Transition Of Graduate Nurses Research Articles

Preparing Graduate Registered Nurses for Independence in Aged Care.

Graduate registered nurses (RNs) start their careers working in a variety of clinical areas including aged care. However, they may not be fully prepared to work in aged care settings that often require them to work independently as the only RN on the premises. A list of essential clinical skills is crucial for supporting the development and effective transition of graduate nurses into aged care. To identify and rank a list of essential clinical skills for graduate RNs working in aged care settings on commencement of practice. An explanatory sequential mixed-methods design was applied and included a modified Delphi Study and semi-structured interviews. Five expert aged care RNs engaged in the three iterative Delphi rounds and five graduate aged care RNs were interviewed to confirm the clinical skills and ranking from their perspective. Quantitative data were presented through descriptive statistics. Qualitative data were analysed using thematic analysis. Thirty-six essential clinical skills for graduate RNs working in aged care settings were identified and ranked by the experienced aged care RNs. Graduate RNs supported this list of essential clinical skills on commencement and identified palliative care as an additional skill required by graduate RNs working in aged care. The derived essential skills offer aged care a guided approach to ensure that graduate RNs are work-ready, safe practitioners and supported to work independently. The study recommends the essential clinical skills for graduate nurses transitioning in their role as RNs in aged care that will support safe, quality clinical care.

Does transition theory matter? A descriptive study of a transition program in Australia based on Duchscher’s Stages of Transition Theory and Transition Shock Model.

Objective: Explore the impact of transition program policy directives grounded in foundational elements of transition theory. Background: Within fast-track health service environments nurse leaders remain committed to improving transition programs that support wellbeing and retain new graduate nurses. Duchscher’s Stages of Transition Theory and Transition Shock model was the framework chosen by the health service nurse leaders to implement in the clinical environment, however, implementing elements can be problematic without sufficient support and clear policy directives. Study Design and methods: Descriptive study using multiple methods in one major national health service that incorporates a number of private (eight) and public (four) hospitals across Australia. Online surveys were distributed to new graduate nurses at one, five and eleven months into the initial transition year. The survey tool was a synthesised adaptation of the Professional Role Transition Risk Assessment Instrument and Professional and Graduate Capability Framework. At the end of the transition year telephone interviews were conducted with the Nurse Managers who were responsible for implementing transition programs policies and processes. Resulting data were summarised using descriptive statistics for quantitative data and a thematic analysis for qualitative data. Results: 158 new graduate nurses returned the online survey and eight Nurse Managers participated in the telephone interviews. As a whole the new graduate registered nurses described feeling accepted during their transition and expressed feeling comfortable when approaching senior staff. They managed challenges of shift work and took time for self-care. The clear majority (88%) of participants reported no plans to leave the profession. Nurse Managers were able, in most clinical areas, to apply transition program policy and directives and enable the implementation of Duchscher’s Stages of Transition as the framework for the transition support initiatives. Retention of new graduates on their wards at the end of the program was determined to be a positive outcome for Nurse Managers. Discussion: A carefully structured Graduate Nurse Transition Program founded on sound theoretically grounded ideology alongside integrated policy directives guided the Nurse Managers implementation of Duchscher’s Stages of Transition Theory and Transition Shock model into practice. Additionally, a dedicated Graduate Nurse Coordinator role with a manageable ratio of graduate nurses was an important component included in the transition program at each participating hospital as it facilitated support of both graduates and Nurse Managers. These positions should be costed into any Graduate Nurse Transition Program. An interesting finding was the consistency in smaller units that were unable to provide or mobilise preceptors for the required allocated mirrored shifts and it was felt this workload management issue impacted the success of graduate transition nurse programs on those units. Conclusions: Implementing policy directives grounded in foundational elements of Duchscher’s Stages of Transition theory and Transition Shock model delivered consistent experiences for new graduate nurses across one major health service that incorporates a number of hospitals across Australia. Data suggested some practical challenges to program implementation for Nurse Managers, including unit/ward size, staffing, and varying levels of understanding of preceptor roles. Implications for research, policy, practice: Introducing formal policy directives that are grounded in strong theoretical frameworks of professional role transition, agreed to and funded by health service nurse leaders are important in guiding a consistent approach across health services in the implementation of evidence-based Graduate Nurse Transition Programs. What is already known about the topic? Duchscher’s foundational research on the Stages of Transition theory and Transition Shock model is applied to inform Graduate Nurse Transition Programs on an international level. There is a current workforce shortage within Australia and internationally. The importance of retention of newly graduated nurses has become a focus for health care services implementing supportive transition programs to prevent new graduates from leaving the profession in the first year. What this paper adds The inclusion of specific policy directives based on Duchscher’s Stages of Transition theory and Transition Shock model provides clear direction to Nurse Managers related to the required implementation steps and time frames to be met during the transition year. Additional Graduate Nurse Coordinator positions, with a manageable ratio of New Graduate Registered Nurses (NGRNs), are important supports for both graduates and Nursing Managers to meet policy directives. Additional positions should be costed within transition programs. Provides additional evidence that well supported newly graduated nurses are likely to remain within the health service.

Nursing/midwifery students' perceptions of caring pedagogy and online learning during the COVID-19 pandemic.

This study aimed to gain a better understanding of nursing/midwifery students' perspectives on a pedagogy of caring and online learning during the COVID-19 pandemic. In addition, it aimed to determine if the COVID-19 pandemic impacted students' perceptions and experience of online learning and students' desire to enter the nursing/midwifery workforce. Mixed methods. A multi-centre cross-sectional survey of Australian nursing and midwifery students was undertaken to explore students' experience of learning during the COVID-19 pandemic. There are several key findings from this study that may be relevant for the future delivery of undergraduate health education, students transitioning to practice and healthcare workforce retention. The study found that although students were somewhat satisfied with online learning during COVID-19, students reported significant issues with knowledge/skill acquisition and barriers to the learning process. The students reported feeling less prepared for practice and identified how clinical staff were unable to provide additional guidance and support due to increased workloads and stress. The textual responses of participants highlighted that connection/disconnection, empathy and engagement/disengagement had an impact on learning during COVID-19. Connection, engagement and isolation were key factors that impacted nursing students' online learning experiences. In addition, graduates entering the workforce felt less prepared for entry into practice due to changes in education delivery during COVID-19 that they perceived impacted their level of clinical skills, confidence and ability to practice as new graduate nurses/midwives. Not applicable. Attention must be given to the transition of new graduate nurses and midwives whose education was impacted by pandemic restrictions, to support their professional career development and to ensure retention of future healthcare workforce. Connection, engagement and isolation were key factors that impacted nursing students' online learning experiences. Educators should consider how connection and engagement can be actively embedded in the online learning environment.

New Graduate Nurses Transition: Role of Lack of Experience and Knowledge as Challenging Factors

Background: Insufficient experience and practical knowledge makes challenges in addressing health-care practice-related issues. Being a professional nurse after completing your nursing studies is a challenging time. Most frequently, the quantity of patients with severe illnesses and co-morbidities, the lack of mentorship, performance anxiety, communication issues, and the blame/complaint culture are blamed for the difficulties faced by inexperienced nurses. The study aimed to identify the challenges and the associated factors which limit the knowledge acquisition of new nurse graduates in Oman. Methodology: Using a cross-sectional study design, 104 people were selected as a sample from Ibri Hospital. We have adopted convenience and snowball sampling methods to reach out to the participants. The data was collected between June, 2022, to September, 2022. Data from nurses was gathered by a primary survey approach utilizing a closed-ended questionnaire. The statistical analysis was carried out using IBM SPSS (Statistical Tool for Social Sciences) version 20.0. Results: Nursing professionals face a number of obstacles, including role expectations, lack of confidence, workload, fear, and orientation concerns. In addition, variables including the physical environment, responsibility, support, and professional development contribute to their dissatisfaction. It is rare for newly graduated nurses to be assigned to cases where they lack the confidence to handle clinical cases. The study also found positive relationship between preceptor support and leadership/communication, organizing and prioritizing, professional satisfaction, and work satisfaction. Conclusion: The study came to the conclusion that the main problem facing nurses in the healthcare setting is transition. During their transitional time, newly graduated nurses face a variety of obstacles related to job expectations, confidence, workload, orientation, and concerns. To overcome these obstacles, nursing administrators and preceptors must come up with and apply important solutions. As a result, the current study suggests that transitional support initiatives are helpful in assisting recently graduated nurses. Also, hospital orientation programs are necessary to adapt to the changing demands of new nurses in a constantly evolving healthcare setting.

Nursing professional development at night

An innovative approach to help new graduate nurses transition into practice.

New Graduate Nurse Transition into Rural Home: A Case Study.

The global shortage of nurses and high attrition rates for newly graduated nurses along with the shifting demand for home care has created a critical need for retention strategies that address the specific challenges of rural settings. The effectiveness of structured transition or mentoring programs are primarily studied in acute care settings, making it difficult to translate to the unique context of rural home care nursing. The complexities of the independent nature of home care nursing practice and limited resources to address transition shock make it difficult to successfully transition newly graduated nurses to rural home care. A case study supports mentorship facilitation as a readily available, effective strategy that can overcome the challenges of rural home care settings. A comparative analysis will link Duchscher's (2008) transition shock theory to mentorship as an effective strategy for supporting NGNs' transition in home care nursing. Recommendations offer rural care leaders practical strategies bundled with mentorship to optimize the successful transition and retention of newly graduated nurses in their workplaces.

Phenomenological Study on Professional Role Transition of New Graduate Nurses

Background Transition from a newly graduated nurse to an expert nurse may involve personal professional intellectual and emotional changes along with skill and role changes. As the global shortage of nurses remains an important issue to be solved it is important to ensure that novice nurses have a safe and smooth professional role transition.Aim The study aimed to address the professional role transition of new graduate nurses during their initial years of practice.Methods A phenomenological research approach was used among the ten nurses who were working as staff nurses at a tertiary care hospital in Bangalore. An interview technique was used to collect the data in two phases Focused group interview and Individual interview.Results The collected data was categorized into three stages based on Judy Boychuk Duchscherrsquos transition theory. During the initial 3-4 months Doing stage the nurses were excited but soon realized that they were not prepared enough to manage the workload and responsibility of their role as staff nurses. The themes that emerged were ldquoBeing scared and stressedrdquo ldquoReality is differentrdquo and ldquoNeed to learnrdquo. Subjects felt scared and stressed and realized that the reality is different and understood the need to learn. During the next 9-12 months Being Stage their competency skill and confidence levels improved. ldquoGaining confidence and Trustworthinessrdquo were the themes that emerged during this phase. From 12 months and above Knowing phase the subjects experienced less stress gained confidence and improved their individual capacity to cope and the themes unfolded were ldquoYes I know and to be empoweredrdquo.Conclusion The study revealed the complexity in the transition from student to registered nurse. In the current scenario with an acute shortage of staff nurses it is vital to address this issue and to plan necessary reforms for strengthening the profession.

Perceptions of New Graduate Nurses’ Transition to Practice Post-Pandemic

Registered nurse turnover is a challenge facing nurse leaders across the country with almost one-third of nursing turnover occurring in the first year of practice. Therefore, support during transition to practice is critical for new graduate nurses. The COVID-19 pandemic further exacerbated workforce challenges, preceptor development, and skill acquisition. The purpose of this article is to describe the perceptions of recent new graduate nurses transition to practice within the context of post-pandemic workforce challenges.

Rural transition to practice: A phenomenological analysis of the new graduate nurses’ experience

Objective/Background: The nursing shortage uniquely impacts rural communities as staffing issues often result in emergency department closures and leave communities without adequate healthcare. One contributing factor in this crisis is difficulty recruiting and retaining new graduate nurses (NGN) rurally. Improving transition to practice for NGNs is a potential solution to this problem. This study explores the new graduate nurses’ lived experience when transitioning to rural nursing practice.Methods: A descriptive phenomenological approach was used. Seven participants completed virtual surveys and virtual, semi-structured focus groups exploring the new graduate nurses transition to practice experience, underpinned by Patricia Benner’s From Novice to Expert model. Transcripts were analysed using thematic concept mapping.Results: Three themes were derived across the stages of transition to practice: education, mentorship and both intrinsic and extrinsic expectations on NGNs. Each phase in the first two years of practice had unique characteristics, most significantly, a six-month delay occurs to accommodate acquisition of non-nursing skills, which deviates from Benner’s model.Conclusions: This research emphasizes the importance of supporting NGNs during the first two years of transition to rural practice. The complex role of the rurally practicing registered nurse requires approximately six months more time than what is described in Benner’s model to develop competence. A focus on nursing education that begins at the undergraduate level and continues into practice is required. A shift to focus on supporting the wellbeing of the NGN is a key intervention; as well as improving mentorship and management support through education and policy change.

Readiness to Practice Indicators: Accelerating New Graduate Nurses Toward Independent Practice

Academic institutions and hospitals want the same outcomes: safe, practice-ready nurses, but each use different tools to evaluate practice-readiness. Successful transition-to-practice programs aimed at closing the academic gap require thoughtful and actionable collaboration between academic and practice settings with consideration of using mutual evaluation tools. Readiness to Practice Indicators (RPIs) are an evidence-based tool intended as a determinant for independent practice that synthesizes the scope and standards of nursing practice with a focus on how to manage a patient assignment. RPIs have been used with new graduate nurses since 2016 and now are being used as the performance evaluation tool shared by academic and hospital organizations in a new Student Readiness to Practice Program. Participating academic institutions, hospitals, and community organizations have agreed to use the RPI evaluation tool across settings. Future research will evaluate whether early exposure to RPIs in the senior practicum accelerates the transition of new graduate nurses into productive staffing and increases retention and satisfaction among new nurses and preceptors.

A Descriptive Phenomenological Study on Professional Role Transition of New Graduate Nurses in Selected Hospital, Bangalore

Background: Nursing is the largest, the most diverse, and one of the most respected among the health care professions. Nurses play an integral role in the healthcare system and they have been correctly referred to as the heart of healthcare. The climate and culture have perhaps the largest impact on a new graduate nurse’s transition into the workforce. New graduates often have a difficult time distinguishing between prioritizing patients and prioritizing care. Objective: The objective of this research was to describe the experiences of new graduate nurses during their professional role transition in their first twelve to eighteen months of experience in critical care areas. Methods: A Descriptive phenomenological approach was selected for the study. Based on the Descriptive phenomenological approach four step was used: bracketing, intuiting, analysis and describing. The investigators identified and clarified their interest in the study and maintained initial reflective note and memoing. Results: The initial stage, (1-3 months) of professional roles transition of new graduate nurses was marked by a high level of stress, fear and disappointment with the disparity between what is anticipated and what is expected from them. Through their professional journey during next 4-5 months, they found themselves moderately stressful, confident and being trusted by their seniors. By the end of 12 months all the graduates have gained confidence and higher level of decision-making abilities and wanted to empower themselves through higher education. Interpretation and Conclusion: The findings of the study shown that life experiences of newly graduate nurses gradually change as they transit from novice to skilled nurse. Keywords: Transition, Professional role transition, and new graduate nurse.

Student to nurse transition and the nurse residency program: A qualitative study of new graduate perceptions

In past years, the attrition of new graduate nurses has been predicted to grow and this is what has been occurring recently due to challenging role transitions. Nurse residency programs are meant to help new graduate nurses transition into their new roles. These programs have been evaluated in a variety of ways. The purpose of this study was to explore more about new graduate nurses' transition perspectives and the function of nurse residency programs in mediating this shift. At a major university hospital in Saudi Arabia, 29 Saudi nurses participated in a qualitative phenomenological study through focus group discussions. Two major themes emerged from thematic analysis in this study. The first theme was namely "Challenges of transition", where nurses expressed the lack of experience, high caseloads, and difficulty communicating with physicians. The second theme was namely, "Residency transition support", where the nurses expressed that it provided them with enhanced learning, peer communication and support, and helped them in building relationships. The themes that emerged indicate that the journey from student to registered nurse is complicated and multidimensional. These findings imply that structures and practices meant to promote the shift, such as the residency program, can help new nurses have a better transition experience.

The interactionism among nursing educators, preceptors and newly graduate nurses related to role transition: An exploratory study

Background and objective: The role transition remains a barrier in the ability of nurses to adjust from the role of student to professional nurse where the interactive mentoring attributes portrayed by nurse educators and clinical preceptors that may influence the role transition of new graduate nurses has not been thoroughly assessed. This study was conducted to explore the interactive mentoring attributes of nursing educators and clinical preceptors that influence new graduate nurses’ ability to successfully adjust from the role of student to that of professional nurse.Methods: Convergent parallel mixed method of research was used in this study, where both quantitative and qualitative data were simultaneously collected, analyzed, merged, compared and interpreted. The quantitative data came from purposively sampled first batch graduates of Bachelor of Science in Nursing at Oman College of Health Sciences A.Y. 2017-2018 (N = 33;n = 27) through survey using researcher-made survey questionnaire in 5-point-Likert scale format based on the five attributes of beginning theory of Faculty Attributes for Confidence, Equilibrium, and Success (FACES) by Sparacino L. (2016). The qualitative exploration focused on the most significant influential interactive mentoring attributes of nursing educators and preceptors solicited through interview. Quantitative data were statistically treated and interpreted using percentage, weighted mean, t test and Pearson’s correlation. Qualitative data representing each participant’s point of view were analyzed using open coding, transcribed, analyzed, compared, and categorized.Results: Quantitative findings revealed that the respondents strongly agreed on the influential effect of interactive mentoring attributes portrayed by their preceptors in terms of professionalism while they agreed with their nursing educators (composite mean: 4.1; 3.9) respectively. Respondents also agreed with the influential effect of knowledge and experiences as well as in terms of care and rigor attributes. However, the t test values and correlation analysis showed no significant relationship (p > .05) between the profile of the respondents in terms of GPA and department with the interactive mentoring attributes portrayed by nursing educators and preceptors during role transition. Qualitatively, caring, rigor and professionalism were the significant interactive mentoring attributes of nursing educators and preceptors most influenced newly graduate nurses on their ability to successfully adjust from the role of student to that of professional nurse.Conclusion and recommendation: The interactive mentoring attributes portrayed by nursing educators and preceptors have a positive influential effects in transition process, although the respondents’ profile were not significantly related nor the relationship between the role portrayed by nursing educators and preceptors to role transition. Therefore, it is recommended to use these findings in curriculum revision and in the modification of clinical orientation or training policy.

Graduate Nurse Transition Programs Pivotal Point of Participants' Practice Readiness Questioned During the COVID-19 Pandemic Crisis: A Scoping Review.

The COVID-19 pandemic requires an accessible, practice-ready nursing workforce to assist with the increase in health service delivery. Graduate nurse transition programs are the entry point for most graduates into professional practice, and this review focused on both empirical studies and gray literature to identify at what point practice readiness occurs and what can assist graduate nurses' transition to become practice ready. A scoping review was conducted using the Joanna Briggs Institute scoping review framework. Consensus purports supportive environments, ideally in formal structured graduate transition to practice programs, to enhance graduate nurses' clinical skills and confidence development. With nursing confidence and competence gained through professional practice experience, it is apparent that for a sustainable nursing workforce, greater access for graduating nurses to transition programs is imperative. Recommendations include restructuring transition programs with possible time reductions, limited rotations, comprehensive orientations inclusive of preceptorship, and dedicated educators to increase and enhance supportive graduate nurse transitions. [J Contin Educ Nurs. 2021;52(8):392-396.].

Assessment of New Graduate Nurses Transition Role at Minia University Hospitals

Assessment of New Graduate Nurses Transition Role at Minia University Hospitals

Nurse Residency Immersion: Moving From a Predetermined Length to Competency-Based Validation.

Structured, evidence-based nurse residency programs have been accepted as necessary for the successful transition of new graduate nurses, and the coordination of programs is a large part of the nursing professional development practitioner role. Using best practices, the nursing professional development practitioner determines the development and design of the nurse residency program, including identification of competencies, curriculum, clinical experiences, and residency length.

New Graduate Nurses' Perceptions of Patient Safety: Describing and Comparing Responses With Experienced Nurses.

A significant proportion of the acute health system workforce is composed of new graduate nurses, yet there is a limited understanding of patient safety perceptions among new graduate nurses and how they compare with nurses who have more experience. This study used a descriptive approach to complete secondary analysis on two sources of data containing new graduate nurses' (n = 1,613) and experienced nurses' (n = 64,906) responses to the Hospital Survey on Patient Safety Culture. New graduate nurses had a more positive perception of safety culture than more experienced nurses. The greatest differences were observed in perceptions of how nurse managers respond to mistakes. Similarities in perceptions were observed on items associated with communication. Educational systems and transitional programs must prepare new graduate nurses for patient care. There is an opportunity for academic and practice partners to collaborate on programs that facilitate the transition of new graduate nurses to the workforce. [J Contin Educ Nurs. 2020;51(7):309-315.].

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.

Association between Hospital Nurses' Perception of Patient Safety Management and Standard Precaution Adherence: A Cross-Sectional Study.

Standard precautions should be applied to prevent health care-associated infections during every nursing activity. However, adherence to standard precautions was reported to be inadequate. Therefore, this study aimed to identify the rates of standard precaution adherence and the association between perception of patient safety management and standard precaution adherence. In this cross-sectional descriptive study, a convenience sample of nurses was recruited from a university-affiliated teaching hospital in Seoul, Korea. Data were collected using a structured self-report questionnaire. Among the 332 questionnaires returned (response rate: 94.9%), a total of 329 nurses were analyzed. In the present study, the overall standard precaution adherence rate was approximately 53.5%. The multiple linear regression results revealed that participants’ perceptions of patient safety management were only significantly associated with standard precaution adherence after adjusting other covariates (β = 0.412, p < 0.001). Nurse supervisors should focus more on raising awareness about nurses’ perception of patient safety management based on the specific work environment, such as the total number of nurses working together and the nurse-to-patient ratio. Nurse educators should develop integrated curricula to help graduate nurses transition smoothly into professional practice and enhance adherence to standard precautions in diverse health care settings.

A Mixed-Methods Study on Patient Safety Insights of New Graduate Registered Nurses.

New graduate nurses transition with limited experience, and with anxiety and stress. They present an increased risk of contributing to preventable errors or adverse events. The purpose was to develop an understanding of new graduate registered nurses' (RNs) patient safety knowledge and actions within the first year of registration. The longitudinal mixed-methods study was conducted using a questionnaire delivered at 3 time points (n = 68). Qualitative data were collected by semistructured interviews (n = 11). Self-reported knowledge of medical error decreased over the 3 time points. Themes emerging from qualitative data include patient safety and insights, time management, making a mistake, experiential learning, and transition. Medical errors and time management persist during transition to the RN role. New graduates reported moderate knowledge of safety and quality issues; however, questioning their own abilities overshadowed growth in their involvement in patient safety.