Practice readiness of new graduate nurses and factors influencing practice readiness: a scoping review of reviews

Prevalence of Impostor Phenomenon Among Final-Semester Baccalaureate Nursing Students

BACKGROUND

Impostor phenomenon (IP) is characterized as an internal sense of intellectual fraudulence and the inability to internalize success. It was identified by Clance and Imes in 1978 in a study with high-achieving women and has since been found among other professionals. Studies regarding IP are limited in nursing and among nursing students.

PURPOSE

The purpose of the study was to evaluate the prevalence of IP among senior baccalaureate nursing (BSN) students at a public central Texas university immediately prior to graduation.

METHODS

Senior BSN students were given an anonymous survey utilizing the Clance Impostor Phenomenon Scale.

RESULTS

Of the 86 senior BSN students, 82.5% completed the anonymous survey. Among students, 45.1% experienced moderate IP, 46.5% experienced frequent IP, and 8.5% experienced intense IP.

CONCLUSIONS

The incidence of IP was higher than expected. This study has implications for the future of nursing, including academic retention and postgraduation performance.

Experiences of undergraduate nursing students and new graduate nurses in paid employment models and health-related work influencing the transition to practice: a qualitative systematic review protocol

OBJECTIVE

This review aims to synthesize qualitative literature exploring the experiences of undergraduate nursing students and newly graduated nurses who are employed for less than 1 year in clinical settings after graduation. It will focus on those who had paid employment and health-related work experience during their undergraduate studies, examining the influence of these experiences on the transition to practice.

INTRODUCTION

Nursing professionals undergo a transformative journey, starting from envisioning themselves as nurses, to developing professional identity and competence. However, the initial transition to nursing practice often poses challenges for undergraduates and newly graduated nurses. To ease this transition, gaining additional clinical experience through paid employment or health-related work during undergraduate studies can be beneficial.

INCLUSION CRITERIA

This review will include qualitative studies on the experiences of undergraduate nursing students and newly graduated nurses in paid employment models and health-related work. No restrictions on the publication date or country will be applied; however, only English-language publications will be included.

METHODS

The JBI methodology for qualitative systematic reviews will be employed. Searches will be conducted in MEDLINE, Embase, Emcare (Ovid); CINAHL Complete (EBSCOhost); and ERIC (ProQuest), along with gray literature in ProQuest Dissertations and Theses and Google Scholar. Study selection, quality assessment, and data extraction will be conducted as per the JBI methodology. Findings will be synthesized using meta-aggregation, and a ConQual Summary of Findings will be created.

REVIEW REGISTRATION NUMBER

PROSPERO CRD42024520724.

Relationship between work readiness, transition shock, and job competency among new nurses in oncology hospitals - A longitudinal study based on a latent growth model

BACKGROUND

Nursing job competency is critical for talent development both globally and in China, relating to work readiness and transition shock. Previous studies, which have typically relied on average measurements at fixed time points, have not provided comprehensive longitudinal insights.

AIM

This study aimed to investigate the developmental trajectories of transition shock in new nurses at oncology specialty hospitals. Furthermore, we sought to explore the longitudinal mediating role of transition shock in the relationship between work readiness and the development of nursing job competency.

DESIGN

Longitudinal follow-up study.

METHODS

We conducted three follow-up surveys over 8 months using the Work Readiness Scale, the Transition Shock Scale, and the Nursing Job Competency Scale to assess 252 novice nurses at two high-volume oncology centers. The surveys were conducted at 0, 4, and 8 months, with demographic information collected during the first survey. Data were analyzed using R 4.1.2 and Mplus 8.0.

RESULTS

(1) Over the 8-month period, transition shock exhibited a linear decrease. Notably, nurses with a higher initial transition shock experienced a slower rate of decline. (2) There were positive correlations between work readiness and nursing job competency at all three measurement points. Conversely, transition shock was negatively correlated with both work readiness and nursing job competency. (3) Transition shock functioned as a longitudinal mediator in the relationship between work readiness and nursing job competency.

CONCLUSION

This study clarified the longitudinal mediating role of transition shock in the relationship between work readiness and job competency in oncology settings. Targeted interventions are necessary to mitigate excessive transition shock, thereby improving the nursing job competency of new nurses in oncology hospitals.

REGISTRATION

23/313-4055.

Novice nurses' transition shock and professional identity: The chain mediating roles of self-efficacy and resilience

AIMS AND OBJECTIVES

The aim of this study was to explore the association between transition shocks and professional identity and the mediating roles of self-efficacy and resilience among Chinese novice nurses.

BACKGROUND

Novice nurses experience transition shock when they start their careers, which might lead to decreased professional identity and ultimately turnover. By contrast, self-efficacy and resilience are excellent psychological resources that may be associated with higher professional identity. It is unclear how transition shock affects professional identity by influencing these two internal resources.

DESIGN

A cross-sectional survey.

METHODS

The STROBE guidelines were followed to report this study. Convenience sampling was used to recruit participants, and 252 novice nurses completed the Transition Shock of Novice Nurses Scale, the Professional Identity Assessment Scale, the General Self-Efficacy Scale and the Connor-Davidson Resilience Scale between April 2022 and May 2022. Influencing factors were primarily identified using independent-sample t-tests and a one-way ANOVA. Structural equation modelling was used to detect the mediating effects of self-efficacy and resilience.

RESULTS

Differences in novice nurses' levels of professional identity were found across age groups, hospitals and departments. Transition shock was negatively related to professional identity. Self-efficacy and resilience mediated the complete chain relationship between transition shock and professional identity.

CONCLUSION

To our knowledge, this study is the first to explore the mediating effect of self-efficacy and resilience on transition shock and professional identity. Higher transition shock may lead to lower professional identity by reducing self-efficacy and resilience.

RELEVANCE TO CLINICAL PRACTICE

Nursing managers ought to emphasise the significant role of psychological resources in the work adaptation process of novice nurses. It may be more effective to improve professional identity and maintain the stability of the health care system.

PATIENT OR PUBLIC CONTRIBUTION

Nursing administrators working at seven preselected hospitals actively assisted us in the process of collecting self-report questionnaires from novice nurses, such as by booking appointments and providing access for questionnaire administration. In addition, the participants were actively involved in the data collection process.

The concept of capability in pre-registration nursing education: A scoping review

BACKGROUND

Capability in nursing education is an emerging concept that includes various requisites, which can be applied in complex or unfamiliar clinical settings. Despite growing research for practising nurses, the requisites of capability for pre-registration nursing students entering the workforce remain unclear.

OBJECTIVE

The objective was to identify the requisites that constitute capability for practice among pre-registration nursing students as well as the enablers to develop capabilities.

DESIGN

A scoping review was performed using the Joanna Briggs Institute methodology.

DATA SOURCES

Records published without date restriction were searched using MEDLINE, Embase, Emcare, CINAHL, and Scopus databases. Grey literature and reference list searching was conducted.

REVIEW METHODS

Sources explicitly reporting requisites of capability or enablers of capability development in pre-registration nursing education were eligible. All global sources written in English and available in full text were included. Data were extracted and synthesised using a specifically designed extraction tool.

RESULTS

The number of records reviewed totalled 896. Twenty-three studies met the criteria for inclusion in the synthesis. Nineteen capability requisites for practice were reported. Whilst various enablers to support development of capability requisites were reported, some challenges were also identified.

CONCLUSION

This study identified requisites of capability for practice and enablers that may support development of capability in pre-registration nursing education. This holistic set of capabilities has previously not been reported. Given the emerging nature of the concept, this collective set of requisites may not be indicative of all required capabilities of nursing students upon graduation. Efforts to develop a definitive set of requisites and explore strategies to support and enable capability development are needed to advance this concept in the pre-registration nursing education context.

New graduate nurses' readiness for practice, transition and integration into the workplace: A longitudinal study with mixed methods research

AIM

To examine the readiness of new graduate nurses for practice and evaluate factors influencing their transition into the workplace.

BACKGROUND

This is new research in Bahrain. Understanding readiness for practice is important during a time when there is a national initiative to promote nursing as a career among the indigenous Bahraini population. The worldwide nursing shortages and aging workforce require new and innovative recruitment and retention measures. There is change, increased demand and complexity, in nursing and healthcare needs with accompanying healthcare specialization. In such a health care environment, the transitioning and readiness of newly qualified nurses is an increasing challenge.

DESIGN

A longitudinal design, with a triangulated, mixed methods, research approach was used.

METHODS

The study population consisted of 50 newly graduated nurses. Data were collected over one year through self-administered questionnaires, reflective diaries and focus groups. Quantitative data were analysed using SPSS and qualitative data using thematic analysis with adherence to GRAMMS reporting guidelines.

RESULTS

In Bahrain, there are actions to recruit young Arabic students to nursing including schools and community presentations by trained nurse ambassadors, social media activities and career exhibitions, however there is a lack of objective information on the perspective of cohorts of nurses who have successfully completed graduate nursing registration programmes and transitioned into practice. International literature suggests that the transition of newly graduated nurses can be stressful and challenging. On entry to practice, the respondents positively perceived their characteristics and attributes; however, their confidence was affected by challenges in the workplace. The transitioning of the new graduate nurses was affected by the availability of support and leadership, induction programmes and the new complex work environment.

CONCLUSION

Understanding work readiness and the emotional needs of new graduate nurses, accompanied by improved support, will enhance the transition of newly qualified nurses into the workplace and reduce attrition.

STUDY REGISTRATION

KHUH/Research/No.279/2019.

Reject the "Practice Readiness Myth": Ask if systems are ready for nursing graduates instead

The nursing profession is engaged in robust national dialogue on how to implement competency-based education. This dialogue often conflates the concept of "competency-based education" with nursing "competence" or "practice readiness." Our aim is to discuss the potential harms of conflating "competency-based education" with "competence" or "practice readiness." This commentary explores the possible risks of issue conflation. Risks include (a) suggesting that nurses who have successfully obtained licensure are not "competent" or "ready to practice," and (b) de-emphasizing the importance of safe and sustainable work environments for new graduate nurses. We discuss the need to separate conversations about "competency-based education" and "practice readiness"; the need to increase the clarity and specificity of discourse surrounding competency-based education; and the need for strategic alignment across academia and practice.

Career adaptability among new oncology nurses: A longitudinal exploration

AIM

This study aims to explore the longitudinal predictive effect of self-awareness on career adaptability in new nurses at a tumor specialty hospital and the mediating mechanisms of work readiness and transition shock.

BACKGROUND

Career adaptability is crucial for the personal development of nurses and also intricately linked to the retention rates among newcomers in oncology nursing. Inadequate career adaptability contributes to higher turnover, which in turn exacerbates the shortage of qualified nursing personnel in this field. There is a pressing need for dedicated research and interventions that support new nurses, especially in specialized areas like oncology, to promote their well-being and career advancement. Comprehending these challenges is essential for devising effective strategies that will retain nursing talent and ensure the sustainability of a robust healthcare workforce.

METHODS

Longitudinal data from four follow-up surveys were collected from 248 new clinical nurses at the National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College. Mediation analyses using R 4.1.2 were conducted to examine the pathways between self-awareness, work readiness, transition shock, and career adaptability.

CONCLUSIONS

Self-awareness not only directly predicts career adaptability but also influences it through the bidirectional and chained mediating pathways of work readiness and transition shock.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

These findings equip nursing managers with flexible strategies to foster and enhance nurses' career adaptability, providing targeted support as nurses assimilate into their clinical roles. This not only strengthens workforce stability but also mitigates turnover, ultimately reinforcing the healthcare workforce.

Factors associated with practice readiness among newly qualified nurses in their first two years of practice

BACKGROUND

Newly graduated nurses undergo stress and role adjustment as they transition into practice during the first year and continue to struggle beyond the first year. Determining their practice readiness can aid in the development of interventions to facilitate workplace readiness for nurses in their first two years entering the nursing profession.

OBJECTIVES

To examine (i) extent of practice readiness of new nurses in their role; and (ii) associations between nurses' practice readiness and demographic and occupational variables, and reasons for choosing nursing profession.

DESIGN

A cross-sectional study.

SETTINGS AND PARTICIPANTS

A total of 445 registered nurses who graduated within the last two years and working in an academic medical centre in Singapore.

METHODS

Participants completed an online questionnaire with questions from Casey-Fink Readiness for Practice Survey and questions related to key competencies for future practice.

RESULTS

More than half (57.5 %) identified at least three skills and procedures which they were uncomfortable performing independently as they transition into the clinical practice, including: (i) responding to emergency (ii) tracheostomy care; and (iii) chest tube care. The top three reasons for choosing nursing as a career were: (i) nursing is a stable industry (54.2 %); (ii) I want to help people (52.1 %); and (iii) able to work anywhere in the world (44.3 %). Nurses were most concerned with areas of trials and tribulations (42.5 %) and clinical competency (36.6 %). When compared to nurses in their first-year post-graduation, those working in their second year reported more confidence in the ability to problem solve (p = 0.003), care for a person who is dying (p = 0.004), and less difficulties in prioritizing care needs (p = 0.04). They also perceived themselves as a good problem solver (p = 0.03).

CONCLUSIONS

It is critical to continue supporting nurses' practice readiness beyond their first year of practice in their confidence and development of skills of higher complexity.

Impact of Nursing Clinical Elective Courses on New Graduate Nurses' Clinical Practice: A Mixed-Methods Descriptive Study

BACKGROUND

Clinical elective courses provide additional specialty knowledge for prelicensure nursing students; however, it is unknown how these courses impact nurses' clinical practice after graduation.

PURPOSE

To describe how clinical nursing electives impact graduates' clinical practice.

METHODS

A mixed-methods descriptive design was used. Students who graduated from a prelicensure nursing program were sent an electronic survey and participated in qualitative interviews.

RESULTS

Thirty-three graduates completed the survey, with 9 participating in interviews. Sixteen graduates worked in the clinical practice areas that were the same, or related to, the clinical elective they took. Many graduates felt that taking the elective course improved their confidence in the clinical setting and provided increased knowledge that put them at an advantage over their peers.

CONCLUSION

Clinical electives may offer a means to meet health care system needs by preparing a more confident, knowledgeable new graduate in specialty areas in which nurses are needed most.

The impact of prior care experience on nursing students' compassionate values and behaviours: A mixed methods study

BACKGROUND

Compassion is critical to the provision of high-quality healthcare and is foregrounded internationally as an issue of contemporary concern. Paid care experience prior to nurse training has been suggested as a potential means of improving compassion, which has been characterised by the values and behaviours of care, compassion, competence, communication, courage, and commitment. There is however a dearth of evidence to support the effectiveness of prior care experience as a means of improving compassion in nursing.

OBJECTIVE

To explore the impact of paid prior care experience on the values and behaviours of pre-registration nursing students indicated as characterising compassionate care.

DESIGN

Longitudinal mixed methods design employing a modified concurrent triangulation strategy, comprising two work packages. Work package 1 was qualitative, and work package 2 adopted a concurrent embedded strategy with a dominant quantitative component. Research is reported in accordance with the Good Reporting of a Mixed Methods Study framework.

SETTING(S)

Three United Kingdom universities.

PARTICIPANTS

Pre-registration nursing students attending one of three universities, and individuals who had previously participated in a Health Education England paid prior care experience pilot. Participant numbers at time point 1 were questionnaires n = 220, telephone interviews n = 10, and focus groups n = 8.

METHODS

Work package 1 consisted of longitudinal semi-structured telephone interviews. Work package 2 comprised validated online questionnaires measuring emotional intelligence, compassion satisfaction and fatigue, resilience, psychological empowerment, and career commitment (as proxies of compassionate values and behaviours), and focus groups. Qualitative data were thematically analysed. Quantitative data were analysed via Analysis of Variance in SPSS v 26.

RESULTS

Qualitative findings suggest that prior care experience has both positive and negative effects on students' compassionate values and behaviours, however positive effects do not extend to qualification. No statistically significant differences were found in any of the quantitative outcome measures between participants with and without paid prior care experience. A statistically significant increase in compassion fatigue was identified in both groups of participants post-qualification. Paid prior care experience did not prevent participants from experiencing reality shock on becoming a student or on qualification.

CONCLUSIONS

There is insufficient evidence of longitudinal beneficial impact to recommend paid prior care experience as an effective intervention to foster nursing students' compassionate values and behaviours. These findings do not support mandating a period of paid care experience as a prerequisite for entry into nurse education.

REGISTRATION

N/A. Tweetable abstract Insufficient evidence of longitudinal beneficial impact to recommend prior care experience as an effective intervention to foster nursing student compassion @PriorCareExp @Sarah_F_R.

[The bibliography group, between dream and reality in nursing practice]

The shock of reality that nursing students face when they start out will affect the nursing profession even more in the future, as it faces a recruitment crisis in the midst of renewal. Restoring meaning to the nursing profession is a complex and daunting challenge. By providing access to scientific literature, the bibliography group can contribute to this, based on an Evidence-Based Nursing approach. This initiative, which is beneficial for professionals whose skills development is thus encouraged, is designed to be simple and accessible to as many people as possible.

The relationship between psychological capital, burnout and perceived stress in junior nurses: a latent profile analysis

Background

Psychological capital, an intrinsic personal asset, enhances junior nurses' ability to navigate transition and sustain superior job performance. This study aimed to classify junior nurses into distinct psychological capital profiles and examine their associations with burnout and perceived stress levels.

Methods

A cross-sectional study involving 480 junior nurses from three hospitals in Beijing assessed psychological capital, stress, and burnout using e-questionnaires, from July 2021 to August 2022. We employed exploratory latent profile analysis for psychological capital profiling and logistic regression with the best subset method to identify the influential factors.

Results

The results of the latent profile analysis supported the models of two latent profiles, which were defined as low psychological capital (224, 46.5%) and high psychological capital (256, 53.5%). Logistic regression revealed that introverted nurses and those experiencing moderate to high levels of burnout and stress were more likely to exhibit low psychological capital.

Conclusion

Nursing management should proactively identify and support junior nurses with low psychological capital, with a focus on introverted individuals, to mitigate the impact of stress and burnout.

A Healthcare-Academic Practice Partnership Program to Promote Student Nurse Readiness for Work

Highly skilled new graduate nurses must be better prepared to face the clinical and professional challenges in today's healthcare environment. Compounding these challenges are the growing resignations of clinical faculty and experienced clinical nurses. Innovative programs are needed to bridge the knowledge-practice gap with opportunities to create pipelines to aid the future nursing workforce. A multihospital health system partnered with a local college of nursing to develop a Nursing Student Pipeline Program, which allows nursing students to perform select nursing tasks as employees of the health system. Fifty-six students have been hired to participate in the pilot program. Of the students eligible for hire and who completed the program, 24 are current employees with the healthcare system. Students, preceptors, and managers report the benefits of this program, including that participating in the program supports increasing readiness for practice upon graduation.

The impact of transition programs on well-being, experiences of work environment and turnover intentionamong early career hospital nurses

BACKGROUND

Transition programs for newly graduated nurses in hospital settings are reported to provide learning opportunities, strengthening confidence, workplace integration and skills, retention and job satisfaction. Still, our knowledge of long-term effects is scarce and few studies have used control groups.

OBJECTIVE

To explore the long-term impact of having attended a transition program on the nurses' experiences of the first years of practice. More specifically, ideology-infused psychological contract, ethical stress, perceived organizational support, job satisfaction, opportunities for learning, and intention to stay in the nursing profession, were explored as outcome variables.

METHODS

A questionnaire survey was carried out among registered nurses from November 2019 to January 2020, with a 54% response rate. The analysis was based on 149 nurses who had attended a transition program, and 72 who had not attended. The nurses had seniority between one and three years. Independent samples t-test were used to investigate differences between the groups.

RESULTS

The two groups showed small and non-significant differences in the outcome variables. However, regarding the frequency of ethical value conflicts induced by insufficient resources, as well as experiences of ethical value conflict distress, the group of nurses who had attended a transition program showed statistically significantly higher mean values, although the effect sizes were small.

CONCLUSION

Newly graduated nurses need more than transition programs and skills training to progress in their nursing role and develop competence, increase job satisfaction, and reduce stress. Achieving these goals requires a long-term supportive learning environment that is integrated into everyday work.

New Graduate Nurse Transition into Rural Home: A Case Study

The global shortage of nurses and high attrition rates for newly graduated nurses along with the shifting demand for home care has created a critical need for retention strategies that address the specific challenges of rural settings. The effectiveness of structured transition or mentoring programs are primarily studied in acute care settings, making it difficult to translate to the unique context of rural home care nursing. The complexities of the independent nature of home care nursing practice and limited resources to address transition shock make it difficult to successfully transition newly graduated nurses to rural home care. A case study supports mentorship facilitation as a readily available, effective strategy that can overcome the challenges of rural home care settings. A comparative analysis will link Duchscher's (2008) transition shock theory to mentorship as an effective strategy for supporting NGNs' transition in home care nursing. Recommendations offer rural care leaders practical strategies bundled with mentorship to optimize the successful transition and retention of newly graduated nurses in their workplaces.

Improving New Graduate Nurse Retention With a Transition to Emergency Nursing Practice Program

INTRODUCTION

Emergency department turnover rates increased at Sentara Northern Virginia Medical Center. Most applicants were new graduate registered nurses. A strength, weakness, opportunity, threat analysis revealed 3 weaknesses regarding new graduate registered nurses in emergency departments. Transition to practice program was necessary, new graduate registered nurse competency needed to progress rapidly, and retention rates needed improvement.

METHODS

The emergency department registered nurse transition to practice pathway was created to address these challenges. Retention statistics were garnered through new graduate registered nurses length of employment. Improving retention rates at Sentara Northern Virginia Medical Center led to expansion of the program to the other 11 hospitals in the system. Self-report surveys were created later to evaluate the new graduate registered nursess' satisfaction with the program and perception of clinical confidence.

RESULTS

Using the emergency department registered nurse transition to practice pathway, turnover rates at Sentara Northern Virginia Medical Center dropped from 46% to 5.1%. Post expansion, the overall program retention rates were 96% at 6 months, and 86% at 1 year. The 2-year retention rate prior to COVID-19 was 82%, afterward, it dropped to 65%. Most surveyed new graduate registered nurses had a confidence level of 25% or less on the first day. After their 17-week orientation, 54% reported confidence levels had risen to 75%. Within 6 months, 81% reported 75% confidence, at 1 year, 87% reported levels between 75% and 100%, and at 2 years, 100% reported a confidence level between 75% and 100%.

DISCUSSION

This development of the emergency department registered nurse transition to practice pathway resulted in improved emergency department registered nurse retention and confidence. Savings from reduced turnover and reduced temporary labor staffing were achieved with this program. Implementation takes careful resource management, ongoing analysis, and research to validate return on investment.

Being a Newly Qualified Nurse: A Nordic Focus Group Study

Introduction

The transition to working life as a newly qualified nurse (NQN) can be challenging, leading to heightened stress levels. While NQNs are generally enthusiastic about starting their careers, they often express concerns about various responsibilities and a perceived lack of experience in independently dealing with clinical care in complex environments.

Objective

To acquire an in-depth understanding, from a caring science perspective, of what it means to be an NQN during the transition period of the first 18 months in the profession.

Methods

This study relied on an exploratory qualitative design. The methodological approach followed Gadamer's hermeneutic philosophy. Six focus group interviews were conducted in northern Norway (n = 3) and northern Sweden (n = 3) from January through May 2021. The interpretation of the data was inspired by Fleming et al. Nineteen female and seven male NQNs working in different contexts, including hospitals and municipalities, participated in the study. The consolidated criteria for qualitative research were used to report the results.

Results

Perspectives on NQNs are presented as three themes: a) the responsibility was perceived as a significant challenge, b) being a nurse is complex and demanding, and c) a desire for personal and professional development. Learning to be a nurse shouldering responsibility necessitates support and guidance from caring and compassionate colleagues and leaders.

Conclusions

This study sheds light on the importance of creating a workplace culture where NQNs' learning is promoted and supported by designated mentors during their transition to working life. The responsibilities should be aligned with their level of knowledge. It is important that leaders hold developmental dialogues and ensure a career plan for NQNs to continuously develop their knowledge and skills. Intervention studies designed to evaluate the meaning of the support from appointed mentors within structured mentorship programs are needed.

Innovative Strategies to Facilitate Newly Licensed Nurse Transition to Practice During the COVID-19 Pandemic: A Quality Improvement Project

As healthcare facilities transition from initial phases of the COVID-19 pandemic, it is imperative to consider innovative strategies to overcome instructional challenges presented to nursing schools in order to maintain a competent workforce amidst nursing shortages and increasing patient volumes and complexity. Nursing professional development practitioners will play a pivotal role in revitalizing transition-to-practice programs to meet the demands of the new workforce. This article details an academia-practice initiative for newly licensed nurses who enter practice during the pandemic.

When caring becomes an art - how clinical gaze are perceived to be developed

PURPOSE

This qualitative study describes nurses' experiences and perceptions of how they develop the clinical gaze.

METHODS

This qualitative study used an inductive approach and content analysis to assess the experiences of newly graduated nurses, nurse managers, and nursing teachers. Nineteen interviews were conducted. To achieve credibility, the study followed the guidelines of the Consolidated Criteria for Reporting Qualitative research (COREQ).

RESULTS

Two themes emerged: nurses' personal abilities and the learning culture. Learning culture was considered the foundation of the development of the clinical gaze. The clinical gaze was found to be developed in relationships with patients and when learning together with colleagues, in which the opportunities for reflection are central. To develop the clinical gaze, structures for learning activities, such as reflection, communication exercises, and simulation, are needed so that they become a natural part of daily work. This can also be achieved through supervision and skills training both at university and in a care context.

CONCLUSIONS

Prerequisites for the development of the clinical gaze include physical presence with the patient combined with learning activities such as conscious reflection with others in a safe learning culture.

Prepared to learn but unprepared for work: A cross sectional survey study exploring the preparedness, challenges, and needs of newly graduated nurses entering a hospital-based transition program

The study aims to investigate new graduate nurses the perceptions of educational preparedness, their challenges, and their expectations during their transition to hospital care and introduction to work.

BACKGROUND

Previous research has raised questions about new graduate nurses' (NGNs) preparedness for work in the clinical setting, and transition programs have been implemented to smooth the transition process. Information about NGNs' expectations of both transition programs and their introduction to work when first entering the nursing profession is scarce.

DESIGN

A cross-sectional survey design was used.

METHOD

NGNs enrolled in a regional transition program in six hospitals were recruited from three-cohorts during September 2021, January 2022 and September 2022. After responding to a survey both a qualitative and quantitative approach was used when analyzing responses.

RESULTS

Quantitative and qualitative findings derived from 248 NGNs responses showed that 65% of the NGNs perceived that nursing education in general prepared them for clinical work, that they were prepared for and committed to workplace learning but require support from a well-designed transition program as well as from colleagues and managers in their ward unit. The conclusion is that the preparation provided by nursing education as well as organizational factors in the healthcare workplace influence new graduate nurses' readiness for clinical work, the challenges they perceive, and their needs for learning and support.

Newly graduated nurses use and further development of assessment skills-An in-depth qualitative study

AIMS

To explore in-depth nurses' use and further development of assessment skills in different nursing contexts in the first 2 years after graduation, and factors that influenced their use and development of assessment skills.

DESIGN

The study had explorative qualitative design.

METHODS

Eight nurses who previously had been interviewed about their learning of physical assessment skills in clinical rotation as students participated in this follow-up study. Individual in-depth interviews were conducted, where the nurses spoke freely about their experiences after graduation.

RESULTS

Four prominent features influencing the nurses' use and development of assessment skills were identified: (a) assessment approaches and readiness for practice, (b) the primacy of communication, (c) recognition related to performing assessments, and (d) the influence of organizational factors on their assessment applications.

CONCLUSION

Newly graduated nurses' use of assessment skills is an important part of providing holistic care. This study suggest that assessment skills is not only an assessment task but is central in relationship building and in supporting the professional development of nursing competence.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution, due to study design.

Primary care nursing competencies in Canadian undergraduate nursing programs: A national cross-sectional survey

AIM

To assess the extent to which Canadian undergraduate baccalaureate nursing programs have incorporated Canadian competencies for Registered Nurses in primary care into their curricula.

BACKGROUND

Canadian competencies for Registered Nurses in primary care have several benefits, including their ability to inform primary care education in undergraduate nursing programs and to assist in building a robust primary care nursing workforce.

DESIGN

We conducted a national cross-sectional survey of undergraduate baccalaureate nursing programs (n = 74).

METHODS

The survey was conducted between April-May 2022. We used a modified version of the "Community Health Nurses' Continuing Education Needs Questionnaire". Respondents indicated their level of agreement on a 6-point Likert scale with 47 statements about the integration of the competencies in their program (1 = strongly disagree; 6 = strongly agree).

RESULTS

The response rate was 51.4%. The overall mean across the six competency domains was 4.73 (SD 0.30). The mean scores of each domain ranged from 4.23 (SD 1.27) for Quality Assurance, Evaluation and Research to 5.17 (SD 0.95) for Communication.

CONCLUSIONS

There are gaps in how these competencies are included in undergraduate education programs and opportunities to strengthen education for this growing workforce in Canada.

Nursing Graduates' Preparedness for Practice: Substantiating the Call for Competency-Evaluated Nursing Education

Practice readiness continues to be a challenge in healthcare. This was especially evident during the COVID-19 pandemic. This focused descriptive-correlational study examined nurses' perceived preparedness for practice during the pandemic. One hundred and eighty-four registered nurses (RN) responded to Qualtrics survey questions addressing the competencies they perceived they had and the competencies they felt they needed that would have better prepared them to care for patients during the COVID-19 pandemic. The results demonstrated that although these nurses felt competent in certain areas, they perceived that they needed more education in those same areas to feel better prepared. Bivariate correlations and linear regression analysis indicated that institutional competency development, education, and work experience influenced perceived competency.

Mediating effects of core competence between the transition shock and work readiness of newly graduated nurses in cancer hospitals: A cross-sectional study

BACKGROUND

Newly graduated nurses face a dilemma of transitioning from student to clinical nurse roles, resulting in a low level of work readiness. The special professional environment of oncology hospitals requires newly graduated nurses to have specialized and novel theoretical knowledge and nursing skills. Therefore, they are constantly expected to develop better core competence. However, whether the core competence of newly graduated nurses mediates the relationship between transition shock and work readiness has not been investigated.

OBJECTIVE

This study examined the relationship among transition shock, core competence, and work readiness of newly graduated nurses in cancer hospitals.

DESIGN

A descriptive, cross-sectional study design.

SETTING

This study was conducted at a tertiary cancer hospital in Beijing.

PARTICIPATIONS

A convenience sample of 188 newly graduated nurses was studied from July to August 2022.

METHODS

Sociodemographic data and Transition Shock Scale for Newly Graduated Nurses, Work Readiness Scale for Newly Graduated Nurses, and Core Competence Scale scores were collected using the online Questionnaire Star support platform. Pearson correlation and multiple regression analysis were applied using the Statistical Package for the Social Sciences version 24 to test the relationship among transition shock, core competencies, and work readiness. The Analysis of Moment Structures version 24.0 software was used to construct structural equation models. This report followed the Strengthening the Reporting of Observational studies in Epidemiology checklist.

RESULTS

The transition shock of newly graduated nurses was negatively correlated with work readiness and core competence, whereas core competence was positively correlated with work readiness. Core competence partially mediated the effect between transition shock and work readiness, accounting for 19 % of the total effect.

CONCLUSION

Core competence is the mediating variable between transition shock and work readiness of newly graduated nurses in oncology hospitals. During the transition period of newly graduated nurses, clinical nursing managers and teachers should pay attention to cultivating the core competence of newly graduated nurses to improve their work readiness.

The Turkish version of the Casey-Fink Readiness for Practice Scale: A validity and reliability study

AIM

The aim was to translate and adapt the Casey-Fink Readiness for Practice Scale (CFRPS) into Turkish and assess its validity and reliability for senior nursing students.

BACKGROUND

Nursing students' readiness for practice is important for quality nursing care and to support new graduate nurses and orient them quickly for their professional life. Nurse educators and nurse managers are responsible for develop nursing students' and new graduate nurses' readiness for practice. Currently, there is no valid and reliable tool to assess this metric for senior nursing students in Turkey.

DESIGN

The study was conducted using a methodological approach.

METHODS

The sample of the study consisted of 179 students who were enrolled in the last year of nursing school across three state universities in one region of Turkey. A socio-demographic form and the Turkish version of the CFRPS were used for data collection. Data were collected online between 12 April - 17 May 2021. Content validity was assessed using expert approval. Confirmatory factor analysis, exploratory factor analysis and structural equation modelling were used to assess validity. Cronbach's alpha and test-retest were performed to assess reliability.

RESULTS

Nursing students' mean age was found to be 22.3 ± 1.12. The content validity index of the scale was calculated as 0.94. Confirmatory and exploratory factor analysis identified 15 items, which could be categorized under one factor, that were obtained differently from the original scale. The factor loads were found to be between 0.39 and 0.70. The Cronbach's alpha of the scale was 0.881. One factor model achieved a good fit.

CONCLUSIONS

The study demonstrated that the Turkish version of the CFRPS is a valid and reliable assessment tool to evaluate senior nursing students' readiness for practice. Information in the Turkish version of the CFRPS was obtained differently from the original scale. Nurse educators can use this tool to assess their students' progress in readiness for practice before they graduate.

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.

A Socioecological Model of Transition to Nursing Practice

A newly licensed nurse's (NLN) transition to practice (TTP) is affected by interactions inside and outside the hospital. The aim of this Delphi study was to create a socioecological model of TTP. Included in the socioecological model are personal characteristics and interactions at the relationship, community, and societal levels that the NLNs feel affects their TTP. This socioecological model can be used to plan TTP programs that address the holistic needs of the NLNs.

Assessing the Impact of the COVID-19 Pandemic on Nursing Education: A National Study of Prelicensure RN Programs

Background

The COVID-19 pandemic has had a profound impact on prelicensure nursing education, leading to widespread disruptions that may have implications for nursing students' learning and engagement outcomes. Understanding how the rapid shift to online and simulation-based teaching methods has affected new graduates' clinical preparedness is critical to ensure patient safety moving forward.

Purpose

To assess the impact of institutional, academic, and demographic characteristics on prelicensure nursing students' academic, initial postgraduation, and early career outcomes during the COVID-19 pandemic.

Methods

We conducted a mixed-methods longitudinal study focused on prelicensure registered nurse (RN) students entering the core of their didactic and clinical nursing coursework during the pandemic. This study uses a combination of real-time student and faculty self-report data, including externally validated instruments, within and end-of-program standardized test scores, and focus group findings. Various statistical methods, ranging from simpler descriptive and non-parametric methods to Generalized Estimating Equation (GEE) models and detailed textual analysis, are applied to assess student, faculty, and institution-level data.

Results

The final sample includes more than 1,100 student and faculty participants affiliated with 51 prelicensure RN programs located across 27 states. Leveraging more than 4,000 course observations collected from fall 2020 to spring 2022 and supplemented by the rich personal narratives of over 60 focus group participants, this study illuminates the breadth, scale, and ever-evolving nature of prelicensure RN programs' efforts to maintain the continuity of nursing students' education during the public health crisis. In doing so, it captures the many ways in which nursing administrators, faculty, and students sought to address the unparalleled challenges they confronted on a day-to-day basis. In particular, the findings provide critical insights into the efficacy of the changes nursing programs made to their course delivery formats to adjust to the confluence of rapidly evolving federal, state, and private restrictions to stem the spread of COVID-19.

Conclusion

This study stands as the most comprehensive assessment of prelicensure nursing education in the United States since the onset of COVID-19. It extends knowledge by linking potential deficiencies in students' didactic and clinical education during the pandemic and their early career preparedness, clinical competence, and the patient safety implications therein.

A conflicted tribe under pressure: A qualitative study of negative workplace behaviour in nursing

AIM

This study explored workplace interactions of Australian nurses in regional acute care hospitals through an examination of nurses' experiences and perceptions of workplace behaviour.

DESIGN

This research is informed by Social Worlds Theory and is the qualitative component of an overarching mixed methods sequential explanatory study.

METHODS

Between January and March 2019, data were collected from 13 nursing informants from different occupational levels and roles, who engaged in semi-structured, in-depth, face-to-face interviews. Data analysis was guided by Straussian grounded theory to identify the core category and subcategories.

RESULTS

Theoretical saturation occurred after 13 interviews. The core category identified is A conflicted tribe under pressure, which is comprised of five interrelated subcategories: Belonging to the tribe; 'It's a living hell'; Zero tolerance-'it's a joke'; Conflicted priorities; Shifting the cultural norm.

CONCLUSION

This study provides valuable insight into the nursing social world and the organizational constraints in which nurses work. Although the inclination for an individual to exhibit negative behaviours cannot be dismissed, this behaviour can either be facilitated or impeded by organizational influences.

IMPACT

By considering the nurses' experiences of negative workplace behaviour and identifying the symptoms of a struggling system, nurse leaders can work to find and implement strategies to mitigate negative behaviour and create respectful workplace behaviours.

PATIENT OR PUBLIC CONTRIBUTION

This study involved registered nurse participants and there was no patient or public contribution.

CLINICAL TRIAL REGISTRATION

Study registration Australian New Zealand Clinical Trials Registry (Registration No. ACTRN12618002007213; December 14, 2018).

Transitioning to Independent Nursing Practice during COVID-19: A Mixed Methods Study

The COVID-19 pandemic presented challenges to onboard and support new graduate nurses (NGNs). This study sought to explore the perceptions of nurses entering clinical practice during the COVID-19 pandemic. Using mixed methods, we investigated the experiences of NGNs entering the field during the pandemic and how a nurse residency program (NRP) adapted to meet their needs. Newly graduated nurses entering practice in November 2019 described their transition through nurse experience surveys and focus group discussions. Results from the quantitative data reported on compassion satisfaction, burnout, and exposure to secondary traumatic stress. The qualitative data mirrored these findings with the discovery of the following five themes: transitioning through an NRP, impact to nursing care, value of coworkers, coping, and professional growth. These findings illustrate the need to better support future practice transitions in times of disruption and change.

Final year undergraduate nursing and midwifery students’ perspectives on simulation-based education: a cross-sectional study

Background

Simulation-based education is a teaching and learning approach that can enhance learning experiences for students on healthcare programmes. Within undergraduate nursing and midwifery education, simulation can support students in developing graduate attributes necessary to become practice-ready professionals. This paper reports on the evaluation of a simulation-based education initiative, which was introduced to support final year undergraduate nursing and midwifery students in preparation for their upcoming clinical internship in practice.

Methods

This study aimed to evaluate a simulation-based education initiative from the perspectives of final year undergraduate nursing and midwifery students (N = 95). An online survey, using the validated Simulation Effectiveness Tool – Modified (SET-M), was distributed to final year nursing and midwifery students at one university in Ireland. This study was conducted and reported in line with the Consensus-Based Checklist for Reporting of Survey Studies (CROSS).

Results

The results of the study highlight final year nursing and midwifery students’ perceptions, experiences, and satisfaction with learning in a simulated environment. Students reported their simulation-based learning experiences as worthwhile, motivating, and as important opportunities to build on previous learning, increase confidence and gain experience in preparation for real-life practice. Students reported feeling more confident in their assessment skills, in providing care and interventions in responding to changes in a person’s health status. All students reported that the simulation-based learning experiences enabled them to think more critically about the clinical case scenarios and critically question their actions and decision-making processes. Pre-briefing and debriefing sessions were highlighted as important aspects of the simulation which helped to increase student confidence and cultivate meaningful learning.

Conclusion

Simulation-based education is a valuable teaching and learning modality, particularly for final year students who are transitioning to real-life clinical practice. Student-centred simulation-based learning experiences can cultivate professional development and support learners in their transition from university student to healthcare professional.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-022-01084-w.

Work readiness of newly graduated nurses transitioning to practice in Saudi Arabia: A cross-sectional study

AIMS

To explore work readiness among newly graduated nurses transitioning to practice in Saudi Arabia.

BACKGROUND

Many challenges encounter newly graduated nurses when transitioning to practice. Higher work readiness has been associated with smooth transitioning to practice. However, little is known about work readiness among newly graduated nurses in Saudi Arabia.

METHODS

Cross-sectional convenience sample of 174 participants.

RESULTS

The mean score in work readiness was 338.8 (SD = 69.6). Weekly working hours correlated with organizational acumen (r = 0.208, p ≤ 0.01), social intelligence (r = 0. 217, p ≤ 0.01), work competence (r = 0.173, p ≤ 0.05) and the number of weeks since the start of internship training (r = 0.180, p ≤ 0.05). There were significant mean differences in a) personal work characteristics based on the country (t = 5.582, p < 0.001) and university from which they graduated (f = 15.618, p < 0.001); b) organizational acumen based on having a second job (t = -2.18, p = 0.03), university from which they graduated (f = 1.837, p = 0.002) and whether the hospital was the first-choice preference (t = - 2.837, p = 0.005) and nursing was the first choice of study (t = -2.879, p = 0.005); and c) work competence based on the university from which they graduated (f = 5.267, p = 0.006).

CONCLUSIONS

The findings showed the work readiness of newly graduated nurses in Saudi Arabia's context.

IMPLICATIONS FOR NURSING MANAGEMENT

Findings have important implications for nurse managers to better design and implement a transition to practice programs for newly graduated nurses to improve their preparedness in their nursing careers.

Nurse preceptors' perceptions of benefits, rewards, support, and commitment to the preceptor role in a new preceptorship program

BACKGROUND

Nurse preceptorship is a new concept emerging in the Iranian health care system. The purpose of this research was to assess preceptor nurses' perceived benefits, rewards, support, and commitment to the role in a new nurse preceptorship program in Iran and to examine the relationships between these concepts.

METHODS

A descriptive correlational study was employed, and using total population sampling method, 45 preceptor nurses were recruited from a tertiary referral teaching hospital in Iran. Data were collected using the Preceptor's Perception of Benefits and Rewards Scale, the Preceptor's Perception of Support Scale, and the Commitment to the Preceptor Role Scale. Descriptive statistics and correlational analysis were used to analyse data.

RESULTS

Preceptors' commitment to their role was positively and moderately associated with their perceived benefits and rewards (r = 0.503, p = 0.001) and perceived support (r = 0.430, p = 0.003). None of the examined demographic and practice variables showed statistically significant association with commitment to the preceptor role.

CONCLUSIONS

Commitment to the preceptor role was associated with benefits, rewards and support that preceptor nurses perceive in relation to their role. To optimise the effectiveness of nurse preceptorship programs, benefits, rewards, recognition, and support should be integral to planning of these programs.