‘They survive despite the organizational culture, not because of it’: A longitudinal study of new staff perceptions of what constitutes support during the transition to an acute tertiary facility

Abstract

Increasing difficulties of recruitment and retention of nursing staff strongly indicate that organizations should identify factors that contribute to successful transition of new staff to the workplace. Although many studies have identified problems facing new staff, fewer studies have articulated best practices. The purpose of this longitudinal study was to ascertain what new staff perceived as supportive elements implemented by the organization to assist their integration. Sixteen staff in Phase I and 12 staff in Phase II attended focus groups. The focus groups at 2-3 months provided specific information, with particular emphasis on negative interactions with other staff members and inadequate learning assistance and support. Different themes emerged within the focus groups at 6-9 months. Staff discussed being 'self-reliant' and 'getting to know the system'. Participants indicated that these skills might be beneficial to new staff in the development of organizational 'know how' and resourcefulness, rather than relying on preceptor support that, unfortunately, cannot be always guaranteed.

Preparing nurses for practice: A phenomenological study of the new graduate in Australia

“…Survival in the 'deep end' requires that the new nurse identify the 'goodies from the baddies' (Fox et al 2005). Despite literature declaring the custom of 'throwing new graduates in at the deep end' as being unrealistic and ineffective, the data suggests that the practice continues to be reinforced in nursing (Maben & Clark 1998, Gerrish 2000, Amos 2001, De Bellis et al 2001.…”

Assisting nurses to facilitate student and new graduate learning in practice settings: What ‘support’ do nurses at the bedside need?

“…Subsequent to this, in the 1990s, roles around supporting learners have been more extensively reported (Saarikoski et al, 2007). However, despite the discussions around how nurses can support learners, studies indicate that they do not always readily engage in behaviours that facilitate integration of the learner nor do they provide effective feedback for continuing development of the learner (Fox et al, 2005;Hamshire et al, 2012). Such findings indicate that insufficient provision has been made for behaviours that are crucial to maximising learning, to routinely be incorporated into practice.…”

“…For example, if continuity of nurse-new graduate, or nurse-student is desired, as is the case with preceptoring and mentoring then rostering needs to be considered to ensure shifts are the same, and commenced at the best time for handover and receiving of information (Fox et al, 2005). Work allocation also needs to be planned to ensure the nature of the work, where appropriate, can be easily observed and the learner can safely constructively participate in care delivery.…”

“…Preceptorship is considered a transition phase for newly registered nurses to build their confidence and further develop competence to practice (Department of Health, UK2010). Preceptorship, the formal process where learners acquire one-to-one experience with rolemodels who also assess their progress, is common place in Australia for new graduates (Fox et al, 2005); and routinely used in the United States to supervise nursing students during their clinical experience (Myrick et al, 2010). For students in Australia, it is largely nurses at the bedside, often referred to as 'buddy' nurses, responsible for guiding their learning [Generally these nurses are supervised by clinical facilitators regarding the students specific needs] (Brammer, 2006;Dickson et al, 2006;Henderson and Tyler, 2011).…”

‘What matters to graduates’: An evaluation of a structured clinical support program for newly graduated nurses

“…One study reported that while most respondents had been allocated mentors less than half were satisfied with their relationships and approximately one-third responded that they were dissatisfied (Parker et al, 2013). Reasons for the preceptorship not working include: attitudes of preceptors; preceptorepreceptee not being rostered together, inappropriate skill mix such that the preceptor is a team leader or managing other junior staff, inappropriate RN being allocated to precept or preceptor's misunderstanding of the role they have been asked to fulfil (Cubit and Ryan, 2011;Henderson and Eaton, 2013;Fox et al, 2005;Johnstone et al, 2008).…”