical elements of new nurse transition programs. Evidence such as this is needed to allow schools and employers to use their limited resources most effectively to support graduate nurses.

The First Year of Practice: New Graduate Nurses' Transition and Learning Needs

Although the phenomenon of reality shock has been acknowledged as part of the new graduate nurse transition for decades, there is evidence to suggest that the problems with the transition into practice are more serious today. This article presents findings about the new graduate nurse transition and learning needs from qualitative research conducted in a community-based novice nurse transition program. The new graduate nurse transition and learning needs are examined through the eyes of new graduates and the nursing leaders and preceptors who work with them. Recommendations are offered for continuing education initiatives that can be designed to meet these needs.

Transition to psychiatric/mental health nursing programs: Expectations and practical considerations

Mental health services have developed transition programs to attract staff, including new graduates, staff with mental health nursing experience without formal qualifications, experienced nurses wishing to move into mental health, and nurses returning to the workforce. Transition to psychiatric/mental health programs are considered to be particularly significant in the mental health field because of the relative under-representation of mental health content in undergraduate curricula. Unfortunately, transition programs have received only minor attention in the literature and there is a paucity of published evaluations to determine their effectiveness. The aim of this paper is to examine transition programs and consider how they meet the expectations of stakeholders, such as consumers of mental health services, and program participants' expectations. It is concluded that published systematic evaluations are lacking, particularly those considered from the perspective of stakeholders. Consideration of these expectations should be reflected in the design and delivery of mental health nursing transition programs.

Patient Safety and the Integration of Graduate Nurses Into Effective Organizational Clinical Risk Management Systems and Processes

This article explores and describes key processes facilitating the integration of neophyte graduate nurses into safe and effective organizational systems and processes as part of a hospital's overall local clinical governance and clinical risk management (CRM) program. This study was undertaken using an exploratory descriptive case study method. Four sample units of analysis were used, notably, 2 cohorts of graduate nurses (n = 11) undertaking a 12-month graduate nurse transition program; key stakeholders (n = 34), that is, nurse unit managers, clinical teachers, preceptors, a quality manager, a librarian, and senior nurse administrators employed by the participating health service; and pertinent literature sources. Data revealed that the cohort of graduate nurses under study became substantively integrated into the hospital's organizational and patient safety system processes within the first 3 to 4 months of their employment. Processes most contributing to this integration included the graduates receiving pertinent information about CRM at the very beginning of their employment (at induction) and thereafter throughout their graduate nurse year. In addition, the graduates needed focused support to assist their efforts to integrate the CRM systems and processes of their employer organization into their "normal working practices." In order for new graduate nurses to become integrated into safe and effective organizational systems and processes as part of a hospital's overall local clinical governance and CRM program, they needed pertinent information on CRM at the beginning of their employment and thereafter be supported throughout their graduate nurse year to develop and translate that information into their "routine" (everyday) practice. Further comparative research involving larger cohorts of graduate nurses is required.

The Nature and Implications of Support in Graduate Nurse Transition Programs: An Australian Study

It is widely recognized that support is critical to graduate nurse transition from novice to advanced beginner-level practitioner and to the integration of neophyte practitioners into safe and effective organizational processes. Just what constitutes support, however, and why (if at all) support is important, when, ideally, support should be given, by whom, how, and for how long, have not been systematically investigated. Building on the findings (previously reported) of a year long study that had, as its focus, an exploration and description of processes influencing the successful integration of new graduate nurses into safe and effective organizational processes and systems, the findings presented in this article strongly suggest that support is critical to the process of graduate nurse transition, and that integration into "the system" is best provided during the first 4 weeks of a graduate nurse transition program and thereafter at the beginning of each ward rotation; that "informal teachers" and the graduate nurses themselves are often the best sources of support; and that the most potent barriers to support being provided are the untoward attitudes of staff toward new graduates. Drawing on the overall findings of the study, a new operational definition of support is proposed and recommendations are made for future comparative research on the issue.

Processes Influencing the Development of Graduate Nurse Capabilities in Clinical Risk Management

To explore and describe key processes influencing the development of graduate nurse capabilities in clinical risk management (CRM). This study was undertaken using an exploratory descriptive case study method. Four sample units of analysis were used, notably: 2 cohorts of graduate nurses (n = 11) undertaking a 12-month graduate nurse transition program; key stakeholders (n = 34), that is, nurse unit managers, clinical teachers, preceptors, a quality manager, a librarian, and senior nurse administrators employed by the participating health service; patient outcome data; and pertinent literature. Data strongly suggested that graduate nurse capabilities in CRM were most influenced not by their supposed lack of clinical knowledge and skills but by their lack of corporate knowledge. The failure to provide new graduate nurses with pertinent information on CRM at the beginning of their employment and thereafter at pertinent intervals during the graduate nurse year program aslo hindered the development of their capabilities to manage clinical risk. Management and educational processes pertinent to informing and involving new graduate nurses in a hospital's local CRM program (including information about the organization's local policies and procedures) need to be implemented systematically at the very beginning of a new graduate's employment and thereafter throughout the remainder of the graduate nurse year.

A Nurse Transition Program for Orthopaedics

A Nurse Transition Program for Orthopaedics

A Nurse Transition Program for Orthopaedics

Successful training and initiation of new graduate nurses is a critical concern for the entire healthcare industry. Current literature reports that as many as 80-90% of new graduate nurses will leave their job within the first year of employment (Bradley, 2001). In summer 2001, the inpatient orthopaedic department of a large community hospital in the southeastern United States was faced with significant recruitment and retention issues. In response, a new nurse graduate transition program was developed for the orthopaedic specialty. This program uses an adult learning model and a single dedicated preceptor. In addition to clinical experience, the program provides special attention to the development of professional behavior, relationship building, and critical-thinking skills. During the next 2 years, the program produced eight new orthopaedic nurses with a first-year turnover rate of 0%. In addition, this program has positively influenced other areas of importance for RN recruitment and retention, including quality of care, patient satisfaction, and staff satisfaction.

Factors that influence the recruitment and retention of graduate nurses in rural health care facilities

Rural nursing is a distinct practice and rural nurses in Australia constitute the largest group in the rural health workforce. However, the rural workforce is ageing and the turnover of nurses in rural areas is high. In addition, rural health services are experiencing recruitment and retention difficulties; very little is known about the recruitment and retention of new graduates nurses in rural health areas and the potential long-term investment they could offer to rural health services. A qualitative study explored the journey of transition for new graduate nurses employed in graduate nurse transition programs in northern New South Wales. This paper presents two major themes from the study that describe the factors that influenced the new graduate nurse to seek and accept a graduate nurse position within a rural health setting and the factors that influenced their retention. Findings indicate that previous connection with a rural area and positive experiences in a rural health care facility during undergraduate preparation were significant factors influencing the graduate nurses' decision to pursue a rural graduate nurse position. No guarantee of a permanent appointment upon completion of the graduate program, and graduates' disappointment with graduate nurse programs, were important factors influencing their retention within rural health care facilities.

Graduate Nurse Transition Program

school and begins work in a hospital. Not only does the new graduate face a conflict between values and behaviors she knew as a nursing student in an educational setting and those of a new graduate in her first work situation, but she also finds that her theoretical knowledge is of little use to her until she no longer is anxious about her clinical skills. The Graduate Nurse Transition Program (GNTP) was designed to assist such nurses to become comfortable as members of the health care team in the realistic work setting of a small to moderate-sized acute care hospital in Northern Virginia. It is a practical guided experience for beginning level staff nurses, structured to enable them, at its end, to function as beginning staff in the critical care area. The nursing administrators' concerns that new graduates come to the hospital setting with limited clinical skills were corroborated by a 1978 Nursing Survey Questionnaire of the Virginia Hospital Association Committee on Nursing, in which a majority of the respondents indicated that associate degree and baccalaureate nurses lack adequate entry-level clinical skills(l). Carozza cites a Colorado Nurses Association statement pointing out serious inadequacies in the clinical performance skills of new graduate nurses(2). In our interviews with several nursing administrators the point was made that generalized orientation programs usually are not long enough or intensive enough to develop adequately the new graduate's proficiency in clinical skills and independent functioning. Arm-

Graduate Nurse Transition Program

Graduate Nurse Transition Program

The Graduate Nurse Transition Program

The Graduate Nurse Transition Program