Transition Shock Research Articles

Group mentoring and nurse residents

Group mentoring and nurse residents

The relationships of both transition shock, empathy, resilience and coping strategies with professional quality of life in newly graduated nurses

BackgroundData on professional quality of life in newly graduated nurses are scarce. This study aimed to describe the levels of professional quality of life, and to explore the relationships of transition shock, empathy, resilience and coping strategies with professional quality of life in newly graduated nurses.MethodsThis was a cross-sectional study, which used a two-stage sampling method to recruit 393 newly graduated nurses in Sichuan province of China. Multiple regression analysis was used to explore the effects of transition shock, empathy, resilience and coping strategies on professional quality of life. Data were collected using standardized scales.ResultsThe prevalence of average levels of compassion satisfaction, burnout and secondary traumatic stress in newly graduated nurses were 80.2, 38.2 and 57.5%, respectively. Transition shock was a significant negative predictor, and empathy, resilience and adaptive coping were significant positive predictors for compassion satisfaction. Transition shock and passive coping were significant positive predictors, and empathy was a significant negative predictor for burnout and secondary traumatic stress. Resilience and adaptive coping contributed to burnout significantly and negatively.ConclusionHigher transition shock and lower empathy cause lower compassion satisfaction and higher compassion fatigue. More resilience and adaptive coping cause more compassion satisfaction and less burnout. More passive coping contributes to higher compassion fatigue. Strategies such as transition or preceptorship programmes, and empathy, resilience and coping training are effective methods to reduce transition shock, facilitate empathy, resilience and coping, and consequently, enhance professional quality of life in newly graduated nurses.

Transition shock, preceptor support and nursing competency among newly graduated registered nurses: A cross-sectional study

BackgroundTransition shock is highly prevalent among newly graduated registered nurses in their early career. Preceptors are widely used to support them in acquiring clinical nursing competencies and to promote their successful transition to practice. However, the mechanism by which transition shock and preceptor support are linked to nursing competency among newly graduated registered nurses remains unknown. ObjectivesThe aim of the study was to examine the relationship between transition shock, preceptor support, and nursing competency in a sample of newly graduated registered nurses. DesignA descriptive, cross-sectional design. SettingsSix tertiary hospitals in the southeast of mainland China. ParticipantsNewly graduated registered nurses undertaking their professional role in the first year. MethodsConvenience sampling was used to recruit 215 newly graduated registered nurses [184 female, 31 male] from six hospitals. Data on transition shock, preceptor support, and nursing competency were collected using questionnaires from November to December 2019. ResultsThe nursing competency of critical thinking/research aptitude (mean = 2.68, SD = 0.63) was scored the lowest among participants. Transition shock (r = −0.21, p < .01) and perceptions of preceptor support (r = 0.56, p < .01) were statistically significantly correlated with nursing competency. Preceptor context, whether the assigned preceptor varied day by day, and the emotional challenges of transition shock were the main predictors of nursing competency (F = 36.86, p = .00), accounting for 34% of the variance in nursing competency. ConclusionsEducational programs aimed at increasing critical thinking and research aptitude in the educational stage and the continuing educational stage can benefit newly graduated registered nurses. A well-organized transition program in hospitals including awareness and recognition of transition shock in newly graduated registered nurses is essential to enhance their competency in providing quality nursing. More support and assistance would be useful in promoting the preceptor's role in improving nursing competency of newly graduated registered nurses.

Clinical teaching behaviour effects professional identity and transition shock in new nurses in western china: A cross-sectional study.

AimTo examine the interrelationship between professional identity, clinical teaching behaviour and transition shock for new nurses in Western China.DesignA cross‐sectional design.MethodsA total of 779 new nurses were recruited in Gansu province and Lanzhou city from June to July 2019. Each patient was given three questionnaires to complete, and structural equation modelling was used to identify the relationships.ResultsThe overall mean scores for the transition shock, professional identity and clinical teaching behaviour were 92.53(SD = 22.17), 89.74(SD = 16.57) 80.12(SD = 12.38), respectively. The most important aspects identified were the Physical aspect, the Sense of Mastery and Committing to Teaching. Professional identity and clinical teaching behaviour were negatively related to transition shock, a better sense of identity coupled with supportive clinical teaching were keys to a smoother journey from new to experienced nurses.

The Social Experiment of Remote Work Forced by the Pandemic from a Qualitative Research Perspective

This paper has two principal goals. The first is reflection over the available source literature, indicating the scant interest in it in the Polish social sciences, and in sociology in particular. The second goal is to present the findings from the first round of qualitative research conducted during lockdown, focusing on the experiences of people working remotely. The analyses of the material accumulated focused on how remote work was imagined prior to the pandemic, on the shock of transition to working remotely, on how a new rhythm took shape in the context of lifestyles, and on a comprehensive appraisal of the remote work experience, including prospects for the future. The findings indicate that despite the dramatic circumstances behind the imposition of remote working and the enormous difficulties experienced by the respondents, they are openminded regarding various options for continuing work in a remote mode. At the same time it proved pertinent to supplement boundary theory as the theoretical interpretative framework with a perspective of the respondents’ lifestyles and current place in life (the life-cycle effect), allowing for a better understanding of the respondents’ experiences and outlining prospects for rewording the schematic representations of this social phenomenon.

The Impact of Hospital Based RN Preceptor Training on Novice Nurses One Year Retention

The nursing shortage is a serious problem in the United States and expected to grow in the coming years. It is imperative for healthcare systems to retain nurses once employed. Novice nurses are leaving their first job at an increased rate due to feelings of being unprepared. This comes at great expense. A lack of retention can lead to a nursing shortage, which creates high patient-nurse ratios, overwork and burnout, and poor patient outcomes. Utilizing a trained preceptor can offer a safe and structured educational experience. Utilizing Duchscher’s theory of transition shock as a framework, the preceptor assists the novice nurse’s transition to practice. The preceptor must be trained to understand the transitional stages the new nurse will experience over the first year. The purpose of this quantitative, retrospective pilot study was to determine if a hospital-based RN preceptor training program could impact retention rates at one year of employment for novice nurses. This study compared demographic data and one-year retention rates from novice nurses hired prior to the RN preceptor training (group 1) and post-RN preceptor training (group 2). The non-parametric Fisher’s exact probability test determined a significant association between a hospital-based RN preceptor training program and novice nurse retention rates at one-year employment (p = .03). This project demonstrates the need for healthcare institutions to invest in initial and ongoing preceptor training as a strategy to increase nurse retention.

Retaining newly Registered Nurses in the profession.

Newly qualified nurses (NQNs) are one group at risk of early exit from the workforce. There is a need to reinforce the 'flaky bridge' (Health Education England [HEE] 2018) and ease 'transition shock' to facilitate NQN retention. (1) establish the current state of the art in the UK for nurse retention and transition from student to Registered Nurse; (2) provide UK healthcare organisations, higher education institutions and individual nurses with an evidence-based approach to plan for successful transition; (3) develop an evidence-based toolkit that enables NQNs and their employers to identify, implement and evaluate an individualised approach to transition. A rapid evidence assessment (REA) of NQN transition and retention was undertaken followed by 40 interviews with final year nursing students, NQNs, clinical leaders and academics and 113 written reflections from final year nursing students captured qualitative data on transition. A 'transition toolkit' was developed and used with one group of students (n=75) and data on retention and employment captured to determine impact on the number of nurses retained at the end of 12 months. A variety of formal and informal approaches that enhance and support transition were identified by the REA including having a formal orientation period; the initial placement; satisfaction with the unit and clinical supervision; empowerment; pre-registration employment; and low stress levels having had previous experience in the unit. Preceptorship was found to significantly increase NQNs competence, though no firm conclusions could be reached regarding the impact on retention. Qualitative data suggested that NQNs still experience transition shock and support during the transition period was important. Quantitative data indicated that most NQNs were employed full-time and working in local NHS hospitals. Most had undertaken employment during their programme and when qualified had not changed employer or role and did not plan to change. In the post-intervention group, most had engaged with the STaR project material and had accessed their place of first employment through the project. There were no statistically significant differences between cohorts, and no statistically significant relationships among the data. A supportive framework incorporating supernumerary status, preceptorship or equivalent, peer and organisational culture of support can help to ensure a smooth, seamless and comfortable transition. The link between NQN support and retention remains poorly evidenced.

Association of work environment and resilience with transition shock in newly licensed nurses: A cross-sectional study.

To examine transition shock in newly licensed nurses and the association of work environment and resilience with nurses' transition shock. Although work environment is related to transition shock in newly licensed nurses, little is known about the factors of nursing work environment associated with transition shock. Furthermore, resilience is known to help nurses positively face workplace challenges; however, there is little evidence on the associations between resilience and transition shock in new nurses. A cross-sectional, descriptive study. Data from 163 new nurses with <12months of work experience in the current hospital since graduation were analysed. Participants' characteristics, work environment, nurse resilience and transition shock were self-reported. Multivariable linear regressions were performed in three steps (following the STROBE checklist). The highest mean score of transition shock was obtained for the item 'I perceive the limitations of my professional knowledge in nursing care'. In the regression analysis adjusted for all variables, two factors of work environment-'nurse staffing and resource adequacy' and 'collegial nurse-physician relationships'-were associated with transition shock. Meanwhile, resilience was not related to transition shock. The gap between newly licensed nurses' theoretical and practical knowledge continues to exist. Adequate nurse staffing and a positive relationship with physicians, rather than nurse resilience, were more likely to associate with new nurses' transition shock. Hospitals need to provide ward-based simulations and case-based learning methods to enhance nurses' transition to professional practice. For nurses' transition, hospitals should make efforts to provide adequate nurse staffing and resources. Furthermore, hospitals should provide communication opportunities to build a positive collaborative culture between nurses and physicians. Unit nurse managers need to assess newly licensed nurses' perception of nurse-physician professional relationship and create an atmosphere of respect and understanding for each other.

Transitional Shock of Multi-Nationality Newly Graduate Nurses in Kuwait.

IntroductionThe transitional period of newly graduate nurses became more stressful, different coping mechanisms are essential. Therefore, effective coping with transition-related stress and anxiety is important for the life and professional of those nurses.ObjectivesTo examine the transitional shock through assessing the occupational stress and coping mechanism of multi-nationality newly graduate nurses in Kuwait.MethodsA descriptive correlational design was used to identify the occupational stress of the newly graduate nurses (NGNs) and their coping mechanisms during the transitional period to their professional life. All the NGNs were recruited. The total number of participants was 152 nurses.ResultsHighly significant correlations on almost all stress domains with p-values P < 0.01. We found that “Death and dying” was ranked as the highest stressor with a mean score of 6.20, followed by “uncertainty concerning treatment” with a mean score of 5.59, and in the “Inadequate preparation” was the least stressor with a mean score of 1.64.Conclusion“Religious coping” was the highest-ranked coping mechanism. In conclusion, NGNs have to adjust quickly to the new practical atmosphere encountered in the health care settings by using the proper coping mechanisms techniques.

Using Duchscher's Theory of Transition Shock To Inform The Experience Of Newly Graduated Nurses In Qatar: A Qualitative Case Study.

This article was migrated. The article was marked as recommended. Background The transition experience of new graduate nurses (NGN) is a complex and stressful period of adjustment and adaptation. The transition period is often negative leading to job dissatisfaction and increased intent to leave. Literature concerned with transition experiences of NGNs in the Middle East is lacking, where the educational, healthcare and cultural context are dissimilar to those in the published literature. Aim To explore the transition experiences of Qatari NGNs to inform development of a formal transition to practice program at a specialty hospital. Methods A qualitative case study design was conducted to explore the professional role transition experiences of Qatari NGNs. Data was collected through the Casey-Fink Graduate Experience Survey, and an unstructured focus group. Results Qatari NGNs experienced challenges of professional role adaptation and feeling ill-prepared in terms of competency and job-readiness, resulting in self-doubt, frustration and fear. Desires to fit-in were negatively impacted by language, discrimination and lack of social support, and professional identity development. Conclusions Professional role transition of Qatari NGNs involves a complex interplay of intrapersonal, interpersonal, organizational and cultural factors. Experiences can be enhanced by accessible, nurturing, multi-level social support to facilitate socialization and improve clinical practice competency. Managing expectations by preparing students for transition and providing transitional support during their first year of practice will improve their experience. Duchscher's Theory of Transition Shock offers insights into the transition expereinces that can inform this support.

Conceptualizing Medical Resident's Journey through Wonderland of Clinical Practice: From transitional shock to role adaptation to independent practice.

Objectives:To explore experiences of medical residents about stages and nature of transitional journey from induction into residency program to achievement of consultant title.Methods:Qualitative phenomenological study was conducted at Sir Gangaram hospital and Fatima Memorial Hospital, Lahore for six months from Feb 2019-July 2019 after IRB/ERC approval from Islamic International Medical College (Ref# Riphah/IIMC/ERC/19/0320). Using purposive criterion sampling, 16 semi-structured interviews in four departments, four strata of junior residents, senior residents, newly-qualified consultants, and supervising consultants with four participants each were conducted till theoretical saturation of data was achieved. After informed consent, audio recorded data was transcribed verbatim & analyzed through Atlas.ti 7 using Interpretive Phenomenological Analysis. After Bracketing and horizontalization, data was coded line by line. Codes (324) were merged to categories (19) for structural and textural description. Composite description of phenomenon was done by abstraction of themes (eight for stages and two for nature of journey).Results:Eight themes for stages as merriment, anguish, melancholy, acceptance and efforts, intensive learning, burnishing to shine, identity formation and intra-stage oscillations were identified. Two themes for journey’s nature were exponential learning & oscillating journey.Conclusion:The transitional journey is a multi-stage complex, oscillating journey. An oscillating electron model is presented upon the findings of this study to explain resident transition

Effect of clinical teaching behaviours on transition shock in graduate nurses.

This study aimed to explore the impact of preceptor clinical teaching behaviours on transition shock in graduate nurses using bi-directional feedback between graduate nurses and clinical preceptors and to assess preceptor clinical teaching behaviours. This was a descriptive cross-sectional study. This study was conducted from January-February 2019. Participants included graduate nurses (N=117) and clinical preceptors (N=908) from a major public tertiary hospital in Western China. Overall level of transition shock of graduate nurses was moderate (mean=89 SD17.54). Transition shock level of graduate nurses rose with the increasing of time in clinical work. Intensive care unit graduate nurses suffered the strongest transition shock, whereas surgery graduate nurses sufferedthe least. Graduate nurses thought that clinical preceptors were best at evaluation and feedback, whereas clinical preceptors thought they were best at showing concern and support. The primary factors associated with transition shock in graduate nurses were the time admitted to the hospital, feedback, and evaluation, use of appropriate teaching strategies, and showing concern and support, explaining 63.5% of the total variation in transition shock in graduate nurses. In Western China, where the development of economic and medical conditions lag, transition shock is a major obstacle to the professional development of graduate nurses and clinical teaching behaviours is the key to overcoming transition obstacles. However, the serious shortage of nurses makes it difficult to not only complete heavy clinical nursing work but also to undertake the teaching of students and graduate nurses. The clinical teaching system is influenced by many factors. Focusing on clinical teaching behaviours and transition shock in graduate nurses will provide valuable data for future intervention studies. The findings of this study will be of interest to managers at all levels and will enable them to support graduate nurses by engaging in excellent clinical teaching behaviours. In the clinical teaching process, giving more feedback and evaluation, improving the ability of using appropriate teaching strategies and focusing on the physical and mental health of graduate nurses may effectively decrease transition shock of graduate nurses and reduce the turnover rate.

Transition of newly graduated nurses in China: An evaluation study

The work adaptation of newly graduated nurses exerts a vital impact on their career developments. It is of great significance to guide newly graduated nurses to get acclimatized to the student-to-nurse transition. This study aimed to investigate the work adaptability disorder from the perspective of the organizational socialization and explore the potential factors of work adaptability disorder of newly graduated nurses. A cross-sectional study was performed. Convenience sampling was adopted to recruit 206 newly graduated nurses at four tertiary hospitals in China. The Work Adaptability Disorder Scale, the Transition Shock of Newly Graduated Nurses Scale, and the Organizational Socialization Questionnaire were utilized to measure the work adaptability disorder. The results showed the level of work adaptability disorder was mediocre among newly graduated nurses in China. The variables of gender, education, only child, family residence, transition shock, and organizational socialization could serve as predictors of work adaptability. Our research showed countermeasure of improving organizational socialization and relieving transition shock should be added to the training program of newly graduated nurses with purpose of promoting their adaptation.

The Impact of Preceptorship Program on Turnover Intention of Fresh Graduate Nurses in Hospital

Introduction: The transition period in the first year of nursing career is a difficult time for new nurses to adapt. The transition process for a new nurse is known as the Duchscher's transition shock model. Almost all hospitals worldwide have experienced difficulties with regards to the ability of new nurses to adapt to profession. The Preceptorship is a program designed to help new nurses adapt during the transition. This study aims primarily at exploring the impacts of the program to the turnover intention of fresh graduate nurses working in hospital.&#x0D; Methods: For this major purpose, a qualitative research with particular reference to phenomenology design was applied. Accordingly, this research applied in-depth interviews with active participation of 13 key informants. The informants are fresh graduate nurses employed in two private hospitals in Jakarta.&#x0D; Results: The results of thematic and cross-case analysis with N Vivo v.12 indicate four themes: preceptorship process, experiences in transition, problem arising during transition period and preceptorship program in helping nurse.&#x0D; Conclusion: It is found that nurses aged 22 years old and 7 months of working experience are the most likely to resign. The experience of new nurses undergoing to transition period affects 48% of their desire to leave work. This study recommends conducting further research on what kind of work environment is ideal for facilitating adaptation for new nurses.

Nurse Practitioner Post-Graduate Residency Program: Best Practice

This review aims to better understand the novice nurse practitioner (NP) transition to practice, while providing content from organizations focused on quality transitional programs. A major problem is the shortage of NPs in primary care. This is related to high turnover due to the difficult transition from expert RN to novice NP. To better understand this transition, Duchscher’s Transition Shock Theory was examined and used to support the importance of residency programs. This review provides support for the use of NP residencies to positively impact the transition to practice for the novice NP. The Community Health Center Inc. NP Residency Program promotes quality NP residencies and is used as an exemplar. The article also addresses the concern with residency variability and the cost associated with these programs.

Transition Shock as Tool of Integration

This paper aims to apply the recent approaches of intercultural interactions between minority-majority groups upon the historical acculturative phases of Sino-Muslims. Muslims in China departed their ghettos during Yuan/Mongol reign (1279-1368A.D) and got acquainted with Chinese culture at larger scale hence we contend that it was the period of ‘transition shock’ for them, to apply Alder’s phrase; as they were not only familiarized with the Chinese society but also revisited their new identity amidst a new people thus underwent a process of change revising their ‘self-understanding’. This cultural shock later propelled them to ‘integration’ during Ming (1368-1644A.D) thus served as a tool of their integration in China. Taking the Berry’s model of acculturation, we suggest the early Mongol’s was a period of ‘contact’ between the two cultures i.e. Islam and China whereas late Mongol and early Ming was characterized with ‘conflict’ and finally Ming age was the period of ‘adaptation’..

Transition shock and job satisfaction changes among newly graduated nurses in their first year of work: A prospective longitudinal study.

To identify the changes in transition shock and job satisfaction among newly graduated nurses during their first year and examine the factors affecting these changes. Newly graduated nurses' high turnover is related to transition shock and job satisfaction. However, insufficient information exists on changes in these variables among such nurses. A prospective longitudinal design was used. Participants were nurses newly graduated from nursing schools and working in hospitals in South Korea. There were 312, 195 and 120 participants at 4, 8 and 12months, respectively. Transition shock and job satisfaction decreased as working period increased; transition shock was lower, and job satisfaction was higher in positive work environments. Linear mixed models revealed work environment was the only factor significantly related to transition shock and job satisfaction changes. The nurses' transition shock and job satisfaction varied as per working period and work environment, which were the most important factors of these changes. Nurse managers can be aware of transition shock and job satisfaction changes, assess their severity and implement solutions in their hospitals. Thus, retention strategies should differ according to the changing needs of nurses at different stages of their career.

Transition shock and newly graduated nurses' job outcomes and select patient outcomes: A cross-sectional study.

This study examined transition shock experiences in newly graduated nurses as well as its relative influence on job outcomes (job satisfaction, stress and burnout, and intent to leave their organisation) and select patient outcomes (missed care, adverse events and perceived quality of care). Transition shock is a reality common among newly graduated nurses and has been considered an issue relevant to nursing administrators. To date, the mechanism by which transition shock perception is linked with nurse and patient outcomes remains unexplored. A descriptive, cross-sectional design was used. One hundred seventy-six newly graduated nurses (nurses with <1year of work experience) were included in the study. Data were collected using seven standardized scales. Hospital classification (e.g., being employed in a government-owned hospital) (β=0.255; p=.001) predicted transition shock. Overall, newly graduated nurses reported greatest challenges with regard to their expectations of the actual work environment (mean=2.60, standard deviation=0.42) and in balancing their professional and personal lives (mean=2.51, standard deviation=0.35). Higher levels of reality shock were associated with adverse patient events (β=0.821; p=.001). New graduates experience great challenges in balancing their professional and personal lives. Ensuring work-life balance and work readiness in newly graduated nurses may potentially reduce the occurrence of missed nursing care and adverse events. Nurse managers can adequately support newly graduated nurses' transition through the implementation of empirically based transition programmes. By providing flexible work arrangement, reasonable workload, adequate nurse staffing, limited mandatory overtime and self-scheduling, nurse managers can effectively assist newly graduated nurses in attaining work-life balance.

Transition shocks during adulthood and health a few decades later in post-socialist Central and Eastern Europe

BackgroundHealth of the population of post-socialist Central and Eastern European (CEE) countries lags behind the European Union average. Our aim in this paper is to analyse the link between transition shocks and health two-three decades later.MethodsWe use retrospective data from the Survey of Health, Ageing and Retirement in Europe. We estimate the implications of stressful periods, financial hardships and job loss occurring around the transition (1987–1993) on subjective and objective measures of health in 2017. We compare these implications across groups of CEE countries and with the health implications of similar difficulties reported by individuals from Western Europe. We also compare the health implications of difficulties occurring around the transition to difficulties occurring before or after the transition.ResultsIn the CEE region there is a peak in the timing of difficulties around the transition. Stressful periods, financial difficulties and job loss around the period of transition are generally associated with worse subjective and objective health at older ages in all groups of CEE countries, even after netting out the effect of childhood health and demographic factors. However, the consequences of hardships due to the transition are not specific, health implications of these difficulties seem to be similar to the implications of other shocks possibly unrelated to the transition.ConclusionsThe high fraction of individuals experiencing stress, financial difficulties and job loss around the transition contributed to the current health disadvantage in the CEE region. As similar shocks in the West and before or after the transition had similar health implications, our results draw the attention to the long-lasting impacts of psychosocial stress and financial hardship during adulthood on later health over the life course.

Contemporary nursing graduates' transition to practice: A critical review of transition models.

To critically review contemporary transition theories to determine how they apply to the newly qualified graduate registered nurse programmes. Graduate nurse transition to employment is the time of significant change which has resulted in high attrition rates. Graduates are often challenged by their expectation of nursing practice and the reality of the role. The transition from hospital-based training to university-based training has resulted in the need for primary employment to commence with graduate/orientation/internship programmes to help support new graduates transition into clinical practice. One transition model, Duchscher's stages of transition theory, utilised three former theories to develop a final model. A narrative critical literature review. The theories selected for the review were Kramer's reality shock theory, Benner's novice to expert theory, Bridges transition theory and Duchscher's stages of transition theory. Duchscher's stages of transition theory reflects the experiences of registered nursing transition into the workforce directly from university. The application of the theory is effective to guide understanding of the current challenges that new graduate nurse's experience today. There is a need for new graduates to complete their university degree as advanced beginners in order to decrease the experience of transition shock and keep pace with rapidly changing demands of the clinical environment. This may be achieved by increasing ward-based simulation in university education. A theoretical framework can provide a deep understanding of the various stages and processes of transition and enable development of successful programmes. Both universities and hospitals need to adapt their current practice to align with the needs of new graduates due to large student numbers and ongoing systematic advancements to decrease the attrition rate.