Transition shock: the initial stage of role adaptation for newly graduated Registered Nurses

Readiness to Practice in Health Care: An Empirical Definition Based on a Content Analysis of the Literature

BACKGROUND

Health care services require practitioners to be ready to practice (R2P), but evidence shows new graduates vary in R2P. Unfortunately, there is a lack of clarity about what R2P entails.

METHOD

A content analysis of the empirical literature (Gaur & Kumar, 2018) was used to quantify the elements and higher-order categories of R2P.

RESULTS

Across 108 articles, professional development activities, communication, previous experience, confidence, clinical skills, patient-centered care, integration of knowledge, teamwork, competency, management, and interpersonal skills were used to define R2P at least 25% of the time. We identified seven domains of R2P: clinical experience, social experiences, professional development experiences, personal attributes, cognitive aspects, onboarding experiences, and educational experiences.

CONCLUSION

Our study empirically defined what is associated with health professionals who were perceived as or perceived themselves as R2P in health care. Our results inform training, preparation, research, and the transition from medical training to the workplace. [J Contin Educ Nurs. 2023;54(7):302-312.].

Exploring nursing students' perceptions from nursing role function (SP-NRF) during the COVID-19 pandemic in Ardabil Province: a cross sectional study from Iran

BACKGROUND

Perception of nursing roles among nursing students significantly influences their active engagement in nursing processes and care delivery. However, there is evidence to suggest that students' interest in and perceptions from the nursing profession at the undergraduate level are often insufficient.

OBJECTIVE

This study aimed to assess nursing students' perceptions of nursing role function and identify areas that require improvement.

METHODS

A cross-sectional study was conducted in 2021 among nursing students in the third- and fourth-years from three faculties in the Ardabil Province. The participants were selected through census sampling. The data were collected through interviews with the Standardized Professional Nursing Role Function (SP-NRF) questionnaire. Statistical analysis was performed using the SPSS-18 software at a significance level of less than 0.05.

RESULTS

A total of 320 nursing students participated in this study. The mean score for nursing role perception was 223.1 ± 20.3 out of 255. The results indicated significant gender differences in the mean scores of perception of the nursing role function, particularly in the supportive, professional-moral care, and professional-educational dimensions. Women scored significantly higher than men did (P < .05). Additionally, students who obtained a mean score of 19 to 20 (A) had significantly higher total scores in perception of the nursing role function than other students. Furthermore, a positive correlation was observed between students' interest in nursing and their perceived ability with nursing role perception (r = .282, P < .01) and all its dimensions.

CONCLUSION

Overall, nursing students demonstrated a favorable perception of nursing role function. However, their perception of mental and spiritual care was relatively weak. These findings highlight the need to review nursing education programs and incorporate the spiritual care dimension to enhance students' understanding of and preparation for their role as nurses.

The experience of resilience in newly graduated nurses: A qualitative metasynthesis

AIM

The aim of the present study was to understand the experiences and perceptions of newly graduated nurses in relation to resilience by providing an interpretive synthesis of the existing qualitative literature on this topic.

BACKGROUND

Resilience in newly graduated nurses has been associated with increased satisfaction and decreased turnover. As the experience of resilience is unique to each individual, qualitative studies are well suited to explore this concept, yet the existing data is heterogenous.

DESIGN

A qualitative metasynthesis was conducted using a meta-ethnographic approach.

METHODS

The search was performed using PubMed, CINAHL, Embase, PsycINFO, ProQuest Dissertations and Theses Global for the English literature and NDSL, KCI, RISS, KISS and DBpia for the Korean literature. The JBI Critical Appraisal Checklist for Qualitative Research was used to assess the quality of studies. An a priori protocol was created and registered on the Open Science Framework (Randall & De Gagne, 2022).

RESULTS

The final review included seven articles published between 2008 and 2021. Three main themes were identified: (1) internal experience of resilience; (2) external sources of resilience; and (3) building resilience over time. Subthemes were also identified.

CONCLUSIONS

This study indicates that resilience can be developed over time during the period of transition from student nurse to professional nurse and is impacted by personal and organizational influences. The promotion of resilience presents considerations and opportunities for health care leaders and administrators.

The mediating effect of clinical teaching behavior on transition shock and career identity among new nurses: A cross-sectional study

BACKGROUND

New nurse attrition is a worldwide problem. Because of the gap between theory and practice in their work, new nurses may experience transition shock, which can have a negative impact on their career identity. Clinical teaching behavior is an important component in reducing the impact of new nurse transition, stabilizing the hospital nursing workforce, and cultivating high-quality nursing talents.

OBJECTIVES

Based on the New Nurse Transition Model, to explore the mediating role of clinical teaching behavior in the relationship between transition shock and career identity in the new nurse population of Gansu Province.

DESIGN

A cross-sectional study.

SETTING

Seventeen hospitals in Gansu province of China.

PARTICIPANTS

A total of 1684 new nurses (1590 female and 94 male) were recruited from seventeen hospitals in Gansu province.

METHODS

Three questionnaires include: The Clinical Teaching Behavior Inventory (CTBI-23), the Transition shock of Newly Graduated Nurses Scale (TSNGNS), and the Nurse's Career Identity Scale (NCIS). Structural equation modeling was used to deal with the relationships among clinical teaching behavior, transition shock, and career identity.

RESULTS

Transition shock was found to be negatively related to both career identity and clinical teaching behavior, with clinical teaching behavior mediates the relationship between transition shock and career identity.

CONCLUSIONS

The clinical teaching behavior of the teaching staff plays a role in mediating the relationship between new nurses' sense of career identity and transition shock. Accordingly, the teaching behavior of clinical teaching should be improved and the quality of clinical teaching behavior should be improved to increase the career identity of new nurses and reduce the turnover rate of new nurses.

Crossing the 'flaky bridge' - the initial transitory experiences of qualifying as a paramedic: a mixed-methods study

Introduction

Newly qualified paramedics (NQPs) may experience emotional turbulence as they transition to professional practice. This may negatively affect confidence and have an adverse effect on attrition. This study highlights the initial transitory experiences of NQPs.

Methods

The study utilised a mixed-methods convergent design. Qualitative and quantitative data were collected simultaneously and triangulated to more fully interpret participants' experiences. A convenience sample of 18 NQPs from one ambulance trust was used. The Connor-Davidson Resilience 25-point Scale questionnaire (CD-RISC25) was administered and analysed using descriptive statistics. Semi-structured interviews were conducted simultaneously and analysed using Charmaz's constructivist grounded theory approach. Data were collected from September to December 2018.

Results

There was a range of resilience scores, with a mean of 74.7/100 (standard deviation 9.6). Factors relating to social support were scored highly, and factors relating to determinism and spirituality were scored lower. Qualitative data constructed a process whereby participants were navigating a new identity across three spheres simultaneously: professional, social and personal identity. Attending a catalyst event such as a cardiac arrest was a trigger for starting to navigate this process. Participants had different pathways through this transitional period. Participants who found this process particularly turbulent seemed to have lower resilience scores.

Conclusion

The transition from student to NQP is an emotionally turbulent time. Navigating a changing identity seems to be at the centre of this turbulence, and this is triggered by a catalyst event such as attending a cardiac arrest. Interventions which support the NQP in navigating this change in identity, such as group supervision, may improve resilience and self-efficacy and reduce attrition.

The well-being of young leaders: demands and resources from a lifespan perspective

Building on the job demand resources (JD-R) model, we examined the experience of work environment and well-being among young leaders in a two-wave survey study of 1,033 leaders within the private sector in Sweden. Our results reveal that young leaders report higher levels of burnout and lower rates of vigor compared to older colleagues. Further, they appraise demand and resources differently, perceiving higher emotional demands and less organizational support, and they seem to struggle with the leader role, seeing it as unclear and conflicting. Our findings underline the necessity of viewing the leader role from a lifespan perspective as well as considering age-specific aspects in the JD-R model. In practice, we urge organizations to improve prerequisites for young leaders by providing support and role clarifications to prevent impaired well-being and improve retention. By bringing leadership and lifespan studies together, we aim for a better understanding of what specific prerequisites young leaders need to thrive in the leader role thus showing how age matters and bring the field of research forward.

Perceptions of being a registered nurse (PRN): development and validation of a survey tool

BACKGROUND

Nursing students enter nursing programs with idealistic perceptions of what it is to be a nurse. Upon graduation, many find these perceptions mismatched with the actual nurse's role. This can lead to discontentment in their chosen career. These issues highlight the importance of nursing students developing an understanding of the nurse's role during their undergraduate nursing education. One way to accomplish this is to assess perceptions and address them accordingly during the nursing program. Survey tools assessing perceptions of nursing exist but lack contemporary and multicultural foci.

AIM

To develop a feasible, valid, and reliable survey tool to identify nursing students' perceptions of being a nurse.

DESIGN/METHODS

In Phase 1, a literature review and Nominal Group Technique meetings were used to generate primary survey items. Phase 2 included a pre-pilot and online pilot testing of the Perceptions of being a Registered Nurse (PRN) survey tool with 797 nursing students across all year levels at three Australian Universities.

RESULTS

The 34-item PRN survey tool uses a five-point Likert scale to measure nursing students' perceptions of nursing, including factors influencing a nurse's well-being, attributes and qualities of nurses, the role of the nurse, and nursing professionalism. The Item-Content validity index was high (> 0.78), and the inter-item correlation validity was identified by Pearson's product-moment coefficient of r = .712. Internal reliability was confirmed with a Cronbach's alpha = 0.83. Based upon the participation completion rate, the survey tool was deemed applicable and feasible. The majority of respondents believed that nurses have altruistic attributes; however, perceptions of nursing varied significantly when rating factors influencing the physical, emotional, and social well-being of a nurse. In later stages of training, respondents were more likely to agree that nursing is physically and emotionally demanding and that nurses experience social isolation due to shift work, finding it difficult to achieve a work-life balance.

CONCLUSIONS

The PRN survey tool was found to be valid, reliable, and feasible. Future use and outcomes from PRN assessments may lead to changes to nursing curricula that enhance nursing students' perceptions of nursing.

Factors related to readiness for practice among undergraduate nursing students: A systematic review

AIM

This systematic review identifies the factors and effective strategies related to nursing students' readiness for practice.

METHOD

A search was conducted from 2012 to 2022 in PubMed, CINAHL, SCOPUS, PsycInfo and EMBASE databases, using a combination of predetermined keywords. Four authors made the selection independently and the methodological quality was assessed using the RoBANS, Analytical cross-sectional studies Critical Appraisal Tool and MMAT tools. Information was extracted using a matrix and analyzed through the thematic synthesis approach.

RESULT

Studies (14,000) were identified from the search and 11 met the predetermined inclusion criteria. The main identified themes were personal characteristics, education-related factors, cognitive factors, psychological characteristics and social factors influencing readiness to practice. Some barriers also affect readiness for practice among undergraduate nursing students.

CONCLUSION

Multiple personal, educational and community factors interact in diverse ways to influences nursing students readiness to practice.

REGISTRATION

The protocol for the conduct of this study was registered on the International Prospective Register of Systematic Reviews (PROSPERO) with the registration number CRD42020222337.

Success factors in adaptation of newly graduated nurses: a scoping review

BACKGROUND

Difficulties in adapting to the workplace can affect newly graduated nurses' transition. Such nurses must adapt quickly, as it can affect their future career prospects. Therefore, this review aimed to identify the success factors that promote newly graduated nurses' effective transition and adaptation.

METHODS

The Joanna Briggs Institute scoping reviews methodology was used. Data were extracted from MEDLINE, Scopus, EBSCOhost, and Web of Science publications published between 2011 and 2020. A total of 23 articles were included in this review, which comprised qualitative, quantitative, and mixed methods primary research studies focusing on the contributing factors that aided newly graduated nurses' adaptation to the work environment during their transition period. Key emerging themes were identified with thematic analysis.

RESULTS

Three main themes were identified: (1) organisational contribution (social development, organisational culture, work characteristics, work readiness, work commitment, professional role), (2) personality traits (self-embodiment, personality masking, being proactive and confident), and (3) academic institutions (pre-entry knowledge and role of nursing faculty). Newly graduated nurses' adaptation should begin during nursing education, be supported by the workplace organisation, and driven by the nurse's personality. We determined that that the role of nursing education in aiding the provision of the required knowledge and actual clinical experiences to students profoundly affected developing nurses' self-confidence levels in delivering nursing care effectively. Additionally, a warm environment supported nurses emotionally and physically.

CONCLUSIONS

While organisations and educational institutions have undertaken numerous efforts to ensure that newly graduated nurses are adequately supported, the nurse's personality and values are also equally important to ease adaptation during the transition process. Academic and workplace programs designed for newly graduated nurses should apply and emphasise this knowledge to develop and strengthen their personalities and values, especially to increase confidence and promote proactive values that facilitate newly graduated nurses' rapid and effective adaptation to their new employment.

Factors Related to Clinical Competence among Graduating Nursing Students during the COVID-19 Pandemic: A Cross-Sectional Study

PURPOSE

This study investigated clinical competency, COVID-19-related anxiety, coping strategies, self-efficacy, and perceived stress among graduating nursing students during the COVID-19 pandemic.

METHODS

We conducted a cross-sectional survey. Participants were recruited from universities located in four major cities in South Korea. General demographic information, clinical competency, self-efficacy, perceived stress, COVID-19-related anxiety, and coping strategies were assessed using reliable questionnaires. Descriptive statistics, correlations, and multiple regression tests were used to analyze the data.

RESULTS

The mean clinical competency, self-efficacy, perceived stress, adaptive coping, and maladaptive coping were 138.16 ± 18.34, 83.85 ±14.02, 21.37 ± 5.79, 53.15 ± 4.64, and 30.98 ± 6.73, respectively. COVID-19-related anxiety was reported by 4.3% of participants. Clinical competency was significantly positively correlated with self-efficacy (r = .44, p < .001) and adaptive coping (r = .20, p = .035) and was significantly negatively correlated with maladaptive coping (r = .20, p = .035). The predictors of clinical competency were self-efficacy (β = .434, p < .001) and adaptive coping (β = .173, p < .039), which explained 23% of the variance in clinical competency.

CONCLUSION

Self-efficacy and adaptive coping strategies are significant predictors of clinical competence during the pandemic. Planning and implementing various curricular and non-curricular activities to increase senior students' self-efficacy and adaptive coping strategies will help prepare competent nursing graduates for the pandemic when they enter the nursing workforce.

Effectiveness of transition programs on new graduate nurses' clinical competence, job satisfaction and perceptions of support: A mixed-methods study

AIM

To assess the effectiveness of two graduate nurse programs on new graduate nurses' overall competence at 3, 6, 9 and 12 months. Secondary aims were to assess new nurses' job satisfaction at 12 months and explore their experiences of support.

BACKGROUND

Most clinical settings have implemented transition programs to help new nurses to adapt to their new environments and expand their competences. To this day, very few studies have assessed the effectiveness of these programs.

DESIGN

Longitudinal mixed-methods study.

METHODS

The study was conducted at two teaching hospitals in Australia. New nurses were recruited during orientation. Data were collected at baseline (T0; n = 88), 3 (T1; n = 29), 6 (T2; n = 15), 9 (T3; n = 11) and 12 months (T4; n = 9). At each time point, the questionnaire included demographic and the Nurse Competence Scale. At T4, the questionnaire also included the Nurse Satisfaction Scale. Semi-structured interviews were conducted from T1 to T4. This study conforms to the STROBE guidelines.

RESULTS

Competence increased significantly at T1, with participants stating that they learned by "getting out" of student mode. At T2, despite no significant difference in competence, participants expressed they were more confident and in control, because they felt supported. Again, at T3, there was no significant increase in competence. Finally, at T4, competence increased significantly, with participants acknowledging that they still had a lot to learn.

CONCLUSION

This study supports that 12-month transition programs are necessary for NGNs to expand their competence. One major factor influencing NGNs during their first year was how well they felt supported and encouraged to seek help when they needed it.

RELEVANCE

There is a need to understand how new NGNs enrolled in transition programs expand their competences. Their professional development depends on a supportive environment where NGNs feel confident in asking questions or for help.

College students' perceptions of anticipated career burnout

Objective: Although burnout has been studied in-depth among working professionals, less is known about college students' perceptions of burnout in their future careers. In this study, we explored the prevalence and correlates of anticipated career burnout and engagement among students. Participants: Participants were 351 undergraduate students. Methods: Students completed an online survey. Results: Students planning to enter both helping and non-helping professions were worried about burnout in their chosen careers. They expected more burnout and less engagement 10 years into their career when compared to two or three years. However, students who perceived their future work as a good fit to their personal skills and abilities expected less burnout and more engagement. Conclusions: These findings can be applied to career assessment and planning so that students are able to move into careers that align with their goals, career orientation, and expectations to maximize their experience of engagement in their future work.

Impact of the COVID pandemic on mental health and training opportunities of Public Health Residents from 4 European countries: A cross-sectional study

Objectives

There is little evidence on the impact of the COVID-19 pandemic on Public Health Residents' (PHR) mental health (MH). This study aims at assessing prevalence and risk factors for depression, anxiety and stress in European PHR during the COVID-19 pandemic.

Methods

Between March and April 2021, an online survey was administered to PHR from France, Italy, Portugal and Spain. The survey assessed COVID-19 related changes in working conditions, training opportunities and evaluated MH outcomes using the Depression Anxiety Stress Scales-21. Multivariable logistic regressions were applied to identify risk factors.

Results

Among the 443 respondents, many showed symptoms of depression (60.5%), anxiety (43.1%) and stress (61.2%). The main outcome predictors were: female gender for depression (adjOR = 1.59, 95%CI [1.05-2.42]), anxiety (adjOR = 2.03, 95%CI [1.33-3.08]), and stress (adjOR = 2.35, 95%CI [1.53-3.61]); loss of research opportunities for anxiety (adjOR = 1.94, 95%CI [1.28-2.93]) and stress (adjOR = 1.98, 95%CI [1.26-3.11]); and COVID-19 impact on training (adjOR = 1.78, 95%CI [1.12-2.80]) for depression.

Conclusions

The pandemic had a significant impact on PHR in terms of depression, anxiety and stress, especially for women and who lost work-related opportunities. Training programs should offer PHR appropriate MH support and training opportunities.

New Graduate Nurses Navigating Entry to Practice in the Covid-19 Pandemic

BACKGROUND

The Covid-19 pandemic has significantly impacted organizational life for nurses, with known physical and psychological impacts. New graduate nurses are a subset of nurses with unique needs and challenges as they transition into their registered nurse roles. However, this subset of nurses has yet to be explored in the context of the Covid-19 pandemic.

PURPOSE

To explore the experiences of new graduate nurses entering the profession in Ontario, Canada, during the Covid-19 pandemic approximately one year after entering the profession.

METHODS

Thorne's interpretive description method was utilized.

FINDINGS

All participants identified as completing second entry nursing programs, offering a unique perspective on new graduate nurse transition. Four themes emerged in the data: 'Virtual Didn't Cut It,' 'Go Where You Know,' 'Picking Up the Pieces,' and 'Learning When to Say No and Let Go.' Participants felt ill prepared to enter the profession and were cognizant of the various challenges facing the nursing profession, and how these pre-existing challenges were exacerbated by the pandemic. They acknowledged the need to protect themselves against burnout and poor mental health, and as such, made calculated early career decisions - demonstrating strong socio-political knowing. Half of the participants had already left their first nursing job; citing unmet orientation, mental health, and wellbeing needs. However, all participants were steadfast in remaining in the nursing profession.

CONCLUSIONS

Second entry new graduate nurses remain a unique subset of nurses that require more scholarly attention as their transition experiences may differ from the traditional trajectory of new graduate nurses.

Impact of the COVID-19 Pandemic on Nurses Working in Intensive Care Units: A Scoping Review

BACKGROUND

The COVID-19 pandemic resulted in significant system strain, requiring rapid redeployment of nurses to intensive care units. Little is known about the impact of the COVID-19 pandemic and surge models on nurses.

OBJECTIVE

To identify the impact of the COVID-19 pandemic on nurses working in intensive care units.

METHODS

A scoping review was performed. Articles were excluded if they concerned nurses who were not caring for critically ill adult patients with COVID-19, did not describe impact on nurses, or solely examined workload or expansion of pediatric intensive care units.

RESULTS

This search identified 417 unique records, of which 55 met inclusion criteria (37 peer-reviewed and 18 grey literature sources). Within the peer-reviewed literature, 42.7% of participants were identified as intensive care unit nurses, 0.65% as redeployed nurses, and 72.4% as women. The predominant finding was the prevalence of negative psychological impacts on nurses, including stress, distress, anxiety, depression, fear, posttraumatic stress disorder, and burnout. Women and members of ethnic minority groups were at higher risk of experiencing negative consequences. Common qualitative themes included the presence of novel changes, negative impacts, and mitigators of harm during the pandemic.

CONCLUSIONS

Nurses working in intensive care units during the COVID-19 pandemic experienced adverse psychological outcomes, with unique stressors and challenges observed among both permanent intensive care unit and redeployed nurses. Further research is required to understand the impact of these outcomes over the full duration of the pandemic, among at-risk groups, and within the context of redeployment roles.

Endured and prevailed: a phenomenological study of doctors' first year of clinical practice

CONTEXT

The challenging nature of the transition from medical student to doctor is highlighted by the associated negative consequences to new doctors' mental health and wellbeing. Enhanced understanding of the lived experience of recent medical graduates as they move through the stages of transition over the first year of practice can inform interventions to ease the difficulties encountered.

METHODS

Using interpretative phenomenological analysis (IPA), a novel approach to this topic, we explored the lived experience of transition from student to doctor over the first year of practice after graduation. Twelve new graduates were purposively recruited. We conducted semi-structured interviews at the end of their first year of practice with respect to their experience over the first year.

RESULTS

The experience of transition was characterised by overlapping temporal stages. Participants' initial adjustment period was characterised by shock, coping and stabilisation. A phase of development followed, with growth in confidence and a focus on self-care. Adversity was experienced in the form of interprofessional tensions, overwork, isolation and mistreatment. Finally, a period of reflection and rationalisation marked the end of the first year.

DISCUSSION

Following initial anxiety regarding competence and performance, participants' experience of transition was predominantly influenced by cultural, relational and contextual aspects of clinical practice. Solutions to ease this challenging time include stage-specific transitional interventions, curricular change at both undergraduate and postgraduate levels and a re-evaluation of the clinical learning environment to mitigate the difficulties endured.

New nurses' experience during a two year transition period to clinical practice: A phenomenological study

BACKGROUND

New nurses' clinical competency is a central concern across the world. The China Health and Planning Commission proposed an "Outline of transition programs for newly graduated nurses (try out)" to promote the new nurses' clinical competency within the first two years. Compared with the transition program in other countries, the one in China is longer. New nurses' experiences in their transition to practice were not fully explored in China. Their lived experience may inform the better transition program in China and other countries.

OBJECTIVE

To explore the experience of new nurses during the two-year transition period to clinical practice.

DESIGN

A descriptive phenomenological study.

METHODS

Face-to-face, semi-structured in-depth interviews were conducted in two teaching hospitals in China to interview 14 nurses within three months after the completion of transition. Data were analyzed using Colaizzi's seven-step data analysis method，which includes familiarization, identifying significant statements, formulating meanings, clustering themes, developing an exhaustive description, producing the fundamental structure, and seeking verification (1978). Tape-recording and observational notes were taken and typed word by word. Two researchers verified the verbatim transcripts.

RESULTS

Five categories and 15 theme clusters were identified: 1.

CHALLENGE

early-stage stress and anxiety; perceived change of mentality and self-reflection; 2.

RESPONSE

self-encouragement; self-compulsion, tolerance, adaptation; peer support and affirmation; 3. Growth: overall clinical competency improvement; perceived harvesting; nursing skills improvement; knowledge enhancement; 4.

REFLECTION

self-inadequacy; rotation benefits; the merits of different departments; lack sense of belonging; and 5. Expectation: desire to be treated equally; hope to have more opportunities.

CONCLUSIONS

The findings of our study suggested that support was most needed while the new nurses were facing challenges in the early stage to promote their sense of belonging. In addition, more systematic learning opportunities are needed to maximize learning for NGNs with different nursing degrees.

Personal Factors and Clinical Learning Environment as Predictors of Nursing Students' Readiness for Practice: A Structural Equation Modeling Analysis

PURPOSE

It is essential to ensure the readiness for practice among undergraduate nursing students since the purpose of such education is to cultivate competent nurses who deliver high-quality and safe nursing. Astin's theory of student involvement suggests that this is affected by their personal factors and learning environment.

METHODS

We conducted a cross-sectional study between November 16, 2020 and December 21, 2020 which examined personal factors and aspects of the clinical learning environment among senior nursing students (n = 838) enrolled across 54 nursing schools in Korea. The participants were asked to fill out a self-administered online survey, which assessed demographic characteristics, self-esteem, depression, work-life balance, clinical learning environment, anxiety during clinical practicum, and readiness for practice. Readiness for practice was measured using the Casey-Fink Readiness for practice survey. We used structural equational modeling to test our hypothetical model.

RESULTS

The nursing students' readiness for practice was significantly affected by their self-esteem, work-life balance satisfaction, and clinical learning environment. Anxiety during clinical practicum directly influenced their readiness for practice.

CONCLUSION

Increasing self-esteem and work-life balance satisfaction, and improving their clinical learning environment by providing sufficient educational and clinical support, could help facilitate the transition from nursing schools to real-world practice for nursing students.

The impact of changes in nursing practicum caused by COVID-19 pandemic on new graduate nurses

BACKGROUND

The impact of the COVID-19 pandemic has brought about major changes throughout nursing education. Most clinical practicum has been substituted by skills laboratories, simulation laboratories, virtual simulation or written assignments. Nursing students who have experienced this change in practicum have fears about their future role as new graduate nurses. However, to date, no studies have been conducted exploring how their fears work when they become new graduate nurses.

OBJECTIVES

To investigate the status of nursing practicum at nursing universities before and during the COVID-19 pandemic, and to explore the relationship between difficulties in nursing tasks, work readiness, reality shock, and organizational socialization among new graduate nurses with nursing practicum experience during this pandemic.

DESIGN

Descriptive comparative research design.

PARTICIPANTS

178 new graduate nurses with a clinical experience from 1 month to less than 12 months and graduating from nursing universities in 2021, the 3rd grade in 2020 and the 4th grade in 2021.

METHODS

Cross-sectional study via a self-administered online questionnaire measuring difficulties in nursing tasks, work readiness, reality shock, and organizational socialization. Data were analyzed by descriptive statistics, independent t-tests, Pearson correlation.

RESULTS

New graduate nurses were divided into 72 in the Clinical/Clinical group and 106 in the Clinical/Substitute group. There was a significant difference in the difficulties in nursing tasks (t = -2.342, p = .020), but there were no significant differences in work readiness, reality shock, and organizational socialization between the two groups.

CONCLUSIONS

Efforts in the clinical field to increase the adaptation of new graduate nurses could prevent problems that may arise due to the restrictions and absence of clinical practicum. Discussions should be continued to develop and implement efficient nursing practicum education that not only can reduce the gap between nursing education and nursing practice, but also respond appropriately to any pandemic situation.

Belonging in high acuity settings: What is needed for newly graduated registered nurses to successfully transition? A qualitative systematic review

BACKGROUND

A worldwide shortage of nurses providing clinical care, coupled with an increase in severity of illness of hospitalised patients has led to newly graduated Registered Nurses being placed into high acuity settings, such as the emergency department, intensive care unit and operating theatre. The feeling of belonging in these settings impacts on successful transition of newly graduated Registered Nurses, their learning, and may lead to high attrition rates.

OBJECTIVE

To comprehensively synthesise qualitative research on newly graduated Registered Nurses' experiences of belonging, while working in high acuity clinical settings.

DESIGN

Elements of the Joanna Briggs Institute (JBI) systematic review protocol were utilised. The Preferred Reporting Items of Systematic reviews and Meta-Analyses (PRISMA) guidelines were used to conduct the review. Data were analysed using thematic analysis.

DATA SOURCES

Ovid Emcare, PsychInfo, CINHAL, Proquest and Scopus.

METHODS

The PICo (population, interest and context) strategy was used as a guide to develop search terms. Published literature from January 2007 to April 2021 was searched. Screening, selection and data extraction were performed by two authors independently. All discrepancies were resolved through discussion with a third reviewer.

RESULTS

A total of 506 studies were identified following the systematic search; after duplicates were removed, 440 were screened by title and abstract and 29 by full text. Six articles were included in this systematic review. Methodological quality was assessed utilising the JBI critical appraisal checklist, and discrepancies ratified through team consensus. The themes; emotional lability, structured program design, preceptors' influence and acceptance were identified.

CONCLUSIONS

Newly graduated Registered Nurses in the high acuity setting feel emotionally insecure related mainly to their educational unpreparedness. They have need for a structured program, inclusive of both theory and supported practice. The role of the preceptorship team is vital in enabling a feeling of belonging, as is acceptance by nursing staff of the learning journey.

Nurses Transitioning to Primary Health Care in Australia: A Practice Improvement Initiative

Introduction

Current nursing programs provide little pre-registration information and clinical exposure to primary health care nursing practice. Newly graduated nurses and those transitioning to primary health care report disorientation and confusion. Limited knowledge about the ideal elements of a program to support transitioning nurses is an imperative to understand how best to support nurses during this period. The peak body for nurses in primary health care was funded to develop and implement a 1-year transition to practice improvement initiative for nurses in Australia about to be employed in or who are new to primary health care. This quality improvement evaluation study aimed to determine the impact of the transition program on participants' nursing knowledge, skills, and confidence, and their overall satisfaction with the program.

Methods

A mixed methods evaluation of the project utilized data from online pre- and post-participation surveys, mentor meetings, and field notes. Descriptive statistics and paired t-tests were employed for quantitative items. Free text and field notes were subject to broad thematic analysis. Findings from qualitative and quantitative data were triangulated.

Results

Ninety-three nurse participants and 62 mentors were recruited. There were statistically significant differences between mean summed post-completion and pre-completion self-assessment rating scores for knowledge, skills, and confidence. Program elements were well received. The orientation workshop, mentoring, and education activities were identified as most influential in supporting transition. The self-assessment framework was identified as least influential.

Conclusion

A 12-month transition program was effective in building the knowledge, skills, and confidence of participants to deliver comprehensive and effective nursing services.

Clinical experiences of final-year nursing students during the COVID-19 pandemic: A systematic review and meta-synthesis

OBJECTIVES

This systematic review aimed to qualitatively synthesise existing literature to examine the clinical nursing experiences of final-year nursing students during the COVID-19 pandemic and provide recommendations for the effective management of clinical placement of nursing students.

DESIGN

A qualitative systematic review was conducted and reported following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

DATA SOURCES

Five electronic databases were searched and qualitative studies were included for analysis if they focussed on the clinical nursing experiences of final-year nursing students during the COVID-19 pandemic.

REVIEW METHODS

Data synthesis was conducted by extracting all findings, developing categories, and producing synthesised findings.

RESULTS

Four synthesised findings were concluded: 1) facing the unknown and willingness to help, 2) challenging the clinical environment, 3) transition improving professional identity, and 4) finding ways out of the pandemic.

CONCLUSIONS

The transition of nursing students to clinical nursing practice during the pandemic is a personally and professionally challenging process, while nursing students try to adapt to the changing clinical environment and enhance their professional identity. Nursing managers and health policymakers should acknowledge the challenges encountered by nursing students during the pandemic and support the professional growth of future nursing teams by providing high-quality supervision.

Nursing the Future: Building New Graduate Capacity (Part I)

The transition from student to practitioner for newly graduated nurses is impacted by their physical, social, professional, and practice environments. COVID-19, global insecurity, institutional restructuring, and "acute on chronic" staffing shortages have increased the immediate burden experienced by emerging nurses. As detailed through the historical development of Duchscher's Stages of Transition Theory and Transition Shock Model, theorization of the transition process offers graduates, their educators, and workplace managers key areas of support opportunities for these new practitioners. In part 1 of a 2-part article series, this article explores how novel new graduate supports have been developed and delivered in partnership with nonprofit groups, government bodies, and employers across much of Canada. For nurse stakeholders, theorists, and beyond, support for the transition period of new nurses remains anecdotally, evidentially, and fiscally advisable, with an increasing urgency due to rising human capital pressures.

Excellence in Nursing Preceptorship-to-Hire, part 1

An academic-practice partnership to recruit and retain nurses.

New Graduate Nurses' Experiences and Challenges during a One-Year Clinical Rotation Programme in the Volta Region of Ghana: Implications for Nursing Management and Nursing Workforce Retention

Background

To help improve the standards and quality of nursing practice, newly graduated nurses and midwives are required after passing the Nursing and Midwifery Council's Licensing Examination to undertake a one-year mandatory clinical rotation at health facilities before registration. However, there is a lack of scientific studies to explore new graduate nurses' experiences and challenges during the one-year mandatory clinical rotation programme.

Aim

This study is aimed at exploring newly qualified nurses' experiences and challenges during the one-year mandatory clinical rotation in health facilities in the Volta Region of Ghana.

Methods

This qualitative exploratory study used a combination of focus group discussions (FGDs) and individual interviews. Thirty (30) newly qualified nurses were selected from two secondary and one tertiary health facilities, where newly qualified nurses are posted for a clinical rotation programmes to participate in the study. A total of two focus group discussions (FGDs) were conducted, comprising five (5) members in each group. Moreover, twenty (20) newly qualified nurses were interviewed individually, and their data were added to what was obtained from the focus group discussions. This study adopted the thematic analysis approach to analyze the data.

Results

The results of this study showed that newly qualified nurses experienced the following during the one-year clinical rotation programme: acquisition of more knowledge and competencies to assume professional nursing roles; lack of knowledge of the objectives of the clinical rotation programme by hospital staff; experience of frustration during the clinical rotation programme; inadequate supervision and support; accommodation and financial challenges.

Conclusion

The study revealed important challenges experienced by new graduate nurses during the clinical rotation programme, including hospital staff's lack of knowledge regarding the objectives of the rotation programme, inadequate supervision and support, and accommodation and financial challenges. There is a need for the Nursing and Midwifery Council to develop guidelines for the one-year mandatory clinical rotation for newly graduated nurses and midwives to make the programme more effective.

[The Validity and Reliability of the Korean Version of Readiness for Practice Survey for Nursing Students]

PURPOSE

This study aimed to evaluate the validity and reliability of the Korean version of the Readiness for Practice Survey (K-RPS).

METHOD

The English Readiness for Practice Survey was translated into Korean using the Translation, Review, Adjudication, Pretesting, and Documentation (TRAPD) method. Secondary data analysis was performed using the dataset from the New Nurse e-Cohort study (Panel 2020) in South Korea. This study used a nationally representative sample of 812 senior nursing students. Exploratory and confirmatory factor analyses were also conducted. Convergent validity within the items and discriminant validity between factors were assessed to evaluate construct validity. Construct validity for hypothesis testing was evaluated using convergent and discriminant validity. Ordinary α was used to assess reliability.

RESULTS

The K-RPS comprises 20 items examining four factors: clinical problem solving, learning experience, professional responsibilities, and professional preparation. Although the convergent validity of the items was successfully verified, discriminant validity between the factors was not. The K-RPS construct validity was verified using a bi-factor model (CMIN/DF 2.20, RMSEA .06, TLI .97, CFI .97, and PGFI .59). The K-RPS was significantly correlated with self-esteem (r = .43, p < .001) and anxiety about clinical practicum (r = -.50, p < .001). Internal consistency was reliable based on an ordinary α of .88.

CONCLUSION

The K-RPS is both valid and reliable and can be used as a standardized Korean version of the Readiness for Practice measurement tool.

Storylines, metaphors, and solutions in the work-readiness literature: A frame analysis

AIM

To investigate how the literature frames the reported poor work-readiness of new graduate nurses and the solutions it recommends.

DESIGN

Critical frame analysis of work-readiness literature storylines.

METHODS

Deductive and inductive analysis of work-readiness literature published 2016-2019.

RESULTS

The three systematic reviews, literature review, and analysis of transition guidelines reinforced the belief that nursing graduates should be work-ready. In addition, the articles summarized service and academic innovations intended to assist newly qualified nurses transition to practice.

CONCLUSION

The literature attributes perceived graduates' poor work-readiness to divergent faculty and employer expectations, personal deficiencies, defective learning environments, and poor workplace support. Internships, mentorship, academic-service partnerships, and curricular and pedagogical innovation are the dominant recommendations for reform. Workplace clinical education and training are not mechanisms for correcting graduates' work performance but essential activities for sustaining the nursing workforce.

IMPACT

The study should encourage more use of frame analysis in nursing education research. Fact-checking storylines must be a priority for future studies. Research that clarifies the fault lines between advocates of work-readiness and dissident academic leaders has the potential to promote dialogue. Work-ready, theory-gap, and other deficit metaphors must be put aside for the debate because universities must not relinquish their responsibility for educating students for the 21st century.

Student to midwife transition: Newly qualified midwives' experiences in Limpopo province

Background

Regardless of educational pathway, the transition from student to the registered midwife is a topic of increasing interest within the profession as this is likely to have implications for retention and attrition. Newly qualified midwives have reported that the reality of putting knowledge into practice in the midwifery field is often challenging and stressful.

Aim

To explore and describe the experiences of newly qualified midwives with regard to the provision of midwifery services during transition from students to qualified midwives, in the Limpopo province, South Africa.

Setting

The study was conducted in the maternity units of each of the five selected public hospitals in the Limpopo province.

Methods

The researcher employed a qualitative approach with explorative and descriptive design. The population comprised all midwifery graduates working in the Limpopo province and have undergone a comprehensive nursing programme regulated by R425 of 19 February 1985, as amended. Five newly qualified midwifery graduates were sampled from each of the five selected hospital, using a non-probability purposive sampling method, resulting in a sample size of 25 participants. Data collection was carried out through unstructured individual interviews and was conducted until participants were no longer bringing new information.

Results

Graduates reported excessive workload, which resulted in physical exhaustion. Challenges related to the roles and responsibilities of a new position as a qualified midwife were expressed. Negative collegial relationship displayed by experienced qualified midwives, negatively affected graduates' midwifery performance.

Conclusion

Effective, transition from student to qualified midwife is a stressful and exhausting process because of unfavourable working conditions in the labour ward, administrative roles as well as negative collegial relationship and disrespect displayed by experienced midwives.

Contribution

Strategies to effectively support newly qualified midwives may be developed, which may consequently help in improving newly qualified midwives' performance.

Accelerating to Practice: Defining a Competency-Based Curriculum Framework for Nursing Education Part 1

AIM

This study aims to address the transition-to-practice dilemma for novice nurse, define gaps, and lay a foundation for a curriculum framework.

BACKGROUND

The National League for Nursing has challenged and supported nurse educators in developing teaching methodologies that prepare novice nurses for professional practice. Over a decade ago, compelling research fueled a debate that continues today, with nursing education and practice research reporting lack of readiness for practice by novice nurses and the goal of identifying gaps and potential strategies for solutions.

METHOD

The Utstein-style meeting strategy consensus approach was used to refine the data gaps reported in the literature.

RESULTS

The findings from this work generated a strong foundation for a transition-to-practice curriculum framework.

CONCLUSION

The Utstein-style meeting provided for a diverse conversation across multiple perspectives. Participants worked collaboratively in real time to further illuminate and refine the data gaps and inform nursing curricula.

Faculty perceptions of the impact of the COVID-19 pandemic on new graduate nurses' transition to practice: A qualitative study

BACKGROUND

The COVID-19 pandemic disrupted nursing education worldwide. Most studies have focused on how the pandemic affected students. With an alarming workforce shortage, a better understanding of the pandemic's impact on new nurses is vital to proactively develop strategies to promote success of the profession's newest members.

PURPOSE

This study explored faculty perceptions of the pandemic's impact on new nurses' practice preparedness and recommendations for promoting effective transition to practice.

METHODS

Using an exploratory-descriptive qualitative approach and convenience sampling, 116 nurse faculty from across North Carolina, United States responded to open-ended questions within an electronic survey. Data were analyzed with thematic analysis.

RESULTS

Four themes emerged: 1) Less Hands-On, 2) Transition-to-Practice Opportunities, 3) Key Role of Preceptors, and 4) Provide Additional Support.

CONCLUSIONS

Findings provide strategies clinical nurses and leaders can implement to meet the needs of new nurses entering professional practice during the ongoing pandemic. Due to less hands-on learning, pandemic graduates may benefit from extended time with a trained preceptor and opportunities to focus on clinical reasoning, managing multiple patients, effective communication, and safe skill performance. Upon entering the clinical environment, pandemic graduates' inexperience may increase the likelihood of transition shock, requiring multi-faceted approaches for providing support.

Supporting newly qualified nurses to develop their leadership skills

Leadership is not expected solely of managers. At any stage of their career, nurses are expected to be able to demonstrate leadership in their day-to-day role. However, newly qualified nurses, who often experience a challenging transition from nursing student to registered nurse, may lack the confidence to demonstrate leadership. Nurse managers can support junior nurses to develop their leadership skills, notably through training, mentoring, reflection and action learning. By guiding newly qualified nurses in the use of different leadership approaches, experienced nurses can contribute to enhancing the quality of patient care. This article discusses how nurse managers can support newly qualified nurses to develop their leadership skills.

Stress and coping experience in Nurse Residency Programs for new graduate nurses: A qualitative meta-synthesis

Objectives

To determine the stress experience and coping styles of new nurses during Nurse Residency Programs (NRPs) by identifying, appraising, and synthesizing data from the qualitative studies.

Design

A systematic review and meta-synthesis of qualitative studies.

Review methods

Eleven databases were systematically searched for relevant publications in March 2022. All qualitative and mixed-method studies in English and Chinese that explored the stress and coping experience during NRPs of new graduate nurses were included. The qualitative meta-synthesis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Two independent reviewers selected the studies and assessed the quality of each study. Meta-synthesis was performed to integrate the results.

Results

A total of 13 studies revealed 13 sub-themes and three descriptive themes: multi-dimensional stressors, somatic and emotional responses, coping resources and coping methods.

Conclusion

New nurses faced a lot of physical and emotional stress during NRPs, which had a negative impact on their physical and mental health. NRPs are a critical period for the career growth of new nurses. Effective management strategies must be implemented to improve nurse capacity, meet their needs, improve self-efficacy, and build organizational support, as this can improve the quality of clinical nursing and keep the enthusiasm and stability of the nursing team.

Work Readiness of Newly Licensed RNs

OBJECTIVE

The aim of this study was to examine the work readiness of newly licensed RNs (NLRNs) based on demographics, education, and work experiences.

BACKGROUND

Work readiness is the extent to which new graduates possess qualities and competencies associated with workplace success. Work readiness of NLRNs complements their clinical knowledge and skills and has been shown to predict job satisfaction and work engagement.

METHODS

Two hundred ninety-seven NLRNs participating in the nurse residency program of a health system in the southeast region of the United States were surveyed using the Work Readiness Scale-Graduate Nurse.

RESULTS

Scores on all readiness dimensions were high. Analysis revealed unexpected differences in readiness dimensions based on race, nursing degree, and completion of a nurse externship program.

CONCLUSIONS

Work readiness adds to our understanding of factors that can affect the transition of NLRNs into the work setting. Further research is needed to understand how work readiness develops over time, factors that predict work readiness, and its relationship to NLRN retention and other outcomes.

Optimising health system capacity: A case study of community care staff's role transition in response to the coronavirus pandemic

The coronavirus disease (COVID-19) increased the demand for critical care spaces and the task for individual countries was to optimise the capacity of their health systems. Correlating governance and health system capacity to respond to global crises has subsequently garnered the pace in reviewing normalised forms of identifying health priorities. Aligning global health security and universal health security enhances the capacity and resilience of a health system. However, weak methods of governance hinder the alignment necessary for controlling infection spread and coping with the increase in demand for hospital critical care. A range of qualitative studies has explored staff experiences of providing care in hospitals amidst the COVID-19 pandemic. Nonetheless, limited understanding of the influence of governance on health and social care staff experiences in response to the COVID-19 pandemic exists. This case study aimed to explore the influence of health system governance on community care staff experiences of role transition in response to the COVID-19 pandemic in England. We used criterion sampling to include community care staff initially recruited to deliver a community integrated model of dementia care at two facilities repurposed in March 2020 to optimise hospital critical care space. Six community care staff participated in the narrative correspondence inquiry. A lack of control over resources, limitations in collective action in decision making and lack of a voice underpinned staff experiences of role transition in contexts of current crisis preparedness, transition shock and moral dilemmas. Health system governance influenced the disposition of community care staff's role transition in response to the COVID-19 pandemic. Staff's mere coping clouds the glass of wider issues in health system governance and capacity. The normative dominance that the control over resources and centrally determined health system priorities ordain require reviewing to enable optimal health and social care cross systems' capacity and resilience.

The relationship between nurse-nurse collaboration and work readiness among new graduate nurses

BACKGROUND

Communication and collaboration with colleagues are crucial for new graduate nurses (NGNs) because of the adaptation to both the healthcare system and professional role. Therefore, working units with effective collaboration among nurses may increase new graduates' work readiness.

AIM

This study aimed to determine the relationship between the perceptions of nurse-nurse collaboration and the work readiness level among NGNs.

METHODOLOGY

This descriptive, cross-sectional study was carried out with 198 NGNs in four private hospitals affiliated with a university. A self-administered questionnaire, including a personal information form, the Nurse-Nurse Collaboration Scale, and Work Readiness Scale, was used to collect data. Data analysis was performed using descriptive tests, and Spearman's rank correlation coefficients.

RESULTS

NGNs had moderate perceptions of nurse-nurse collaboration, with a median score of 2.46 (2.23-2.88) out of 4. Work readiness among NGNs was moderate, with a median score of 304 (270-332) out of 460. There was a statistically significant correlation between nurse-nurse collaboration and work readiness (r_s  = 0.26; p < .001).

CONCLUSION

The results of this study demonstrated that improving nurse-nurse collaboration is an effective way to increase work readiness among NGNs.

The Structural Dimensions of “Double-Qualified” Teachers’ Work Role Transition Competence and Its Generation Mechanism

The competence to change work roles is a key factor for individuals in achieving a successful work role transition. In this study, we analyzed in-depth interview data of 31 “double-qualified” teachers and related teaching managers in higher education institutions using the grounded theory method and constructed a model of the structural dimensions of teachers’ work role transition competence and its generation mechanism. The model was also interpreted using work role transition theory, the Job Demand–Control–Support (JDCS) model, and employee learning theory. The research results show that the work role transition competence of teachers in higher education institutions is mainly composed of four dimensions: old role detachment, psychological adaptation, new role cognition, and resource reserve capacity; the four factors of work role demand (initiation factor), role breadth self-efficacy (internal contextual factor), social support (external contextual factor), and individual learning (direct factor) follow the theoretical logic of “demand–context–learning–competence” to influence the formation of work role transition competence. This study enriches and expands the theory of work role transition, which can help teachers in higher education institutions to effectively apply it in their work role transitions and can help higher education institutions to further improve the corresponding norms of human resource management practice.

Understanding Health Care Graduates' Conceptualizations of Transitions: A Longitudinal Qualitative Research Study

PURPOSE

Although transitions have been defined in various ways in the higher education literature (e.g., inculcation, development, becoming), little research exists exploring health care learners' conceptualizations of transitions across their transition from final year to new graduate. How they understand transitions is important because such conceptualizations will shape how they navigate their transitions and vice versa.

METHOD

The authors conducted a 3-month longitudinal qualitative research study with 35 health care learners from 4 disciplines (medicine, dietetics, nursing, and pharmacy) across their final year to new graduate transition to explore how they conceptualized transitions. Data collection occurred between July 2019 and April 2020 at Monash University in Victoria, Australia. The authors employed framework analysis to interrogate the interview and longitudinal audio diary data cross-sectionally and longitudinally.

RESULTS

The authors found 10 different conceptualizations of transitions broadly categorized as time bound and linear (one-off events, systems, linear, adaptation, linked to identities), ongoing and complex (ongoing processes, multifaceted, complex), or related to transition shock (labor, linked to emotions). The adaptation conceptualization increased in dominance over time, the linear conceptualization was more apparent in the interviews (time points 1 and 3), and the multifaceted and emotion-linked conceptualizations were more dominant in the longitudinal audio diaries (time point 2).

CONCLUSIONS

This novel study illustrates conceptualizations of transitions as broadly consistent with existing higher education literature but extends this research considerably by identifying differences in conceptualizations across time. The authors encourage health care learners, educators, and policy makers to develop expanded and more sophisticated understandings of transitions to ensure that health care learners can better navigate often challenging graduate transitions. Further research should explore stakeholders' transition conceptualizations over lengthier durations beyond the new graduate transition.

Job change among early career nurses and related factors: A postgraduation 4-year follow-up study

AIMS

This study aimed to identify the job change status and related factors among nurses during the first 4 years of their professional life.

BACKGROUND

The early turnover and job change of nurses results in negative patient and nurse outcomes and financial losses.

METHODS

A prospective longitudinal observational design and convenience sampling were used. From five nursing schools in South Korea, 526 individuals participated in the first survey conducted before graduation; 317 and 338 individuals participated in the second and third surveys, respectively (4 months after employment, and 4 years after graduation).

RESULTS

In total, 42.0% of the participants remained at the hospital of their first job, 26.6% switched hospitals, and 12.1% moved to a nonhospital job. Multinomial logistic regression analyses showed that switching hospitals was associated with nurses' grade point average, type of hospital, first job satisfaction, and current pay. Moving to a nonhospital job was related to gender, type of hospital, current pay, and work-life balance.

CONCLUSION

To reduce the early turnover and job change, hospitals should provide educational programmes for nurses, support male nurses, and increase job satisfaction and work-life balance.

IMPLICATIONS FOR NURSING MANAGEMENT

Since this study addresses the working conditions and satisfaction of individuals who were re-employed after experiencing job turnover, it clarifies how nurse managers may reduce turnover. Namely, nurse managers should establish a work environment promoting good work-life balance.

İşe Yeni Başlayan Genç Hemşirelerin Kıdemli Meslektaşları ile İlişkileri: Fenomenolojik Bir Çalışma

Giriş: İşe yeni başlayan genç hemşirelerin uyum süreçleri, arkadaşça olmayan davranışlara maruz aldıkları çalışma ortamlarından olumsuz etkilenmektedir. Bu nedenle, işe yeni başlayan genç hemşirelerin deneyimledikleri meslektaş ilişkilerinin bilinmesi uyum süreçlerinin iyileştirilmesi açısından önemlidir. Amaç: İşe yeni başlayan genç hemşirelerin, çalışma yaşamlarının ilk altı ayında kıdemli meslektaş ilişkileri ile ilgili deneyimlerinin, düşüncelerinin ve duygularının özünü anlamaktır. Yöntem: Araştırma, tanımlayıcı fenomenolojik nitel tasarımda, Nisan-Ağustos 2021 tarihleri arasında İzmir’deki bir üniversite hastanesinde amaçlı örneklem yöntemiyle seçilen 14 işe yeni başlayan genç hemşire ile gerçekleştirilmiştir. Derinlemesine görüşmeler video konferans yöntemi ile yapılmıştır. Görüşme dökümleri Colaizzi’nin tekniğine göre analiz edilmiş ve çalışmanın ana temalarının oluşturulması aşamasında deneyimlerin özüne ulaşmak için “Watson İnsan Bakım Kuramı” kullanılmıştır. Bulgular: İşe yeni başlayan genç hemşirelerin, kıdemli meslektaşlarıyla olan ilişkileri üç ana tema ve iki alt temadan oluşmaktadır: ana temalar; “sevecen/olumlu yaklaşımlar”, “nezaketsiz davranış”, “yetersiz destek”; alt temalar;“destekleyici ve geliştirici yaklaşım”, “kabul görme ve önemsenme” olarak belirlenmiştir. Sonuç: Çalışmanın sonuçları, işe yeni başlayan genç hemşirelerin, geçiş sürecinde özellikle rehber hemşire yaklaşımlarını sevecen ve geliştirici bulması ve olumlu deneyimler yaşamasının destekleyici ilişkinin varlığını; öte yandan yönetici ve kıdemli meslektaşlarının nezaketsiz davranışlarına maruz kalmasının ve yardım görmemesinin olumsuz ilişkilerin varlığını ortaya koymuştur. İşe yeni başlayan genç hemşirelerin, geçiş sürecinde olumsuz meslektaş ilişkilerine maruz kalmasının önlenmesi için kurumsal ve ulusal düzeyde Watson’ın İnsan Bakım Kuramı’na temelli stratejiler geliştirilebilir.

A Longitudinal View of Perceptions of Entering Nursing Practice During the COVID-19 Pandemic

Background The COVID-19 pandemic significantly changed the landscape of health care and transition to practice for new graduates. The purpose of this pilot study was to explore the effects of the pandemic on the first-year experience of new nurses. Method A longitudinal, observational, descriptive study design was used. One hundred eighteen survey links were sent to new bachelor of science in nursing graduates from June 2020 to May 2021, with 56 responses to the first survey. Results Participants indicated the COVID-19 pandemic negatively affected the new graduate experience, resulted in concern for personal health and safety, and negatively altered preparation for the first year in practice. However, desire to be a nurse and view of nursing remained positive. Conclusion The first year in practice is stressful and challenging. The pandemic posed additional challenges to employers and new graduates. Future research should explore the long-term impact of the pandemic on an already strained nursing workforce. [J Contin Educ Nurs. 2022;53(6):256-263.].

Knowledge, Attitude, and Perceived Barriers of Newly Graduated Registered Nurses Undergoing Standardized Training in Intensive Care Unit Toward Early Mobilization of Mechanically Ventilated Patients: A Qualitative Study in Shanghai

Aim: To explore the knowledge and attitudes of newly graduated registered nurses, who have undergone standardized training in the intensive care unit, about the early mobilization of mechanically ventilated patients and identify perceived barriers to the application of early mobilization.

Background: Early mobilization of mechanically ventilated patients has been gradually gaining attention, and its safety and effectiveness have also been verified. Nurses in intensive care units are the implementers of early mobilization, and the quality of their care is closely related to patient prognosis. However, the knowledge and attitude of newly graduated registered nurses undergoing standardized training, in intensive care units, on the early mobilization of mechanically ventilated patients and the obstacles they face in clinical implementation are still unclear.

Methods: This qualitative study utilized the phenomenological method to explore the experiences of 15 newly graduated registered nurses undergoing standardized training in intensive care units in a 3rd hospital in Shanghai, China. Semi-structured face-to-face interviews were conducted in June 2020. The Colaizzi seven-step framework was used for data analysis.

Findings: A total of 15 new nurses comprised the final sample after data saturation. Three main themes emerged from the analysis and seven subthemes: perceived importance, low implementation rate, and perceived barriers.

Conclusions: Newly graduated registered nurses undergoing standardized training in intensive care units have a high level of awareness of the importance of early mobilization of mechanically ventilated patients and are willing to implement it. However, there is a lack of relevant knowledge and other obstacles that restrict clinical implementation. Early mobilization should be included in the standardized training of new nurses in intensive care units.

Graduating Nursing Students’ Empowerment and Related Factors: Comparative Study in Six European Countries

New nurses are needed in healthcare. To meet the role expectations of a registered nurse, nursing students must feel empowered at graduation. However, there are only a few studies focusing on nursing students’ empowerment. This study aims to describe and analyze graduating nursing students’ level of empowerment in six European countries and potential related factors. A comparative and cross-sectional study was performed in the Czech Republic, Finland, Italy, Portugal, Slovakia, and Spain with graduating nursing students (n = 1746) using the Essential Elements of Nurse Empowerment scale. Potentially related factors included age, gender, a previous degree in health care, work experience in health care, graduation to first-choice profession, intention to leave the nursing profession, level of study achievements, satisfaction with the current nursing programme, clinical practicums, theoretical education, and generic competence measured with the Nurse Competence Scale. The data were analysed statistically. Graduating nursing students’ self-assessed level of empowerment was moderate, with statistical differences between countries. Those with high empowerment had no intention to leave the nursing profession, had a higher level of study achievements, and a higher self-assessed generic competence level. The results suggest that empowerment needs to be enhanced during nursing education. Further research is needed to understand the development of empowerment during the early years of a nursing career.

Novice nurses' transition to clinical setting in the COVID-19 pandemic: a phenomenological hermeneutic study

Background

: The COVID-19 pandemic both exposed and increased weaknesses in the healthcare system, so that novice nurses have become a more vulnerable group during this context.

Aim

: This study sought to illuminate experience of novice nurses in providing care during the COVID-19 pandemic.

Method

: It consists of a qualitative study conducted with data collected by means of semi-structured interviews, audio recorded, transcribed, anonymised, and analysed in the light of the phenomenological hermeneutic approach. Fourteen registered novice nurses from two health areas in northwest X, being twelve women and two men, who experienced the COVID-19 pandemic within their first five years of professional experience, were selected through a non-statistical snowball sampling.

Results

: After analysing the narratives, we identified four main themes: "Transitioning to a hostile, unknown and uncertain clinical setting from inexperience," "Invisible wounds because of being on the front line," and "Healing to return to the front line."

Discussion

: The uncertainty of an unknown illness and the lack of support during the COVID-19 pandemic has been affecting novice nurses, impacting their health conditions. At the same time, this context created opportunities for professional development. According to the interviewees, self-care and social support were elements to cope with exhaustion.

Conclusion

: Our study investigates the experiences of a group barely approached in the literature, highlighting the reality and difficulties of these nurses in transitioning to the clinical setting and providing insights to managerial leaders and educators.