On the difficulty of finding one’s place: A qualitative study of new nurses’ processes of growth in the workplace

Abstract

Aims and objective To explore new nurses’ processes of growth in the workplace in order to understand the challenges they face. Background Quantitative and qualitative research to date has not adequately explored the complex ways in which initial work experiences may shape new nurses’ very high quit rate and, consequently, impact the long‐term nursing shortage in Taiwan. Design/Methods We conducted in‐depth interviews with new nurses to explore their professional development, including the challenges they faced, and their feelings about staying or quitting. Twenty newly registered nurses who had worked in a hospital setting full‐time for a year or less in two southern Taiwan medical centres were interviewed. Data were collected from March–November 2016. EQUATOR guidelines were followed, using the COREQ checklist. Results Interview transcripts were analysed and coded; three stages of growth were discovered: Feeling disillusioned and shocked, Gaining experiential knowledge and Making a place for oneself. Most nurses (n = 18/20) went through these three stages within 9 months and continued to work in nursing at follow‐up 2 years later. Conclusions Job continuity was contingent upon new nurses’ enduring a painful process of adjustment in the first two stages when new nurses were unsure of themselves and their interactions with preceptors were wrought with social tensions. New nurse development and retention efforts should make explicit the possibility of these tensions and how to deal with them. Relevance to clinical practice A better understanding of new nurses’ growth processes and adjustment pains can help refocus professional development and retention efforts towards how new nurses can succeed in finding a place for themselves.

New Nurses’ Work Adaptation Experience

“…The participants experienced psychological conflicts arising from stress and tension due to their inexperience and confusion, which was caused by the gap between the theories they learned in school and in-hospital clinical practice. Our findings were consistent with previous studies showing that new nurses experience disillusionment and shock as they face role conflicts because of the gap between the expectations and realities of their work [20]. In other countries, a substantial orientation period is considered important for facilitating new nurses' smooth adaptation to their work environment [21,22].…”

“…These findings are in line with the results of previous studies that suggest that self-confidence and work satisfaction decrease in new nurses [24,25] because of frequent work-related mistakes [26,27]. Moreover, a negative relationship with senior nurses, upon whom they are reliant, imparts a sense of betrayal, leading to feelings of hatred and sadness [20]. Therefore, it is understandable that Cheng et al [4] reported that new nurses with three to six months of work experience have a high intention of changing careers.…”

Developing and validating the transition status scale for newly graduated nurses in China

“…Better evaluation of transition will contribute to better support for the new nurses and promote their professional confidence and competence (Hussein et al., 2017). However, the existing tools are neither sufficient nor convenient when evaluating the transition process (Cline et al., 2017; Ke & Stocker, 2019). The Transition Status Scale for Newly Graduated Nurses is newly developed to enrich and facilitate the accurate assessment of the transition status.…”

Perceptions of managers regarding prerequisites for the development of professional competence of newly graduated nurses: A qualitative study

“…Healthcare settings face challenges regarding recruitment and retention of nurses from an international perspective (Ahlstedt et al, 2019;Cummings et al, 2010;Ke & Stocker, 2019;Rudman et al, 2014), and residency programmes have emerged as an intervention to support newly graduated nurses (henceforth referred to as nurses) in their transition to professional nurses (Beecroft et al, 2001;Olson-Sitki et al, 2012). However, oriented and supportive structures have a wide variation for nurses entering healthcare organisations (Kovner et al, 2007).…”