Transition experiences, intrapersonal resources, and job retention of new graduate nurses from accelerated and traditional nursing programs: A cross-sectional comparative study

What might make nurses stay? A protocol for discrete choice experiments to understand NHS nurses' preferences at early-career and late-career stages

INTRODUCTION

Like many countries, England has a national shortage of registered nurses. Employers strive to retain existing staff, to ease supply pressures. Disproportionate numbers of nurses leave the National Health Services (NHS) both early in their careers, and later, as they near retirement age. Research is needed to understand the job preferences of early-career and late-career nurses working in the NHS, so tailored policies can be developed to better retain these two groups.

METHODS AND ANALYSIS

We will collect job preference data for early-career and late-career NHS nurses, respectively using two separate discrete choice experiments (DCEs). Findings from the literature, focus groups, academic experts and stakeholder discussions will be used to identify and select the DCE attributes (ie, job features) and levels. We will generate an orthogonal, fractional factorial design using the experimental software Ngene. The DCEs will be administered through online surveys distributed by the regulator Nursing and Midwifery Council. For each group, we expect to achieve a final sample of 2500 registered NHS nurses working in England. For early-career nurses, eligible participants will be registered nurses who graduated in the preceding 5 years (ie, 2019-2023). Eligible participants for the late-career survey will be registered nurses aged 55 years and above. We will use conditional and mixed logit models to analyse the data. Specifically, study 1 will estimate the job preferences of early-career nurses and the possible trade-offs. Study 2 will estimate the retirement preferences of late-career NHS nurses and the potential trade-offs.

ETHICS AND DISSEMINATION

The research protocol was reviewed and approved by the host research organisation Ethics Committees Research Governance (University of Southampton, number 80610) (https://www.southampton.ac.uk/about/governance/regulations-policies/policies/ethics). The results will be disseminated via conference presentations, publications in peer-reviewed journals and annual reports to key stakeholders, the Department of Health and Social Care, and NHS England/Improvement retention leaders.

REGISTRATION DETAILS

Registration on OSF http://doi.org/10.17605/OSF.IO/RDN9G.

Ramifications of the COVID-19 Pandemic on Nursing Students' Transition to Practice

As the COVID-19 pandemic altered the course of nursing education worldwide, it disrupted efforts to transition nursing students to professional practice. The investigators examined clinical nursing faculty members' assessment of senior students' practice strengths and challenges compared to graduates of prior years. Findings demonstrated COVID-19's wide-ranging impacts on nursing students' transition to practice and offered suggestions about the implications for nursing professional development practitioners.

The correlation of intrapersonal intelligence levels of nurses with their emotional contagion and caring behaviours

AIM

Determine the correlation of the intrapersonal intelligence levels of nurses with their emotional contagion and caring behaviours.

BACKGROUND

Intrapersonal intelligence is an introverted concept that includes the capacity to understand and reflect one's self. A high level of intrapersonal intelligence contributes morally to the world and promotes success in professions with a heavy moral dimension. It is stated that emotional contagion, which is defined as the transfer of emotions and moods from one person to another, can occur in groups of two or more people. Within this context, nurses who are affected by emotional contagion may be more likely to withdraw from or desensitise to the people who cause this effect. Both situations may lead to the disruption of essential and non-deferrable care and formation of negative effects on nurses' caring behaviours.

METHODS

The sample of this descriptive study consisted of 257 nurses working in the Gaziantep province. A "Personal Information Form", the "Multiple Intelligence Inventory", the "Emotional Contagion Scale" and "Caring Behaviours Inventory" were used as data collection tools in the study.

RESULTS

It was found that the mean scores of the nurses were 39.76 ± 5.02 for Intrapersonal Intelligence, 50.09 ± 8.32 for Emotional Contagion, and 5.06 ± 0.75 for Caring Behaviours.

CONCLUSIONS

It was determined that the intrapersonal intelligence levels, emotional contagion and caring behaviour levels of the nurses were above average. As the intrapersonal intelligence levels of the participants increased, so did their emotional contagion and caring behaviours.

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.

Construction of learning objectives and content for newly graduated nurses in tertiary teaching hospitals: A Delphi study

BACKGROUND

Transition education is a robust strategy to improve the core competency of newly graduated nurses and the quality of clinical nursing and ensure people's safety. Limited information about the learning objectives and educational content for newly graduated nurses in China was available.

OBJECTIVE

Construct the learning objectives and educational content for newly graduated nurses based on defined core competencies.

DESIGN

We used a literature review and the e-Delphi method to conduct this study.

SETTINGS

Ten tertiary teaching hospitals and six nursing schools in Zhejiang Province, China, were selected.

PARTICIPANTS

Experts (n = 21) were invited to the e-Delphi study.

METHODS

Based on seven competencies from the literature review and the research group discussions, we formed an initial set of objectives and specific educational content for newly graduated nurses. Subsequently, experts provided supportive and modification advice on the competencies, objectives, and specific content in the two Delphi rounds. The consensus percentage and the weight of each first-level, second-level, and third-level item were calculated.

RESULTS

Consensus was achieved on seven core competencies, 44 learning objectives, and 60 components of educational content. The positive coefficient of the two Delphi rounds was 100 %, the authority coefficient was 0.83 and 0.87, the proportion of experts who made suggestions was 71.40 %, the coefficient of variation (CV) was <0.25 (P < 0.05) except for two items and the Kendall coefficient (W) was 0.15-0.48 (P < 0.01).

CONCLUSION

The developed objectives and content framework provide a reference for implementing systematic and standardized education for newly graduated nurses.

Supporting the transition to practice: preceptor behaviors that foster a positive student preceptorship experience

OBJECTIVES

Preceptors support nursing students when transitioning to the professional nursing role. This study explored student perceptions of preceptor characteristics that promoted or hindered learning.

METHODS

A Likert-scale survey including two open-ended questions was sent to 571 nursing students completing a preceptorship experience. Descriptive statistics were used to analyze responses to the Likert-scale items. Qualitative analysis was completed on the two exploratory questions to extract themes.

RESULTS

Students rated the preceptor between 4=Very Good and 5=Outstanding for all items. No significant differences in scores were found when comparing results between programs. Themes assisting in learning included: increasing independence gradually and pushing out of comfort zone. Themes identified that hindered learning included: doubting self and being pushed aside.

CONCLUSIONS

Future implications include communicating preceptorship objectives and providing ways to apply research to practice. These findings can guide collaboration between academic and practice partners to assist with transition to practice.

Effects of group psychological counselling on transition shock in newly graduated nurses: A quasi-experimental study

AIM

This study examined the effects of group psychological counselling on transition shock in newly graduated nurses.

BACKGROUND

Newly graduated nurses are often faced with transition shock as they enter the workforce. Helping them adapt to the new work environment and role as quickly as possible is an important goal for nursing managers.

METHOD

This prospective, parallel-group, quasi-experimental trial enrolled 71 newly graduated nurses who were randomly assigned to the intervention (n = 38) or control (n = 41) group. In addition to routine hospital training, the intervention group received psychological counselling. Participants were evaluated with the Transition Shock Scale of Newly Graduated Nurses before (pre) and after (post) the training with or without intervention.

RESULTS

The total score and score on each dimension of the scale were decreased after the intervention (P < .05); control subjects showed no difference between pre- and post-scores. The total score and score on each dimension were higher in the control group than in the intervention group (P < .05).

CONCLUSION

Psychological counselling alleviates transition shock in newly graduated nurses entering the workforce.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing managers can introduce group psychological counselling into their training programmes to increase the job readiness of newly graduated nurses.

Development and implementation of a standardized training program for newly graduated mental health nurses: Process and preliminary outcomes

BACKGROUND

Training programs are crucial for newly graduated nurses transitioning from nursing school to independent clinical nursing careers. However, few studies have focused on the training of newly graduated mental health nurses.

OBJECTIVES

The aim of this study was to develop, implement, and preliminarily evaluate a standardized training program for newly graduated nurses entering psychiatric nursing.

DESIGN

The Delphi technique was adopted for program development, and a quasi-experimental design was employed for program implementation.

SETTINGS

Six mental health institutions were involved in the practice training, and among these, three university-affiliated psychiatric hospitals were the study sites for theoretical training.

PARTICIPANTS

A total of 180 newly graduated nurses hired by the six hospitals were involved and 154 finished the training program.

METHODS

The program was developed using the Delphi method based on the results of a literature review and semi-structured interview with clinical practitioners. Change in mental health nurses' core competencies before and after the program was compared during program implementation. Focus group interviews were employed to collect the opinions and influence of the standardized training program after the intervention, and content analysis was used to analyze it.

RESULTS

A two-round Delphi expert consultation was done, and 7 core competency elements and 37 training topics were designed for the standardized training program. The six-month training program consisted of two months for course training and four months of practical training, which were guided by a manual. Total CIRN scale score improved (142.29 ± 34.87 vs. 160.35 ± 32.46, P < 0.01) after receiving the program as did the scores for each dimension (P < 0.01). Participants gave positive feedback and suggested optimal training length and certification for the program.

CONCLUSIONS

The standardized training program focused on mental health nursing proved to be a viable method of novice nurse training and resulted in positive outcomes. The program length and its long-term effects deserve further exploration to determine the best practical training program for sustaining optimal development of mental health nursing.

International nursing students' and international nursing graduates' experiences of transition to the nursing workforce: A systematic review of qualitative evidence

OBJECTIVE

The objective of this systematic review was to identify and synthesise existing evidence on the experiences of international nursing students' and international nursing graduates' transition to the host country's nursing workforce.

BACKGROUND

International students' experiences of transition to the host country has been extensively explored by researchers. International students experience unique challenges related to communication and language, socialisation, finance, and temporary student visa. One under-researched area is the experiences of transition for international nursing students and international nursing graduates. This systematic review examined the existing evidence on international nursing students' and international nursing graduates' experiences of transition to the host country's nursing workforce.

INCLUSION CRITERIA

This review considered published and unpublished studies-qualitative, quantitative, mixed methods, evidence syntheses, and grey literature-that included international nursing students enrolled in an undergraduate nursing programme outside their home country and international nursing graduates, either employed or not yet employed in nursing and within their first year of completing an undergraduate nursing programme outside their home country.

METHODS

A three-step search strategy was utilised in this review. The search strategy aimed to find published and unpublished literature in English from January 2000 to April 2020. The databases searched were Ovid Medline, Scopus, Emcare, ERIC, PsycINFO, ProQuest Central, ProQuest Dissertations and Theses Global, JBI Evidence-based Practice Database, and ScienceDirect. Two reviewers independently screened the titles/abstracts and full texts of studies for inclusion and appraised the methodological quality of the included studies. Findings and accompanying illustrations were extracted by one reviewer, assigned a level of credibility, and checked by the others. Results were analysed using JBI's approach to qualitative meta-aggregation.

RESULTS

This review included three qualitative papers published between 2011 and 2018. All included studies were appraised as of moderate quality. Sixty-five study findings and nineteen categories were aggregated into the following six synthesised findings: international nursing graduates developed confidence and satisfaction through challenges; personal challenges; clinical challenges; discrimination and justice; academic barriers to success; and what international nursing students liked and wanted.

CONCLUSION

The synthesised findings revealed ongoing anxiety, lack of preparedness and role uncertainty that was experienced by international nursing students and international nursing graduates as they transition to the host country's nursing workforce. They expressed the need for information about professional role expectations, guidance, and support to transition. University transition programmes and services could provide support to address the workforce transition challenges faced by international nursing students and international nursing graduates.

TWEETABLE ABSTRACT

Systematic review shows international nursing students and international nursing graduates experience anxiety, limited preparedness and role uncertainty when transitioning to the host country's nursing workforce.

Transition experiences of newly qualified registered graduate nurses employed in a Neonatal Intensive Care Unit

OBJECTIVE

To explore the experiences of newly qualified registered graduate nurses' clinical and professional learning experiences, during their first six-months of post registration employment within a graduate nurse transition program in a Neonatal Intensive Care Unit (NICU).

METHOD

Narrative inquiry with thematic analysis was used to explore the newly qualified registered graduate nurses' accounts via semi-structured interviews, conducted between January 2018 - January 2019, of their clinical and professional learning during their employment in the Neonatal Intensive Care Unit.

SETTING

In total, eight newly qualified registered graduate nurses employed at two Western Australian Hospitals sites were recruited.

FINDINGS

Themes identified included: feeling unprepared; experiences of horizontal violence; the need for a supportive structural environment and seeking feedback. Participants reported overwhelming feelings of stress, emotional exhaustion, concerns for patient safety and for some, fear of early career burnout.

CONCLUSION

In this study, newly qualified registered graduate nurses were clinically underprepared for entering a Neonatal Intensive Care Unit with all participants reporting high levels of psychosocial distress. This was further compounded by a lack of structured support, horizontal violence, and inadequate or no regular feedback from preceptors, resulting from a negative workplace culture and poor educator behaviours. Recommendations for improving the experiences of newly qualified registered graduate nurses employed in the Neonatal Intensive Care are discussed.

Impact of nurse burnout on organizational and position turnover

BACKGROUND

The National Academies of Medicine describes clinician burnout as a serious threat to organizational health, including employee turnover.

PURPOSE

To determine the relationship between resilience, burnout, and organizational and position turnover.

METHODS

We surveyed direct care nurses in three hospitals 1 year apart between 2018 and 2019; 1,688 nurses completed 3,135 surveys included in analysis.

FINDINGS

Fifty-four percent of nurses in our sample suffer from moderate burnout, with emotional exhaustion scores increasing by 10% and cynicism scores increasing 19% after 1 year. The impact of burnout on organizational turnover was significant, with a 12% increase in a nurse leaving for each unit increase on the emotional exhaustion scale, though it was not a factor in position turnover.

DISCUSSION

These findings contribute to the growing body of evidence of nurse burnout and support policies and programs for annual measurement of burnout, increased employee wellbeing support, and improved work environments.