New graduate nurses' experiences about lack of professional confidence.
Ortiz Jennifer
Nurse education in practice
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.
10.1016/j.nepr.2016.04.001
Psychometric properties of an instrument measuring communication within and between the professional groups licensed practical nurses and registered nurses in anaesthetic clinics.
Randmaa Maria,Engström Maria,Mårtensson Gunilla,Leo Swenne Christine,Högberg Hans
BMC health services research
BACKGROUND:The most common cause of clinical incidents and adverse events in relation to surgery is communication error. There is a shortage of studies on communication between registered nurses and licenced practical nurses as well as of instruments to measure their perception of communication within and between the professional groups. The aim of the present study was to evaluate the psychometric properties of the Swedish version of the adapted ICU Nurse-Physician Questionnaire, designed to also measure communication within and between two professional groups: licensed practical nurses and registered nurses. Specifically, the aim was to examine the instrument's construct validity using confirmatory factor analysis and its internal consistency using Cronbach's Alpha. METHODS:A cross-sectional and correlational design was used. The setting was anaesthetic clinics in two Swedish hospitals. A total of 316 questionnaires were delivered during spring 2011, of which 195 were analysed to evaluate the psychometric properties of the questionnaire. Construct validity was assessed using confirmatory factor analysis and internal consistency using Cronbach's Alpha. To assess items with missing values, we conducted a sensitivity analysis of two sets of data, and to assess the assumption of normally distributed data, we used Bayesian estimation. RESULTS:The results support the construct validity and internal consistency of the adapted ICU Nurse-Physician Questionnaire. Model fit indices for the confirmative factor analysis were acceptable, and estimated factor loadings were reasonable. There were no large differences between the estimated factor loadings when comparing the two samples, suggesting that items with missing values did not alter the findings. The estimated factor loadings from Bayesian estimation were very similar to the maximum likelihood results. This indicates that confirmative factor analysis using maximum likelihood produced reliable factor loadings. Regarding internal consistency, alpha values ranged from 0.72 to 0.82. CONCLUSIONS:The tests of the adapted ICU Nurse-Physician Questionnaire indicate acceptable construct validity and internal consistency, both of which need to be further tested in new settings and samples. TRIAL REGISTRATION:Current controlled trials http://www.controlled-trials.com Communication and patient safety in anaesthesia and intensive care. Does implementation of SBAR make any differences? Identifier: ISRCTN37251313, retrospectively registered (assigned 08/11/2012).
10.1186/s12913-019-4805-7
Association of work environment and resilience with transition shock in newly licensed nurses: A cross-sectional study.
Kim Soon Ok,Kim Ji-Soo
Journal of clinical nursing
AIMS AND OBJECTIVES:To examine transition shock in newly licensed nurses and the association of work environment and resilience with nurses' transition shock. BACKGROUND: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. DESIGN:A cross-sectional, descriptive study. METHODS:Data from 163 new nurses with <12 months 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). RESULTS: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. CONCLUSIONS: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. RELEVANCE TO CLINICAL PRACTICE: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.
10.1111/jocn.15649
Registered Nurses' experiences of psychological well-being and ill-being in their first year of practice: A qualitative meta-synthesis.
Jarden Rebecca J,Jarden Aaron,Weiland Tracey J,Taylor Glenn,Brockenshire Naomi,Gerdtz Marie
Journal of advanced nursing
AIM:To synthesize Registered Nurses' self-reported perceptions and experiences of psychological well-being and ill-being during their first year of practice. DESIGN:Qualitative meta-synthesis. DATA SOURCES:Databases included Cumulative Index of Nursing and Allied Health Literature, Excerpta Medica database, Medical Literature Analysis and Retrieval System Online and Psychological Information. Qualitative studies were considered for inclusion if published in English, from 2009-2019, reporting primary data analysis including psychological well-being and ill-being experiences of graduate nurses in first year of practice. REVIEW METHODS:Qualitative studies were systematically identified and critically appraised. A meta-synthesis was applied using an open card sort technique to organize empirical data into a matrix of graduate nurses' voices of psychological well-being and ill-being. RESULTS:Twenty-two studies were included. Analysis revealed patterns of positive experiences and emotions. These included feeling valued and part of the team and learning from and feeling supported by other nurses. Negative experiences and emotions such as feeling overwhelmed, stressed, alone and inadequately prepared were also identified. CONCLUSION:Graduate nurses' perceptions and experiences of their psychological well-being and ill-being revealed both positive and negative dimensions during this transition period. Specific examples of strategies that may promote transition nurses' well-being and prevent ill-being were identified such as social connection and support. IMPACT:Increasing the numbers of new nursing graduates world-wide is required to strengthen health systems. Developing strategies to retain these graduates in the workforce is paramount. This review found some graduate nurses experience the transition period as a time of personal growth and fulfilment, for others this period was a stressor. These findings were illustrated in a model of 'ways to well-being'. The potential for knowledge translation of this model extends from graduate nurses as individuals, to nurse entry to practice programs and graduate nurse programs, to organizational policy targeting future health workforce. SYSTEMATIC REVIEW REGISTRATION NUMBER:CRD42020148812.
10.1111/jan.14667
Preventing Stress-Related Ill Health Among New Registered Nurses by Supporting Engagement in Proactive Behaviors-A Randomized Controlled Trial.
Worldviews on evidence-based nursing
BACKGROUND:New registered nurses (RNs) are at risk of developing symptoms of stress-related ill health. OBJECTIVES:To evaluate the effect of a 3 × 3 hour group intervention aiming to prevent symptoms of stress-related ill health among new RNs by increasing engagement in proactive behaviors. The intervention involves discussions and models of newcomer experiences and stress and the behavior change techniques reinforcing approach behaviors, systematic exposure, and action planning. DESIGN:A randomized parallel group trial with an active control condition. PARTICIPANTS:The study sample consisted of 239 new RNs participating in a transition-to-practice program for new RNs in a large county in Sweden. METHODS:Participants were randomized to either the experimental intervention or a control intervention. Data on experiences of stress, avoidance of proactive behaviors, engagement in leisure activities, role clarity, task mastery, and social acceptance were collected before and after the intervention. Effects were evaluated using multilevel model analysis and regression analysis. Missing data were imputed using multiple imputation. RESULTS:The control group experienced a statistically significant increase in experiences of stress during the period of the study (t(194.13) = 1.98, p = .049), whereas the level in the experimental group remained stable. Greater adherence to the intervention predicted a greater effect on experiences of stress (β = -0.15, p = .039) and social acceptance (β = 0.16, p = .027). LINKING EVIDENCE TO ACTION:Transition-to-practice programs may benefit from adding an intervention that specifically addresses new RNs' experiences of stress to further support them as they adjust to their new professional role. However, replication studies with larger samples, more reliable measures, and longer periods of follow-up are needed.
10.1111/wvn.12442
The theory of organisational socialisation and its potential for improving transition experiences for new graduate nurses.
Phillips Craig,Esterman Adrian,Kenny Amanda
Nurse education today
BACKGROUND: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. OBJECTIVES: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. DESIGN:Theoretical paper based on a program of research. METHODS: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. RESULTS: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. CONCLUSIONS: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.
10.1016/j.nedt.2014.07.011
Nurse Students' Thoughts on a Sustainable Professional Life as Nurses: A Qualitative Study.
Advances in medical education and practice
INTRODUCTION:In a global context of an increasing and aging population, along with environmental changes, nurses play an important role in relieving suffering among vulnerable people and groups in society. Sustainability in nursing contributes to sustainable development through providing an environment that is not detrimental to/protects present and future generations' opportunities for good health. There is a global shortage of nurses, and it has been shown that, locally, every fifth newly graduated nurse considers leaving their new profession five years after graduation. The aim was to describe how nursing students' thought about a sustainable professional life as nurses before their graduation. MATERIALS AND METHODS:A qualitative design with a written data set was used, and a thematic analysis was performed. One hundred five students (80 women and 25 men) in semester six out of six of the nursing education program participated. RESULTS:The analysis resulted in three themes: 1) to have an ethical foundation that guides the individual nurse in protecting the nursing care and developing the nursing care for their patients; 2) to be in a listening, reflexive and supportive workplace enabling a professional nurse to continuously grow and learn and 3) to be a proud professional nurse with integrity, not risking with their own health or personal professional development. CONCLUSION:The nursing students describe their thoughts on the requirements for having a sustainable professional life as nurses as having a strong inner ethical compass to help guide, protect and develop the nursing care for the patients. In addition, it requires a workplace with a reflexive and supporting culture. However, the nursing students also put their own health and the opportunities for professional growth at the top of their priorities, and if these conditions are lacking, they will switch to another workplace.
10.2147/AMEP.S245877
How do new graduated nurses from a competency-based program demonstrate their competencies? A focused ethnography of acute care settings.
Charette Martin,Goudreau Johanne,Bourbonnais Anne
Nurse education today
BACKGROUND:Following major organizations' recommendations, healthcare professionals' education has been reformed in the last decade into competency-based education (CBE) to better prepare them with core competencies. This change was intended to prepare new graduates for the reality of health systems and future challenges. Few studies have focused on how new graduate nurses (NGNs) from these reformed programs use the competencies they have developed. OBJECTIVE:To describe the competencies of NGNs from a Canadian competency-based baccalaureate program, as perceived by various actors in acute-care settings. METHODS:A focused ethnography was conducted on three acute-care wards of an academic hospital. Participants (n = 19) from four subgroups (NGNs, preceptors, clinical nurse specialists, and nurse managers) participated in individual semi-structured interviews or focus groups. Data were also collected through observation and fieldnotes; an ethnographic analysis framework was used. RESULTS:Three themes were identified to describe the deployment of NGNs' competencies: NGNs' appropriation of their new role, fragmentation of practice into tasks, and development of practice; NGNs' collaboration within the interprofessional team, management of the dyad with licensed practical nurses, and ability to integrate patients and families into the team; and NGNs' scientific practice, increased scientific curiosity, and use of credible sources. Analysis of these themes' elements in light of the competency framework of the program showed that NGNs deploy seven of the eight competencies developed during their training. CONCLUSION:This study's results can be applied by nursing educators and hospital decision makers to ensure NGNs are able to use their competencies and to smoothen the transition period between the academic and clinical settings.
10.1016/j.nedt.2019.05.031
Psychological resilience in New Zealand registered nurses: The role of workplace characteristics.
Tabakakis Costantinos Kosta,McAllister Margaret,Bradshaw Julie,To Quyen G
Journal of nursing management
AIM:To investigate the impact of workplace factors on psychological resilience in registered nurses. BACKGROUND:Nursing is characterized by persistent workplace adversity. Psychological resilience has been postulated as a means to mitigate the effects of workplace adversity. There is little research that examines the role of workplace factors (i.e., practice environment and bullying) in shaping resilience. METHODS:A cross-sectional survey was conducted among 480 registered New Zealand nurses. Psychological resilience was self-reported using the CD-RISC-10, while practice environment and workplace bullying were self-reported using PES-NWI and NAQ-R, respectively. RESULTS:For every point increase in PES-NWI and NAQ-R, there was an increase of 2.84 points (95%CI = 1.79, 3.89; p-value = <0.001) and a decrease of 0.07 points (95% CI = -0.12, -0.03; p-value = 0.002) in resilience, after controlling for demographic and job-related characteristics. These two factors explained for 12.6% of the variation in resilience. About 25.8% of registered nurses experienced bullying. CONCLUSION:Workplace factors are associated with psychological resilience in registered nurses. IMPLICATIONS FOR NURSING MANAGEMENT:Nurse managers are key to transforming health care work environments to promote positive outcomes for nurses, the organisation and patient outcomes. Future efforts to promote psychological resilience in registered nurses need to enhance the practice environment and reduce workplace bullying.
10.1111/jonm.12815
Exploring pairing of new graduate nurses with mentors: An interpretive descriptive study.
Devey Burry Robin,Stacey Dawn,Backman Chantal,Donia Magda B L,Lalonde Michelle
Journal of clinical nursing
AIMS AND OBJECTIVES:To explore mentorship pairing practices for new graduate nurses in a tertiary care hospital. BACKGROUND:Many organisations have implemented mentorship transition programmes to decrease new nursing graduate turnover in the first two years of practice. Little is known about mentorship pairing processes. DESIGN:An interpretive descriptive qualitative study was conducted in a multicampus academic health science centre in Ontario, Canada. The COREQ reporting guideline was used. METHODS:Thirty-one semistructured interviews were conducted from July 2018-July 2019 in a multicampus academic health science centre with new nursing graduates, experienced nurses and nurse leaders who participated in the New Graduate Guarantee programme or were involved in the mentor-mentee pairing process in 2016 or 2017. Data collected were analysed using thematic analysis within the groups and triangulated across groups. RESULTS:Neither the new graduates nor the mentors were aware of the pairing processes. Nursing leaders relied on their knowledge of the participants to pair new graduates and mentors with many stating participants' personalities were considered. New graduates and mentors described making an initial connection and socialisation as important themes related to facilitating the pairing process. Organisational influences on pairing included taking breaks together, the location of the final student placement, and the management of workload and scheduling. CONCLUSIONS:Increased awareness and transparency regarding nursing mentorship pairing processes is required. Pairing processes suggested by participants warrant further investigation to determine efficacy. RELEVANCE:Findings reinforce the need to discuss and research nursing specific mentorship pairing processes.
10.1111/jocn.15360
Fatigue in new registered nurses: A 12-month cross-lagged analysis of its association with work motivation, engagement, sickness absence and turnover intention.
Austin Stéphanie,Fernet Claude,Trépanier Sarah-Geneviève,Lavoie-Tremblay Mélanie
Journal of nursing management
AIM:This longitudinal study examines the motivational factors that explain why and how fatigue acts on new nurses' affective (work engagement), attitudinal (intention to leave the occupation) and behavioural (sickness absence) work outcomes. BACKGROUND:Growing nurse shortage makes it crucial to understand how and why fatigue can cut short the career of nurses. METHODS:This two-wave longitudinal study (baseline, 12-month follow-up) was conducted among 630 French-speaking new registered nurses from Canada. The proposed cross-lagged model was analysed using the EQS statistical software package for structural equation modelling (SEM). RESULTS:Time 1 fatigue was positively related to time 2 controlled motivation (working under internal or external pressure). Taking into account the cross-lagged effects of T1 fatigue on T2 outcomes, T1 controlled motivation was positively associated with T2 sickness absence, whereas T1 autonomous motivation (working because the activity is valued or inherently interesting) was related to all T2 outcomes. CONCLUSION:These findings provide insights into the motivational processes that affect nurses' early career functioning, revealing that distinct forms of motivation explain how fatigue relates to work outcomes. IMPLICATIONS FOR NURSING MANAGEMENT:Organisational efforts to strengthen autonomous over controlled motivation constitute a promising strategy to improve new nurses' well-being and retention in the occupation.
10.1111/jonm.12962
Balance, Health, and Workplace Safety: Experiences of New Nurses in the Context of Total Worker Health.
Oneal Gail,Graves Janessa M,Diede Tullamora,Postma Julie,Barbosa-Leiker Celestina,Butterfield Patricia
Workplace health & safety
Transitioning into independent professional practice may be a difficult and trying process for newly licensed nurses, who may be at risk for burnout and quitting their jobs. Issues related to new nurses' well-being at work may also impact their personal lives. Using thematic analysis within the framework of Total Worker Health, this study examined factors related to the overall work, safety, and health of newly licensed nurses that should be addressed in work environments to promote well-being and prevent burnout and attrition. The main component of Total Worker Health is to find and understand the relevant issues that lead to safety and health risks in the workplace and affect workers' well-being at work and home. The overarching concept of included three main themes: Health, Work Environment, and Learning to Be (a nurse). These themes with their subthemes described the difficulties participants had in balancing the complex interactions of work conditions and social life changes during the transition from student to professional nurse. Participants identified new physical health problems, mental health challenges, physical violence, lack of support structures at work, and alterations in family and friend relationships. However, they also developed protective factors from new connections with coworkers. These findings showed that new nurses are vulnerable to many factors at home and work that affect well-being and may lead to burnout and attrition. Implications include interventions at work that focus on health promotion, group support, and safety risk prevention through occupational nurse management.
10.1177/2165079919833701
Anxiety and work stress among newly employed nurses during the first year of a residency programme: A longitudinal study.
Lin Yueh-E,Tseng Chien-Ning,Wang Mei-Fang,Wu Shu-Fang Vivienne,Jane Sui-Whi,Chien Li-Yu
Journal of nursing management
AIM:To explore changes in anxiety and work stress among new nurses in the first year of a 2-year residency programme. BACKGROUND:Few studies have examined the anxiety and work stress of new nurses in a residency programme. METHODS:This longitudinal study examined levels of anxiety and work stress among newly employed nurses over 1 year at 1 week and 1, 2, 3, 6, 9 and 12 months. Participants were purposively sampled from a medical centre in Taiwan. The Beck Anxiety Inventory and the Nurse Stress Checklist were used to measure anxiety and stress, respectively. RESULTS:The nurses (N = 200) generally perceived mild levels of anxiety and moderate work stress. However, anxiety and stress peaked at the first and second months. Levels stabilized by the sixth month. General ward nurses perceived higher stress levels than did those in emergency or operating rooms. CONCLUSIONS:Stress and work anxiety for new nurses peaked at 1-2 months of employment. IMPLICATIONS FOR NURSING MANAGEMENT:Nurse managers, preceptors and educators must work together with newly employed nurses in individualized learning and support, doing so to improve the transition experience and reduce levels of work stress and anxiety.
10.1111/jonm.13114
Changing New Graduate Nurse Profiles and Retention Recommendations for Nurse Leaders.
Tyndall Deborah E,Scott Elaine S,Jones Lenna R,Cook Kristy J
The Journal of nursing administration
OBJECTIVE:This study compares and contrasts new graduate nurse attributes and perceptions using findings from a 2010 study and a recent analysis of new graduate nurses participating in the same residency program. BACKGROUND:As millennials saturate the healthcare work environment, their unique views and needs will influence the evolution of new graduate nurse residencies. METHODS:This study used previously reported data on new graduate nurses between 1999 and 2009 and compared it with a secondary analysis of data collected on new graduate nurses between 2011 and 2016. RESULTS:This study provides evidence that millennial new graduate nurses' levels of commitment and satisfaction do not moderate turnover intentions in the 1st 2 years of practice as they did in the previous group of new graduate nurses. CONCLUSIONS:Job embeddedness, a construct that measures the likelihood of whether a person is going to stay, may be a better measurement among new graduate nurses than commitment or satisfaction because millennials, a generation that is predominant in current new graduate nurses, are more engaged than loyal.
10.1097/NNA.0000000000000716
Intention to leave among newly graduated nurses: A descriptive, multicenter study.
Li Zhen,Cao Jing,Wu Xinjuan,Li Fangfang,Zhu Chen
Journal of advanced nursing
AIMS:To investigate newly graduated Chinese nurses' intention to leave their jobs and to explore the association of intention to leave with nurse characteristics, person-environment fit, and social support. DESIGN:This was a cross-sectional descriptive study. METHODS:Newly graduated nurses (N = 1,313) were recruited from 18 hospitals in six provinces in China, during 2018. An online questionnaire explored intention to leave and related factors, including proactive personality, personal-environment fit, and perceived social support. Chi-squared and multilevel logistic regression analysis were used to examine associations between factors. RESULTS:Among 1,313 newly graduated nurses, 88 (6.7%) reported high-level intention to leave. Nurses working in specialty areas (i.e., outside of medical-surgical wards) and those with higher degree of person-organization fit showed lower intention to leave, whereas those with higher level of education, exposure to negative workplace/life events during the previous year and a proactive personality showed higher intention to leave. CONCLUSION:Among newly graduated Chinese nurses, intention to leave is significant and is influenced by work area, level of education, negative workplace/life events and person-organization fit. The intention to leave is dynamically multifactorial and supportive strategies must be similarly multifaceted to effectively reduce turnover. IMPACT:Little is known about the factors influencing the intention to leave among newly graduated nurses. We found significant intention to leave among new nurses which was negatively associated with work in a specialty area and degree of person-organization fit and positively associated with level of education, exposure to negative workplace/life events and proactive personality. This information adds to our understanding of nurse turnover and will support nurse administrators in the introduction of specific strategies to decrease turnover in this population.
10.1111/jan.14545
"Hit the ground running": perspectives of new nurses and nurse managers on role transition and integration of new graduates.
Chernomas Wanda M,Care W Dean,McKenzie Jo-Ann Lapointe,Guse Lorna,Currie Jan
Nursing leadership (Toronto, Ont.)
The workplace for new graduates must be a constructive learning environment to facilitate their development. Nurse managers need new graduates who can "hit the ground running." Conflict between the needs of new nurses and the realities of the workplace often creates role confusion and tension in new graduates and threatens employers' ability to retain them. As part of a larger study that examined the effectiveness of a new strategy on new nurse retention and workplace integration, we conducted focus groups with new nurses and nurse managers. This paper discusses the perspectives of new nurses on their role transition from graduates to practising professionals and the perspectives of nurse managers on the workplace integration of new nurses. The thematic findings integrate new nurses' perspectives on their needs during role transition with the perspectives of nurse managers in meeting those needs. The discussion includes strategies to facilitate successful transition and integration of new nurses into the workplace within the context of recruitment and retention.
10.12927/cjnl.2010.21598
Transition shock and newly graduated nurses' job outcomes and select patient outcomes: A cross-sectional study.
Labrague Leodoro J,De Los Santos Janet Alexis A
Journal of nursing management
AIM: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). BACKGROUND: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. METHODS:A descriptive, cross-sectional design was used. One hundred seventy-six newly graduated nurses (nurses with <1 year of work experience) were included in the study. Data were collected using seven standardized scales. RESULTS: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). CONCLUSION: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. IMPLICATIONS FOR NURSING MANAGEMENT: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.
10.1111/jonm.13033
Educating new graduate nurses in their first year of practice: The perspective and experiences of the new graduate nurses and the director of nursing.
Doughty Lesley,McKillop Ann,Dixon Robyn,Sinnema Claire
Nurse education in practice
New graduate nurses are the future of nursing and the education they receive as they transition into the workforce as a newly registered nurse is critical for building a suitably qualified nursing workforce that will adequately serve the future population. Variation exists in education programmes for new graduate nurses in their first year of practice which is known to impact on transition experience. A qualitative study using focus groups and semi-structured interviews was undertaken to explore the experiences and perceptions of New Graduate Nurses undertaking a new graduate programme and Directors of Nursing supporting them to complete the programme which may or may not have been inclusive of a postgraduate course (Masters Level). The findings of this study are in line with previous research and support the value of new graduate programmes but did reveal a lack of consensus in regards to the structure and content of such programmes. This study revealed some commonalities and challenges between the differing programmes but has identified the need for further research to establish the impact of postgraduate education in the first year of practice and how this impacts on nursing practice and patient care. There are numerous terms in the literature with reference to new graduate programmes; transition to practice programme, nurse entry to practice programme, first year of clinical practice programme, new graduate programme and early career nursing programme. For the purpose of this article the term Nurse Entry to Practice (NETP) will be used in reference to any form of new graduate programme.
10.1016/j.nepr.2018.03.006
The impact of undergraduate clinical teaching models on the perceptions of work-readiness among new graduate nurses: A cross sectional study.
Patterson Emma E B,Boyd Leanne,Mnatzaganian George
Nurse education today
BACKGROUND:Clinical Placements are an essential component of bridging the gap between academic theory and nursing practice. There are multiple clinical models designed to ease the transition from student to professional, yet there has been little exploration of such models and their impact on graduates' perceptions of work-readiness. OBJECTIVES:This cross sectional study examined perceptions of work-readiness of new graduate nurses who attended one of the following clinical teaching models: the University Fellowship Program (UFP), the Traditional Multi-facility Clinical Model (TMCPM), and the Mixed Program (MP). METHODS:Three groups of first year graduate nurses (UFP, TMCPM, and MP) were compared using the Work-readiness Scale, a validated and reliable tool, which assessed nurses' perceptions of work-readiness in four domains: organizational acumen, personal work characteristics, social intelligence, and work competence. A multivariable Generalized Estimating Equations regression investigated socio-demographic and teaching-modelrelated factors associated with work-readiness. RESULTS:Of 43 nurses approached, 28 completed the survey (65% response rate) of whom 6 were UFP attendants, 8 attended the TMCPM and 14 the MP. Those who had attended the UFP scored higher than the other two in all four domains; however, the crude between-group comparisons did not yield statistically significant results. Only after accounting for age, gender, teaching setting and prior work experience, the multivariable model showed that undertaking the UFP was likely to increase perceptions of work-readiness by 1.4 points (95% CI 0.11-2.69), P=0.03). The UFP was superior to the other two placement models. CONCLUSION:The study suggests that the UFP may enhance graduate nurses' perceptions of work readiness.
10.1016/j.nedt.2017.05.010
Nurse Preceptor Role in New Graduate Nurses' Transition to Practice.
Powers Kelly,Herron Elizabeth K,Pagel Julie
Dimensions of critical care nursing : DCCN
The transition to practice period is a challenging and demanding time for new graduate nurses. Leaving the structured environment of nursing school and entering professional practice can cause reality and transition shock for the new nurse resulting in unsafe patient care, as well as intention to leave their position or the profession. Successful transition to practice depends on the new nurse building confidence and gaining essential clinical reasoning abilities while orienting to their role. In critical care settings, patient care is more complex and fast-paced, which adds another dimension of overall stress to the new graduate. Structured orientation programs with trained preceptors have been found to be the most successful means of preparing new graduate nurses for clinical practice. Ensuring preceptors are provided with education related to the development of clinical reasoning is essential to successfully assist new nurses in their transition to practice. Safe and effective patient care, especially in the critical care unit, is dependent upon having nurses who are well prepared for their role through being provided guidance and support from trained preceptors.
10.1097/DCC.0000000000000354
Essential Professional Behaviors of Nursing Students and New Nurses: Hospital Nurse Leader Perspectives Survey.
Sortedahl Charlotte,Persinger Sara,Sobtzak Kathryn,Farrell Brooke,Jaeger Nicholas
Nursing education perspectives
AIM:This two-part study was conducted to determine which professional behaviors hospital nurse leaders believe are essential for nursing students to learn in the classroom. BACKGROUND:Nursing students need to be educated to lead high-quality care in complex health care environments. Little is known regarding the professional behaviors deemed essential for novice nurses. METHOD:Hospital leaders were surveyed (n = 221) using the Hospital Nurse Leader Perspectives survey. This survey, developed from interviews, includes 41 items in change, communication, conflict, leadership, and self-awareness. RESULTS:The highest-ranked category was communication (n = 159, 72 percent), followed by self-awareness (n = 32, 14.4 percent). The highest items in each category were patient communication, prioritization, expect change, learning from failure, and conflict resolution. CONCLUSION:The results provide practical information to inform curricula and prepare leaders.
10.1097/01.NEP.0000000000000240
The impact of postgraduate education in transition to practice programmes on new graduate nurses' knowledge and skills: A pre- post survey design.
Doughty Lesley,Sinnema Claire,McKillop Ann,Dixon Robyn
Nurse education today
BACKGROUND:Research indicates that nurses perceive postgraduate education to have a positive effect on their knowledge and practice. Many jurisdictions offer/require new graduate nurses to undertake postgraduate coursework however the consequences of this are not clear. OBJECTIVES:This research aims to determine the impact of completing a postgraduate course in clinical assessment on the capabilities of new graduate nurses. DESIGN:A two group pre/post design with a naturally occurring intervention employing an online questionnaire was used to gather data. SETTINGS:Two metropolitan hospitals in New Zealand delivering new graduate programmes, one inclusive of a postgraduate course and the other not. PARTICIPANTS:Eighty five nurses completed the questionnaire on commencement of the programme and fifty-two on completion of the programme. METHODS:An online questionnaire was administered to two new graduate cohorts, on commencement and completion of their new graduate programme. RESULTS:Results showed significant pre/post increases for four out of five factors for those who had completed a postgraduate course compared to only one significant increase for those who had not. In addition, when comparing the scores of the two groups there was no significant differences between groups on the pre-measures. However, on post measures there were significant differences with the postgraduate group scoring higher on three of the five subscales: Knowledge for Practice, Explaining Practice and Applied Diagnostic Reasoning. CONCLUSION:It is the author's belief that this is the first study that has attempted to quantify new graduate nurses' perceptions of their educational experience in their first year of practice and suggests that the inclusion of the postgraduate course enhanced knowledge for practice and diagnostic reasoning skills.
10.1016/j.nedt.2021.104888
Newly graduated nurses' socialisation resulting in limiting inquiry and one-sided use of knowledge sources-An ethnographic study.
Voldbjerg Siri Lygum,Wiechula Rick,Sørensen Erik Elgaard,Grønkjaer Mette
Journal of clinical nursing
AIM:To explore how the socialisation into the clinical setting and interaction between newly graduated nurses and experienced nurses influences the new graduates' use of knowledge sources. BACKGROUND:Newly graduated nurses' use of knowledge sources in decision-making has been subject to an increased interest in relation to evidence-based practice. Despite interventions to strengthen nurses' competencies required for making reflective clinical decisions within an evidence-based practice, studies highlight that new graduates only draw on knowledge from research, patients and other components within evidence-based practice to a limited extent. Research exploring new graduates' use of knowledge sources calls attention to the experienced nurses' decisive role as a valued knowledge source. The new graduates' process of socialisation and their interaction with the experienced nurse raises further questions. METHODS:Ethnography using participant-observation and individual semi-structured interviews of nine newly graduated nurses from a University Hospital in Denmark. Data were collected in 2014. The study adheres to COREQ. RESULTS:Two main structures were found: "Striving for acknowledgment" and "Unintentionally suppressed inquiry." CONCLUSIONS:New graduates are socialised into limiting their inquiry on clinical practice and unintentionally being restricted to using the experienced nurse as predominant knowledge source. Depending on how the experienced nurse responds to the role as predominant knowledge source, they could either limit or nurture the new graduates' inquiry into practice and thus the variety of knowledge sources used in clinical decision-making. Limited inquiry into the complexity of nursing practice indirectly excludes the use of a variety of knowledge sources, which are fundamental to an evidence-based practice. RELEVANCE:If clinical practice wishes to benefit from the newly graduated nurses' inquiring approach and skills within evidence-based practice, clinical practice will have to greet the nurses with a supportive culture where questioning practice is seen as a strength rather than a sign of insecurity and incompetence.
10.1111/jocn.15592
Exploring barriers and facilitators for successful transition in new graduate nurses: A mixed methods study.
Kim Ju Hee,Shin Hye Sook
Journal of professional nursing : official journal of the American Association of Colleges of Nursing
BACKGROUND:The transition phase from student to nurse is an important time when new graduates grow and develop as professional nurses. Globally, the attrition rate of new graduate nurses is reported to range from 24.5 to 70%. PURPOSE:The study aimed to explore the barriers to, and facilitators of new graduate nurses' successful transition. METHODS:A convergent mixed methods design was used. Newly graduated nurses (n = 212) were recruited from two K university medical centers. The quantitative research used a cross-sectional study, and the qualitative research used a focus group interview design. The survey and focus group interview were conducted from October to December 2017. The questionnaire comprised items on demographic characteristics (age, gender, employment duration, orientation duration, etc.) and items on transition experience, job satisfaction, self-efficacy, nursing work stress, and structural empowerment. RESULTS:This qualitative study found that significant factors affecting transition (R = 0.41, F = 35.29, p < .05) included self-efficacy (β = 0.27, p < .01), job satisfaction (β = 0.11, p < .01), nursing stress (β = -0.04, p < .05), and structural empowerment (β = 0.41, p < .01). The qualitative findings supported the quantitative results and also identified the barriers to and facilitators of a successful transition. The barriers were fears, workload, excessive role expectations, and emotional difficulties resulting from bullying. And, the facilitators are self-confidence, interaction with colleagues, positive and supportive work environments, and a phase transition program. CONCLUSION:This study showed that formal and informal strategies, to strengthen organizational factors (structural empowerment, phase transition program, etc.) and enhance individual factors (self-efficacy, self-confidence, interaction, etc.), are important for new graduate nurses' successful transition into their professional roles.
10.1016/j.profnurs.2020.08.006
Prevalence and retention status of new graduate nurses with special support needs in Japan.
Ikematsu Yuko,Egawa Koji,Endo Midori
Nurse education in practice
Early resignation of new graduate nurses is a global concern. Tendencies of developmental disorders or special support needs may contribute to the early resignation. A national mail survey about new graduate nurses with special support needs was conducted in Japan in 2013. A modified battery developed for a national survey of school children with special educational needs was used. The questionnaire was completed by the nurse managers of the participating hospitals who supervised the nurses. Among the 500 hospitals invited to participate in the survey, 141 hospitals responded. Sixty-six nurses were identified as having special support needs among the 2,761 nurses who were newly employed at 128 hospitals with 300 or more beds, which comprises 2.39% of the total. The most prevalent need was "social interaction/restricted interest" followed by "inattentiveness." Of these, 40.9% of the nurses left their initial hospital jobs within one year. The need for an individualized support program specific to nurses' needs is implied. Further research studies are warranted to prospectively identify nurses with special support needs and explore their experiences as working nurses.
10.1016/j.nepr.2019.02.007
Benner's model and Duchscher's theory: Providing the framework for understanding new graduate nurses' transition to practice.
Murray Melanie,Sundin Deborah,Cope Vicki
Nurse education in practice
The transition to quality and safety in the new graduate registered nurses' practice remains problematic directly impacting patient outcomes. Effective mentoring during transition serves to enhance experiential learning, allowing the development and establishment of safe, quality nursing practice. Comprehensive understanding of the transition process, including the barriers and effective enablers to transition is the key to effective mentoring. A theoretical framework guided by Duchscher's Stages of Transition Theory and Transition Shock Model and Benner's From novice to expert model can facilitate such understanding. Nurse Theorists play an important part in shaping nurse education and practice and have provided nurse educators and leaders an understanding to shape skill acquisition and the transition process for new graduate registered nurses. The res ultantresearchmodels and theory of these influencial nurses are pertinent to transition of new graduate registered nurses. This paper outlines the theories of Duchscher and Benner and how their research formed the theoretical framework to facilitate the measurement, understanding and improvement of the safety and quality of nursing care and impact the future nursing workforce.
10.1016/j.nepr.2018.12.003
"Hoping to be recognized, appreciated, and given clinical privilege": A phenomenology study of new nurses' experiences during orientation.
Pertiwi Bela,Hariyati Rr Tutik Sri,Pujasari Hening
Enfermeria clinica
New nurses who have just worked have not been given clinical privilege during their orientation. Feelings, experiences, and expectations can influence the quality of nursing services. This study aimed to explore the experiences of new nurses, especially in the orientation period, before they are given the clinical privilege. This research applied a descriptive qualitative phenomenology design-semi-structured, in-depth interviews. Data were analyzed by the Colaizzi method using thematic analysis. Four themes: new nurses lack understanding of clinical privilege; new nurses provide nursing care based on senior orders; new nurses want to be recognized, appreciated, and given clinical privilege; and hospitals need to facilitate the process of adaptation of new nurses. This study shows that the new nurse carries out nursing care in the hope of being recognized and developing skills. Nurse managers are expected to provide appropriate orientation programs.
10.1016/j.enfcli.2020.10.022
New graduate nurses' understanding and attitudes about patient safety upon transition to practice.
Murray Melanie,Sundin Deborah,Cope Vicki
Journal of clinical nursing
AIMS:To explore the transition experiences of newly graduated registered nurses with particular attention to patient safety. BACKGROUND:New graduate registered nurses' transition is accompanied by a degree of shock which may be in tune with the described theory-practice gap. The limited exposure to clinical settings and experiences leaves these nurses at risk of making errors and not recognising deterioration, prioritising time management and task completion over patient safety and care. DESIGN:Qualitative descriptive approach using semi-structured interviews. METHODS:Data were collected during 2017-18 from 11 participants consenting to face-to-face or telephone semi-structured interviews. Interviews were transcribed verbatim, and data were analysed using thematic analysis techniques assisted by Nvivo coding software. The study follows the COREQ guidelines for qualitative studies (see Supplementary File 1). RESULTS:Key themes isolated from the interview transcripts were as follows: patient safety and insights; time management; making a mistake; experiential learning; and transition. Medication administration was a significant cause of stress that adds to time management anguish. Although the new graduate registered nurses' clinical acumen was improving, they still felt they were moving two steps forward, one step back with regards to their understanding of patient care and safety. CONCLUSION:Transition shock leaves new graduate registered nurses' focused on time management and task completion over patient safety and holistic care. Encouragement and support needed to foster a safety culture that foster safe practices in our new nurses. RELEVANCE TO PRACTICE:Having an understanding of the new graduate registered nurses' experiences and understanding of practice will assist Graduate Nurse Program coordinators, and senior nurses, to plan and provide the relevant information and education during these initial months of transition to help mitigate the risk of errors occurring during this time.
10.1111/jocn.14839
Nurses' perception of individual and organizational changes caused by a novel clinical training system for new graduate nurses: A qualitative research using photovoice.
Horii Satoko,Pham Huong Thi Thu,Dang Thanh Tran Ngoc,Nguyen Chinh Thi Minh,Amaike Naomi
Nurse education today
BACKGROUND:Clinical training for new graduate nurses has a positive impact on their clinical competence; however, there is limited evidence on the impact of this training at the organizational level and on the processes that mediate these impacts. OBJECTIVES:To identify the individual and organizational impacts of a clinical training system and the mechanism that produces them by exploring nurses' perceptions of the changes in health facilities after the introduction of a standardized clinical training system in Vietnam. DESIGN:Qualitative research using an ethnographic approach; photovoice was used to obtain insights into nurses' perceptions. SETTING:Health facilities of four provinces and one city in Vietnam participated in the Project for Strengthening of the Clinical Training System for New Graduate Nurses. PARTICIPANTS:New graduate nurses, preceptors, and managers who engaged in the clinical training program. METHODS:Qualitative data, including photographs, were collected through photovoice sessions and inductively analyzed using thematic analysis. RESULTS:Sixteen photovoice sessions were conducted with 94 nurses from 22 hospitals. Three themes emerged: "acquiring competency" as an individual change, "fostering mutual learning culture" as an organizational change, and "improved quality of care and nurse empowerment" as the impact. The clinical training system was found to enhance diverse competencies of new graduate nurses, preceptors, and nurse managers, while facilitating collaboration among different professions, departments, and organizations and cultivating a better learning environment. Organizational changes were initiated with the hospital director's support. These changes were interactively related and produced the impact. CONCLUSIONS:The novel clinical training system for new graduate nurses could strengthen nurses' competencies and facilitate organizational changes to actualize a positive impact on nursing care and nurses' status. These findings could facilitate the design of an effective training program to stimulate organizational learning to produce better health outcome.
10.1016/j.nedt.2021.104901
Educational needs for new graduate nurses in Korea.
Lee Soon Hee,Kim Jung-Hee,Jung Dukyoo,Kang Sook Jung
Nurse education in practice
New nursing graduates often experience difficulty adjusting to clinical work environments, despite completing well-structured education programs. This study explored the educational needs of recent nursing graduates from the perspectives of new nurses and their clinical educators in Korea. Four focus-group interviews with 7 nurse educators and 8 new nurses were conducted. Data were analyzed using Patton's inductive content analysis. Five analytic categories emerged: communication skills that build good relationships, managing unexpected situations, prioritization, practical experiences, and different ways of delivering education. Educators and new nurses agreed that communication skills are essential in building and maintaining interpersonal relationships. Future educational programs for new graduate nurses should reflect the needs of nurses and their educators so new registered nurses can successfully make the transition to expert nurses.
10.1016/j.nepr.2018.11.021
Role-modelling and the hidden curriculum: New graduate nurses' professional socialisation.
Hunter Kiri,Cook Catherine
Journal of clinical nursing
AIMS AND OBJECTIVES:To explore new graduate nurses' experiences of professional socialisation by registered nurses in hospital-based practice settings, and identify strategies that support professional identity development. BACKGROUND:Professionalism is reinforced and stabilised in the clinical environment through the "hidden curriculum", with major learning coming from practice role-models. New graduates observe attitudes, behaviours, decision-making and skills, and gain feedback from registered nurses, which they translate into their own practice. Professional socialisation occurs through encounters with desirable and undesirable role-modelling; both are significant in professional identity formation. DESIGN:Qualitative descriptive design. METHOD:Data collection was undertaken through semistructured interviews with five new graduate nurse participants. A general inductive approach guided analysis. The meaningful descriptions gained provided insight into their experiences. RESULTS:Three main themes identified from the data include: "Lessons from the wilderness"; "Life in the wild"; and "Belonging to a wolf pack". The data set highlighted the major transitional process from student identity to registered nurse. CONCLUSIONS:New graduates' rethinking of beliefs and professional nursing identities were influenced by organisational pressures and experienced nurses' role-modelling practices contrary to professional values. Despite encountering a range of professional behaviours, attitudes and dilemmas, new graduates were capable of moral agency and critical thinking. However, they rapidly acculturated and described compromises to cope. To promote high morale and a sense of belonging, a concerted effort is required by all nurses to facilitate the socialisation process to encourage self-authorship. RELEVANCE TO CLINICAL PRACTICE:A well-developed professional identity enhances nursing as a profession, contributing towards better healthcare delivery and outcomes. It is critically important how professional values are learnt within the culture of nursing. Tensions in clinical practice need to be understood better to avoid moral distress caused by dissonance between expectation and experience. It is advantageous to increase early positive socialisation.
10.1111/jocn.14510
Are rural and urban newly licensed nurses different? A longitudinal study of a nurse residency programme.
Bratt Marilyn Meyer,Baernholdt Marianne,Pruszynski Jessica
Journal of nursing management
AIM:This study aimed to compare rural and urban nurse residency programme participants' personal and job characteristics and perceptions of decision-making, job satisfaction, job stress, nursing performance and organisational commitment over time. BACKGROUND:Nurse residency programmes are an evolving strategy to foster transition to practice for new nurses. However, there are limited data available for programme outcomes particularly for rural nurses. METHOD:A longitudinal design sampled 382 urban and 86 rural newly licensed hospital nurses during a 12-month nurse residency programme. Data were collected at the start of the programme, at 6 months and the end of the programme. RESULTS:At the end of the programme, rural nurses had significantly higher job satisfaction and lower job stress compared with urban nurses. Across all time-periods rural nurses had significantly lower levels of stress caused by the physical work environment and at the end of the programme had less stress related to staffing compared with urban nurses. Perceptions of their organisational commitment and competency to make decisions and perform role elements were similar. CONCLUSIONS:Differences in these outcomes may be result from unique characteristics of rural vs. urban nursing practice that need further exploration. IMPLICATIONS FOR NURSING MANAGEMENT:Providing a nurse residency programme in rural and urban hospitals can be a useful recruitment and retention strategy.
10.1111/j.1365-2834.2012.01483.x
New graduate registered nurses' knowledge of patient safety and practice: A literature review.
Murray Melanie,Sundin Deborah,Cope Vicki
Journal of clinical nursing
AIMS AND OBJECTIVES:To critically appraise available literature and summarise evidence pertaining to the patient safety knowledge and practices of new graduate registered nurses. BACKGROUND:Responsibility for patient safety should not be limited to the practice of the bedside nurses, rather the responsibility of all in the healthcare system. Previous research identified lapses in safety across the health care, more specifically with new practitioners. Understanding these gaps and what may be employed to counteract them is vital to ensuring patient safety. DESIGN:A focused review of research literature. METHODS:The review used key terms and Boolean operators across a 5-year time frame in CINAHL, Medline, psycINFO and Google Scholar for research articles pertaining to the area of enquiry. Eighty-four articles met the inclusion criteria, 39 discarded due to irrelevant material and 45 articles were included in the literature review. RESULTS:This review acknowledges that nursing has different stages of knowledge and practice capabilities. A theory-practice gap for new graduate registered nurses exists, and transition to practice is a key learning period setting new nurses on the path to becoming expert practitioners. Within the literature, there was little to no acknowledgement of patient safety knowledge of the newly registered nurse. CONCLUSIONS:Issues raised in the 1970s remain a concern for today's new graduate registered nurses. Research has recognised several factors affecting transition from nursing student to new graduate registered nurse. These factors are leaving new practitioners open to potential errors and risking patient safety. RELEVANCE TO CLINICAL PRACTICE:Understanding the knowledge of a new graduate registered nurse upon entering clinical practice may assist in organisations providing appropriate clinical and theoretical support to these nurses during their transition.
10.1111/jocn.13785
New Graduate Nurses' Perceptions of Patient Safety: Describing and Comparing Responses With Experienced Nurses.
Forbes Thompson H,Scott Elaine S,Swanson Melvin
Journal of continuing education in nursing
BACKGROUND: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. METHOD: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. RESULTS: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. CONCLUSION: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.].
10.3928/00220124-20200611-06
Nurse Prescribing-Readiness of Polish Nurses to Take on New Competencies-A Cross-Sectional Study.
Bartosiewicz Anna,Różański Andrzej
Healthcare (Basel, Switzerland)
From January 2016, nurses in Poland received new competencies for prescribing. The work is the first in Poland to elaborate on the subject of nurses' readiness to learn and develop in the context of new nursing rights regarding autonomous prescription of medication and continuation of the prescription for medication. The aim of the study is to analyze the readiness of Polish nurses to learn and develop in the context of new competencies to write prescriptions. The research was conducted among 756 nurses. The standardized questionnaire (Readiness of Employees for Learning and Development) was used. For all subscales of readiness for learning and development, average scores prevailed. The readiness to write prescriptions was significantly related to the level of openness to changes in the work environment (A1 scale), self-evaluation of past educational development (C5 scale) and educational and professional goals alignment- employee and company (scale D2) and increasing the readiness of nurses to practice all of the aforementioned agents, in particular medical devices. The readiness of nurses to learn and develop at all levels of the subscales was on an average level. Younger nurses, with a shorter seniority, having higher education and additional qualifications had a higher readiness to prescribe medications and write prescriptions. The higher readiness for learning and development was matched by a greater readiness to prescribe. The results obtained can be used to plan training and courses, as well as to create special pro-development programs, which may increase the nurses' involvement in personal and professional development.
10.3390/healthcare7040151
New graduate nurses' self-assessed competencies: An integrative review.
Song Youngkwan,McCreary Linda L
Nurse education in practice
Much of the ongoing shortage of nurses can be attributed to high turnover rates, and open positions are mostly filled by new graduate nurses who often lack the competencies required to provide quality patient care. An additional problem is that over 20% of these nurses leave their positions within 1 year, and low nursing competency is a main contributor to their decision. New graduate nurses' competencies are typically evaluated by experienced nurses who attempt to provide objective assessment of deficiencies, but this approach has not reduced turnover rates. Therefore, this integrative review explored new graduate nurses' self-assessed competencies. The review revealed that new graduate nurses' self-assessed deficiencies included advanced technical skills, critical thinking, communication, teamwork, helping role, and professionalism, most of which were associated with "soft" skills. New graduate nurses' possession not only of "hard" nursing skills within the cognitive and psychomotor domains but also of soft skills that mostly lie within the affective domain is vital to achieve higher retention rates. Because soft-skill competencies are problematic to objectively evaluate, recommendations include development and frequent application of a more objective measure such as a rubric, greater emphasis on soft skills in education, and supervised hands-on training in supportive practice settings.
10.1016/j.nepr.2020.102801
Newly qualified nurses' transition from learning to doing: A scoping review.
Aldosari Nasser,Pryjmachuk Steven,Cooke Hannah
International journal of nursing studies
OBJECTIVES:To identify newly qualified nurses' experiences during transition to professional practice, and explore their and other key stakeholders' perceptions of nursing transition programmes. DESIGN:Scoping review using the Arksey and O'Malley framework. METHODS:Several electronic databases were searched for relevant articles, which were supplemented by hand-searching and internet searches for grey literature. 1823 potentially relevant articles published between 1974 and 2019 were retrieved from the initial search, and an additional ten articles were obtained from the supplemental search. Each article was independently reviewed, leaving 60 articles eligible for inclusion in the review. FINDINGS:Two overarching themes emerged: 1) the transition experience; 2) the perceived benefits of nursing transition programmes. Evidence that nursing transition programmes positively impact the transition experience is inconclusive. Some studies suggest a positive impact on newly qualified nurses' competency, level of confidence and attrition rates; others reported no impact. There was a general consensus that newly qualified nurses still encounter difficulties when transitioning into professional practice. Most articles found were quantitative in nature, focusing on measurable outcomes of nursing transition programmes. Few investigated the experiences and perceptions of newly qualified nurses, preceptors, and managers regarding the transition to professional practice. CONCLUSIONS:Literature mapping suggests that newly qualified nurses frequently struggle to successfully complete the transition into professional practice, and that this transition is complex and multifaceted. There is limited evidence to justify the widespread implementation of nursing transition programmes. Additional research focusing on experiences and perceptions of newly qualified nurses and their transitory process is warranted. Tweetable abstract: Are newly qualified nurses receiving sufficient transition support (e.g. #nursing residency programs or #preceptorship)? #Nurse #Nurses #nursing_intern.
10.1016/j.ijnurstu.2020.103792
New graduate registered nurses' experiences with psychological safety.
Lyman Bret,Gunn Margaret M,Mendon Camille R
Journal of nursing management
AIM:The purpose of this study was to gain insight into new graduate registered nurses' experiences with psychological safety. BACKGROUND:Organizational learning allows acute care hospitals to consistently provide high-quality patient care. Psychological safety is critical for organizational learning. New graduate nurses in particular need to feel psychologically safe as they transition into professional nursing practice. Understanding new graduate registered nurses' experiences of psychological safety can guide leaders and others to create work environments that foster psychological safety and organizational learning. METHOD:Semi-structured interviews were conducted with 13 newly graduated registered nurses working in inpatient hospital settings. Interviews were analyzed using thematic analysis. RESULTS:Four primary themes featured prominently in the new graduate nurses' experiences of psychological safety: building credibility, making personal connections, feeling supported and seeking safety. CONCLUSION:Understanding these themes will help nursing education programmes, nurse managers, nurse colleagues and new graduate registered nurses foster psychological safety and create environments conducive to organisational learning. IMPLICATIONS FOR NURSING MANAGEMENT:All members of the health care team involved in the new graduate registered nurses' transition to practice have a role in fostering psychological safety. Additional research is needed to better understand psychological safety and how to foster it.
10.1111/jonm.13006
Why nurses stay: Analysis of the registered nurse workforce and the relationship to work environments.
Reinhardt Anita C,León Teresa G,Amatya Anup
Applied nursing research : ANR
AIM:To examine how factors such as a sense of belonging to a nursing work group, work environmental characteristics, and workplace violence effects the duration of employment in professional settings in a southwest region of the United States. DESIGN:The descriptive correlational survey study conducted in 2014. METHODS:A random sample of 700 licensed registered nurses (RN) from a Board of Nursing's list of currently licensed RNs' (approximate n = 2300). Participants completed and returned four survey tools to the principal investigator. The return rate was 36.8% (258/700). RESULTS/FINDINGS:Analysis indicated that a sense of belonging, as well as supportive workplace characteristics, played a role in why nurses stay. The three survey tools provided strong correlations in the survey data and further authenticated the tools' reliability. A healthy work environment supports nurse retention. CONCLUSION:The three survey tools used in this study showed substantial and significant correlations. Although not all sub-scales correlated, those that did had strong Cronbach alpha scores. The weakest correlations were with the belongingness scale. Rapid turnover rates of nursing staff continue to plague healthcare organizations. A variety of reasons including difficult practice settings and stressful work environments contribute to the outflow of nurses. IMPACT:Health care administration and management leaders can improve retention via their efforts to continue to create and sustain healthy work environments that address affiliation, belongingness, and the characteristics that attract and retain nurses.
10.1016/j.apnr.2020.151316
Entrepreneurship and nurse entrepreneurs lead the way to the development of nurses' role and professional identity in clinical practice: A qualitative study.
Jakobsen Lizette,Wacher Qvistgaard Laura,Trettin Bettina,Juel Rothmann Mette
Journal of advanced nursing
AIMS AND OBJECTIVES:To explore the experiences and perspectives of nurses' transition into entrepreneurship in a clinical and cultural nursing setting and the impact of entrepreneurship on the nurses' role and professional identity. BACKGROUND:Entrepreneurship is a relatively unknown phenomenon in international nursing research, and the prevalence of entrepreneurial nurses is only 0.5-1% of all working nurses globally. Unfortunately, several barriers occur within the healthcare system and existing nursing culture that may affect the potential of bringing entrepreneurship into the nursing profession. DESIGN:The qualitative study used a phenomenological-hermeneutical approach based on an interpretative phenomenological analysis and COREQ-guided reporting. METHODS:Nine individual, semi-structured interviews were conducted face to face (n = 6) and by telephone (n = 3) with Danish nurse entrepreneurs between February and March 2019. RESULTS:The analysis revealed four themes: (a) prejudice towards entrepreneurship; (b) to become an entrepreneur in a nursing culture; (c) rebellion against the traditional role as employee and (d) challenged professional identity and new professional roles. CONCLUSION:Nurse entrepreneurs are caught between traditional and new ways of viewing nursing identity, norms, values and roles, and they face a conflict of professional values and a stereotyped view of 'real' nursing. Our findings show that entrepreneurship entails a huge learning process that develops nurses' ability to think outside the box in a broader health perspective and challenge the existing nursing culture and role. However, nurse entrepreneurs' ability to engage in entrepreneurship is compromised by professional values, the duty to behave as a good nurse and their own prejudices towards entrepreneurs. IMPACT:Entrepreneurship and nurse entrepreneurs pose a huge potential development of the nursing role and identity, as they challenge the current view on the nursing profession. This development is important for patients and health professionals, as future health challenges call for new ways of thinking and acting.
10.1111/jan.14950
Identifying the experiences of new graduate nurses during the transition period to practice as a professional nurse.
Journal of clinical nursing
AIMS AND OBJECTIVES:To assess the impact of orientation programmes on new graduate nurses' transition periods. BACKGROUND:The transition of graduate nurses from students to the practising professional nurse is often found to be stressful. DESIGN:The study has employed a descriptive correlational design. METHODS: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. RESULTS: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. CONCLUSION:The study implied instigation of the structured orientation programme to overcome the challenges faced by the new graduate nurses in their transition period. RELEVANCE TO CLINICAL PRACTICE: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.
10.1111/jocn.15344
The development and validation of the Clinical Teaching Behavior Inventory (CTBI-23): Nurse preceptors' and new graduate nurses' perceptions of precepting.
Lee-Hsieh Jane,O'Brien Anthony,Liu Chieh-Yu,Cheng Su-Fen,Lee Yea-Wen,Kao Yu-Hsiu
Nurse education today
BACKGROUND:Few studies have examined the perceptions of clinical teaching behaviors among both nurse preceptors and preceptees. PURPOSES:To develop a Clinical Teaching Behavior Inventory (CTBI) for nurse preceptors' self-evaluation, and for new graduate nurse preceptee evaluation of preceptor clinical teaching behaviors and to test the validity and reliability of the CTBI. METHODS:This study used mixed research techniques in five phases. Phase I: based on a literature review, the researchers developed an instrument to measure clinical teaching behaviors. Phase II: 17 focus group interviews were conducted with 63 preceptors and 24 new graduate nurses from five hospitals across Taiwan. Clinical teaching behavior themes were extracted from the focus group data and integrated into the domains and items of the CTBI. Phase III: two rounds of an expert Delphi study were conducted to determine the content validity of the instrument. Phase IV: a total of 290 nurse preceptors and 260 new graduate nurses were recruited voluntarily in the same five hospitals in Taiwan. Of these, 521 completed questionnaires to test the construct validity of CTBI by using confirmatory factory analysis. Phase V: the internal consistency and reliability of the instrument were tested. RESULTS:CTBI consists of 23 items in six domains: (1) 'Committing to Teaching'; (2) 'Building a Learning Atmosphere'; (3) 'Using Appropriate Teaching Strategies'; (4) 'Guiding Inter-professional Communication'; (5) 'Providing Feedback and Evaluation'; and (6) 'Showing Concern and Support'. The confirmatory factor analysis yielded a good fit and reliable scores for the CTBI-23 model. CONCLUSIONS:The CTBI-23 is a valid and reliable instrument for identifying the clinical teaching behaviors of a preceptor as perceived by preceptors and new graduate preceptees. The CTBI-23 depicts clinical teaching behaviors of nurse preceptors in Taiwan.
10.1016/j.nedt.2015.12.005
The Professional Behaviors New Nurses Need: Findings From a National Survey of Hospital Nurse Leaders.
Sortedahl Charlotte,Ellefson Shanna,Fotsch Danielle,Daley Katie
Nursing education perspectives
AIM:The purpose of this study was to survey hospital nurse leaders throughout the United States to determine which professional behaviors they believe are essential for nursing students to learn in the classroom. BACKGROUND:This study was part of a multiphase study. The survey was revised from a previous survey administered to nurse leaders in the Midwest. METHOD:Participants were surveyed using 46 items in the categories of Change, Communication, Conflict, Leadership, and Self-Awareness. RESULTS:The highest ranked category was Communication, followed by Self-Awareness, Change, Leadership, and Conflict. The highest rated items in each category were communication with patients, accept constructive criticism, manage change, prioritization, and conflict resolution techniques. CONCLUSION:Nurse educators and leaders can use the findings to continue to refine nursing education.
10.1097/01.NEP.0000000000000622
Patient-Nurse Ratio is Related to Nurses' Intention to Leave Their Job through Mediating Factors of Burnout and Job Dissatisfaction.
Chen Yi-Chuan,Guo Yue-Liang Leon,Chin Wei-Shan,Cheng Nai-Yun,Ho Jiune-Jye,Shiao Judith Shu-Chu
International journal of environmental research and public health
In healthcare settings, nurses' workload, burnout, and job satisfaction are associated to the patient-nurse ratio. Whether this ratio also affects their intention to leave the nursing profession, along with the underlying stress pathway, remains unclear. This study aimed to investigate the effects of the patient-nurse ratio on nurses' intention to leave and considering the mediating roles of burnout and job dissatisfaction. The study analyzed the data of two pooled cross-sectional surveys collected in 2013 and 2014. Measures were obtained by a structure questionnaire, which queried the average daily patient-nurse ratio (ADPNR), nurses' personal burnout, client-related burnout, job dissatisfaction, intention to leave, and other demographics. ADPNRs were standardized according to hospital levels. Multiple regression models examined mediation hypotheses, and a percentile bootstrap confidence interval was applied to determine the significance of indirect effects. A total of 1409 full-time registered nurses in medical and surgical wards of 24 secondary or tertiary hospitals in Taiwan completed self-administered questionnaires. Most of the participants were female (97.2%), and the mean age was 29.9 years. The association between the standardized ADPNR and intention to leave their job was significantly mediated by personal burnout, client-related burnout, and job dissatisfaction. Higher standardized ADPNRs predicted higher levels of personal burnout, client-related burnout, and job dissatisfaction, each of which resulted in higher levels of intention to leave the current job. The results highlight that appropriate patient-nurse ratio standards may be further discussed by selecting personal burnout, client-related burnout, and job dissatisfaction as indicators.
10.3390/ijerph16234801
Effects of the Nurse Athlete Program on the Healthy Lifestyle Behaviors, Physical Health, and Mental Well-being of New Graduate Nurses.
Hrabe David P,Melnyk Bernadette Mazurek,Buck Jacalyn,Sinnott Loraine T
Nursing administration quarterly
Recognizing that transition from nursing student to point-of-care nurse can be a stressful time period in one's career. A pilot study at a large Midwestern medical center tested the preliminary effects of a health-oriented workshop, the Nurse Athlete, on new graduate nurses' healthy lifestyle beliefs, healthy lifestyle behaviors, depressive and anxiety symptoms, as well as health outcomes. The Nurse Athlete workshop, provided in partnership with Johnson & Johnson's Human Performance Institute (HPI), used materials from HPI's Corporate Athlete program. The 2-day workshop focuses on energy management through a comprehensive examination of goals and values in relation to one's spiritual, mental, emotional, and physical development and provides practical strategies to improve self-care. Eighty-eight new graduate nurses hired at the university's medical center were offered the opportunity to participate in the Nurse Athlete program and associated study. Sixty-nine percent of these new graduate nurses (n = 61) consented and participated in the program. There was a statistically significant decrease in the participants' weight and body mass index from baseline to the 6-month follow-up assessment, which resulted in small to medium positive effects for the Nurse Athlete program. There was also a significant decrease in body fat percentage across time, resulting in a large positive intervention effect. Statistically significant reductions in depressive symptoms were measured between baseline and 6 months.
10.1097/NAQ.0000000000000258
Construction of a new model of job engagement, psychological empowerment and perceived work environment among Chinese registered nurses at four large university hospitals: implications for nurse managers seeking to enhance nursing retention and quality of care.
Fan Yuying,Zheng Qiulan,Liu Shiqing,Li Qiujie
Journal of nursing management
AIM:To explore the relationships among perceived work environment, psychological empowerment and job engagement of clinical nurses in Harbin, China. BACKGROUND:Previous studies have focused on organisational factors or nurses' personal characteristics contributing to job engagement. Limited studies have examined the effects of perceived work environment and psychological empowerment on job engagement among Chinese nurses. METHOD:A cross-sectional quantitative survey with 923 registered nurses at four large university hospitals in China was carried out. Research instruments included the Chinese versions of the perceived nurse work environment scale, the psychological empowerment scale and the job engagement scale. The relationships of the variables were tested using structural equation modelling. RESULTS:Structural equation modelling revealed a good fit of the model, χ(2) /df = 4.46, GFI = 0.936, CFI = 0.957. Perceived work environment was a significant positive direct predictor of psychological empowerment and job engagement. Psychological empowerment was a significant positive direct contributor to job engagement and had a mediating effect on the relationship between perceived work environment and job engagement. CONCLUSIONS:Perceived work environment may result in increased job engagement by facilitating the development of psychological empowerment. IMPLICATIONS FOR NURSING MANAGEMENT:For nurse managers wishing to increase nurse engagement and to achieve effective management, both perceived work environment and psychological empowerment are factors that need to be well controlled in the process of nurse administration.
10.1111/jonm.12369
What Do Nurses Need to Practice Effectively in the Hospital Environment? An Integrative Review With Implications for Nurse Leaders.
Worldviews on evidence-based nursing
BACKGROUND:When staffing legislation was introduced, New Jersey nurse leaders recognized from the research and their years of clinical leadership experience that the work environment is a multidimensional concept and that staffing is not the only variable related to nurse and patient outcomes. Thus, an understanding of what nurses need in their hospital environment to practice nursing effectively was sought. AIMS:The aim of this study was to examine the evidence regarding clinical nurses' perception of what they need to practice nursing effectively in the acute care hospital environment. METHODS:The following population, intervention, comparison, outcome question was used to search the literature databases PubMed, CINAHL, Johanna Briggs, and the Sigma Theta Tau Henderson Library: In the hospital environment what do nurses perceive as needed to practice nursing effectively? Specific search criteria and the Johns Hopkins nursing guidelines and tools were used to identify relative studies. RESULTS:The final review, which addressed what nurses in the hospital environment need to practice nursing effectively, included 25 articles: 20 were an evidence level III, and five were evidence level II. From this review, five key concepts were identified: Leadership, autonomy/decision making, respect/teamwork, resources/staffing, and organizational commitment to nursing. LINKING EVIDENCE TO ACTION:This integrative review, which explored nurses' perceptions of what is needed to provide effective quality care, identified that providing quality care is multifactorial in nature. Resources, including but not limited to staffing, and leadership were identified as important by nurses as a key factor in supporting quality care. Nurses must be provided with resources and infrastructure to do their jobs, in an environment supported by authentic transformational leadership.
10.1111/wvn.12401
Nurse Leaders' Assumptions and Attitudes Toward Residency Programs for New Graduate Nurses.
Nursing administration quarterly
The Future of Nursing Report from 2010 offered key recommendations for the practice of nursing, including the need for nurse residency programs for all new graduate nurses. Although numerous articles can be found about the programs themselves, finding information about the support of nurse leaders for such programs is more challenging. In the spring of 2019, a small group of invited nurse leaders from across the United States met during a "Think Tank." The purpose of this gathering was to discuss a policy brief offered by the American Academy of Nursing requiring all new graduate registered nurses to participate in a nurse residency program as part of their transition into practice. To determine nurse leaders' assumptions and attitudes toward nurse residency programs, the think tank planners conducted a national survey. Over 500 members of the American Organization for Nursing Leadership participated in this survey. In this article, the authors offer that nurse leaders are supportive of residency programs for new graduate nurses although some are still struggling with demonstrating the value proposition. In addition, nurse leaders are not in support of a national mandate.
10.1097/NAQ.0000000000000442
Transition experiences of nurses as students and new graduate nurses in a collaborative nurse residency program.
Wildermuth Melinda M,Weltin Ann,Simmons Andrea
Journal of professional nursing : official journal of the American Association of Colleges of Nursing
BACKGROUND:A small Midwestern college of nursing and an affiliate hospital partnered to design a nurse residency program where students are extended pre-hire job offers in a practice area of their choice and are then partnered with a preceptor who they will work with in a clinical immersion experience during the last semester of their nursing program and in their orientation period as new nurses. PURPOSE:The purpose of this qualitative, phenomenological study was to explore the lived experiences of a cohort of nurses as students and new graduate nurses during transition in this collaborative nurse residency program. METHOD:A transcendental phenomenological qualitative approach using Meleis' Transition Experience Theory as a theoretical framework is used for this study. RESULTS:Themes of feeling overwhelmed, supported, and confident were identified. A finding unique to the literature and this nurse residency program model is a theme of overwhelming support. CONCLUSIONS:This information can be used to improve the nurse residency program and its outcomes and also further the advancement of nursing knowledge of the transition experience of new nurses.
10.1016/j.profnurs.2019.06.006
Transitioning to practice in long-term care: New graduate nurses' experience of an accelerated transition to nurse leader.
Whitmore Carly,Kaasalainen Sharon,Ploeg Jenny,Baxter Pamela
Journal of advanced nursing
AIM:To describe the transition to practice experience of new graduate nurses in long-term care. BACKGROUND:Nursing is facing increasing pressures related to outpaced demands and a greater acuity of patients accessing services. Hiring new graduate nurses into long-term care (LTC) is a strategy to counteract these pressures, however, little is known about the transition experience of new graduate Registered and Licensed Practical Nurses in this setting. DESIGN:A qualitative, explanatory case-study design explored the transition to practice experience of seven new graduate nurses and the observations of two LTC directors from two homes. The study focused on the self-described transition to practice experience and those contextual factors present in LTC that influenced this experience. METHODS:Thematic analysis of semi-structured interview transcripts and key document review were completed in 2017. RESULTS:Results of this study introduced contextual factors that must be considered in LTC as each influences the transition to practice experienced by new graduate nurses. These factors included five processes that resulted in an accelerated transition to practice experience: (a) struggling to meet expectations; (b) practicing in isolation; (c) relying on others; (d) developing skill and confidence despite challenges; and (e) recognizing complexity and value in LTC practice. CONCLUSION:The findings from this study refute universally applied transition to practice theory and contribute new understanding of the experience of the new graduate nurses in LTC settings. This study reinforces the need for greater support for nursing graduates in LTC settings.
10.1111/jan.13945
Starting Out: qualitative perspectives of new graduate nurses and nurse leaders on transition to practice.
Regan Sandra,Wong Carol,Laschinger Heather K,Cummings Greta,Leiter Michael,MacPhee Maura,Rhéaume Ann,Ritchie Judith A,Wolff Angela C,Jeffs Lianne,Young-Ritchie Carol,Grinspun Doris,Gurnham Mary Ellen,Foster Barbara,Huckstep Sherri,Ruffolo Maurio,Shamian Judith,Burkoski Vanessa,Wood Kevin,Read Emily
Journal of nursing management
AIM:To describe new graduate nurses' transition experiences in Canadian healthcare settings by exploring the perspectives of new graduate nurses and nurse leaders in unit level roles. BACKGROUND:Supporting successful transition to practice is key to retaining new graduate nurses in the workforce and meeting future demand for healthcare services. METHOD:A descriptive qualitative study using inductive content analysis of focus group and interview data from 42 new graduate nurses and 28 nurse leaders from seven Canadian provinces. RESULTS:New graduate nurses and nurse leaders identified similar factors that facilitate the transition to practice including formal orientation programmes, unit cultures that encourage constructive feedback and supportive mentors. Impediments including unanticipated changes to orientation length, inadequate staffing, uncivil unit cultures and heavy workloads. CONCLUSIONS:The results show that new graduate nurses need access to transition support and resources and that nurse leaders often face organisational constraints in being able to support new graduate nurses. IMPLICATIONS FOR NURSING MANAGEMENT:Organisations should ensure that nurse leaders have the resources they need to support the positive transition of new graduate nurses including adequate staffing and realistic workloads for both experienced and new nurses. Nurse leaders should work to create unit cultures that foster learning by encouraging new graduate nurses to ask questions and seek feedback without fear of criticism or incivility.
10.1111/jonm.12456
Cultural competence among pre-graduate nursing students, new graduate nurses, nurse mentors, and registered nurses: A comparative descriptive study.
Lin Hui-Ling,Guo Jong-Long,Chen Hsiao-Jung,Liao Li-Ling,Chang Li-Chun
Nurse education today
BACKGROUND:Achieving and improving cultural competence in nursing is an ongoing process, beginning in the student period and continuing through the professional career. OBJECTIVES:The present study aims to compare pre-graduate students, newly graduated nurses, registered nurses, and nurse mentors in Taiwan in terms of their respective levels of cultural competence, and to determine associated influencing factors. DESIGN:A comparative cross-sectional study. SETTINGS:Three universities and three hospitals (one regional hospital and two teaching hospitals) in Taiwan. PARTICIPANTS:A total of 756 nurses/students (103 pre-graduate nurses, 321 newly graduated nurses, 101 registered nurses, and 231 nurse mentors). METHODS:The Cultural Competence Scale for Pre-Graduated Students to Licensed Professionals was used to measure the cultural competence level. One-way analysis of variance and hierarchical regression analysis were used for statistical analysis. RESULTS:For overall cultural competence and the subscales of knowledge, awareness, and skills, the pre-graduate students scored lower than the other three groups. Experience of caring for patients from diverse cultures and countries significantly influenced the cultural competence of all four groups. Ability to speak fluent English and receiving cultural competence education during nursing education only significantly influenced the cultural competence of the pre-graduate and new graduate nurses. Current job position and primary practice setting significantly influenced the cultural competence of the registered nurses and nurse mentors. CONCLUSION:Pre-graduate students, newly graduated nurses, registered nurses, and nurse mentors have differing levels of cultural competence and differing influencing factors. Cultural competence education that accords with the influencing factors for each nursing position would continuously cultivate nursing staff's cultural competence.
10.1016/j.nedt.2020.104701