A Process of Becoming: The Stages of New Nursing Graduate Professional Role Transition

Abstract

Newly graduated nurses are entering the work force and finding that they have neither the practice expertise nor the confidence to navigate what has become a highly dynamic and intense clinical environment burdened by escalating levels of patient acuity and nursing workload. This research used qualitative methods to build on and mature aspects of the new nurse's transition experience into acute care. The theory of transition presented in this article incorporates a journey of becoming where new nursing graduates progressed through the stages of doing, being, and knowing. The whole of this journey encompassed ordered processes that included anticipating, learning, performing, concealing, adjusting, questioning, revealing, separating, rediscovering, exploring, and engaging. Although this journey was by no means linear or prescriptive nor always strictly progressive, it was evolutionary and ultimately transformative for all participants. The intense and dynamic transition experience for these newly graduated nurses should inspire educational and service institutions to provide preparatory education on transition as well as extended, sequential, and structured orientation and mentoring programs that bridge senior students' expectations of professional work life with the reality of employment.

Perceptions of Professional Practice and Work Environment of New Graduates in a Nurse Residency Program

“…The six month decline in job satisfaction, organizational commitment, and clinical decision-making are consistent with findings in the literature (Altier & Krsek, 2006;Duchscher, 2008;Casey, Fink, Krugman & Propst, 2004;Goode, et al, 2009;Krugman et al, 2006). In particular, Casey et al (2004) found that the most difficult role adjustment time was between six to twelve months after hire.…”

“…This may reflect that new graduates are still in the shock phase and grappling with their professional role transition and have yet to enter the resolution and recovery phases as identified by Kramer (1974) and Duchscher (2008). However, significant increases from midpoint to program end does lend support for the value of residency programs since it may demonstrate the influence of the program to expedite the new graduates' recovery of disillusionment and questioning that occurs in this middle phase of the transition experience.…”

“…New nurses' high stress levels and their inexperience make them especially prone to error and turnover (Duchscher, 2008;Duchscher & Cowin, 2004;Smith, 2003), thus exacerbating safety concerns on the patient care unit. Moreover, high numbers of inexperienced staff has been identified as another contributing factor of nurse turnover which also negatively influences patient health outcomes and safety (Beecroft, Dorey & Wenten, 2007;Del Bueno, 2005;Orsolini-Hain & Malone, 2007).…”

‘Ready to hit the ground running’: Alumni and employer accounts of a unique part-time distance learning pre-registration nurse education programme

“…They expressed feeling overwhelmed and, in many instances, ill-prepared to move to NQN roles. Increasing research interest in this transition to NQN in general has led to the development of theoretical frameworks to better understand the nature of the transition (see for example, Duchscher, 2008Duchscher, , 2009. However, there is comparatively little evidence concerning the impact of previous employment as a HCSW on this transition.…”

ToUCH Program on competence, occupational stress and self-efficacy of newly graduated registered nurses in United Christian Hospital: A mixed method research study

“…[13] Affection Facing life and death situation of critical ill patient, interpersonal relationship with paramedical staff, and adapting to hierarchical nursing culture are some significant challenges which lead to psychological burden on new graduates. [14] Therefore two identical sessions of 'principles and application of self-help, cognitive-behavioral therapy and mindfulness-based wellness resilience' are arranged to promote self-awareness, self-compassion, healthier life with more adaptive lives, and awareness of dysfunctional thoughts and cognition, by applying basic cognitive therapy techniques to alleviate psychological distress. In addition, life and death education is also offered to strengthen skills in handling life-and-death situations.…”