Nurse Preceptor Role in New Graduate Nurses' Transition to Practice

Addressing Nurse Burnout: Moving Beyond the Conversation

BACKGROUND

Nurse burnout is a widespread issue in the health care industry, jeopardizing the well-being of both health care professionals and the patients they serve, manifesting as an intense sense of exhaustion, depersonalization, and a diminished sense of personal achievement.

METHOD

In nursing, professionals are exposed to an extraordinary array of challenges and demands that increase their likelihood of experiencing burnout and resulting mental health issues. Although burnout has been aggressively discussed and studied in recent years, strategies for preventing and mitigating burnout have been underreported.

RESULTS

This article highlights leading causes of burnout, delves into its alarming prevalence, and underscores the critical need for comprehensive strategies to address and prevent it.

CONCLUSION

This article highlights several initiatives established by a resilience program at a college of nursing that can be implemented within health care systems to directly address both individual and organizational burnout. [J Contin Educ Nurs. 2024;55(8):407-412.].

Pressure Ulcer Management Virtual Reality Simulation (PU-VRSim) for Novice Nurses: Mixed Methods Study

BACKGROUND

Pressure ulcers (PUs) are a common and serious complication in patients who are immobile in health care settings. Nurses play a fundamental role in the prevention of PUs; however, novice nurses lack experience in clinical situations. Virtual reality (VR) is highly conducive to clinical- and procedure-focused training because it facilitates simulations.

OBJECTIVE

We aimed to explore the feasibility of a novel PU management VR simulation (PU-VRSim) program using a head-mounted display for novice nurses and to investigate how different types of learning materials (ie, VR or a video-based lecture) impact learning outcomes and experiences.

METHODS

PU-VRSim was created in the Unity 3D platform. This mixed methods pilot quasi-experimental study included 35 novice nurses categorized into the experimental (n=18) and control (n=17) groups. The PU-VRSim program was applied using VR in the experimental group, whereas the control group received a video-based lecture. The PU knowledge test, critical thinking disposition measurement tool, and Korean version of the General Self-Efficacy Scale were assessed before and after the intervention in both groups. After the intervention, the experimental group was further assessed using the Clinical Judgment Rubric and interviewed to evaluate their experience with PU-VRSim.

RESULTS

The results compared before and after the intervention showed significant improvements in PU knowledge in both the experimental group (P=.001) and control group (P=.005). There were no significant differences in self-efficacy and critical thinking in either group. The experimental group scored a mean of 3.23 (SD 0.44) points (accomplished) on clinical judgment, assessed using a 4-point scale. The experimental group interviews revealed that the VR simulation was realistic and helpful for learning about PU management.

CONCLUSIONS

The results revealed that PU-VRSim could improve novice nurses' learning of PU management in realistic environments. Further studies using VR for clinical training are recommended for novice nurses.

Readiness levels of intern nursing students during the transition to professional practice within the Al Jouf Region in Saudi Arabia

BACKGROUND

The transition of newly graduated nurses into the workforce is recognized as a complex undertaking and has been examined extensively in the literature.

OBJECTIVE

This study aimed to assess the readiness levels of intern nursing students and investigate the factors affecting their transition to professional practice within the Al Jouf region in Saudi Arabia.

METHODS

The study employed a combination of descriptive, correlational, and qualitative methodologies to conduct its investigation. Data were acquired via an online questionnaire that included demographic information, the Nursing Practice Readiness Scale (NPRS), and two open-ended questions. A total of 135 nursing intern students were recruited to participate in the study. Benner's "novice-to-expert" theory of clinical competence was utilized to guide the theoretical underpinning of the study.

RESULTS

Findings revealed that most intern nursing students (63.7%) exhibited a moderate level of readiness. Furthermore, 70.4% and 55.6% of the students showed moderate readiness in terms of their professional attitudes and patient-centeredness, respectively. More than one-third of the students demonstrated a high level of readiness in the self-regulation domain (36.3%), while a similar proportion indicated a high level of readiness in the domain of collaborative interpersonal relationships (33.3%). The students underscored their reliance on the education system as pivotal in enhancing their preparedness for clinical practice.

CONCLUSION

Nursing internship programs contribute to a more comprehensive readiness of nurses for active participation in clinical practice as compared to traditional educational programs.

Adopting a nurse-led model of care to advance whole-person health and health equity within Medicaid

BACKGROUND

Medicaid payment reforms and delivery model innovations are needed to fully transform U.S. healthcare structuring and provision.

PURPOSE

To synthesize nurse-led models of care and their implications for improving health care access, quality, and reducing costs for Medicaid recipients.

METHODS

A critical review of the literature regarding nurse-led models and implications for addressing social determinants of health (SDOH), adopting population health approaches, managing complex care, and integrating behavioral and physical health care within Medicaid.

DISCUSSION

Three interrelated findings emerged (a) investing in dynamic nurse-led models is important for mitigating SDOH and adopting value-based care, (b) regulations preventing nurses from practicing at the fullest extent of their training and licensure limit clinical impact and value, and (c) directed payments can establish value-based expectations for Medicaid managed care.

CONCLUSION

Adoption of a nurse-led model of care has the potential to advance the goals of reducing inequity and promoting whole-person health within Medicaid and nationally.

Competence and Confidence With Quality and Safety Education for Nurses Competencies by Newly Licensed Registered Nurses

Understanding newly licensed registered nurses' perceived confidence in the Quality and Safety Education for Nurses (QSEN) competency domains and corresponding knowledge, skills, and attitudes will help inform clinical leaders to develop successful transition-to-practice programs. Newly licensed registered nurses and prelicensure nursing students had confidence in their understanding of QSEN competencies as they began their transition to practice. Online learning and virtual practicums were effective for attaining QSEN competencies, offering support for using these interventions in academic settings and transition-to-practice programs.

Transition status and influencing factors of newly graduated nurses: A descriptive survey design

AIMS

To assess the transition status of newly graduated nurses in China and identify its influencing factors.

BACKGROUND

Newly graduated nurses are the indispensable part of nursing human resource. The successful transition of into clinical work is crucial for their future career development. However, the transition status of new nurses in China remains inadequately explored.

DESIGN

A descriptive survey design was employed in this study.

METHODS

From October 2022 to January 2023, 1261 newly graduated nurses were surveyed online with the Transition Status Scale for Newly Graduated Nurses. Description statistical analysis was adopted to evaluate the transition status of new nurses. Independent-samples t-test, Analysis of Variance and Multiple Regression Analysis was used to explore the influencing factors of the transition status.

RESULTS

The total mean score of Transition Status Scale for Newly Graduated Nurses was 4.00 (SD=0.61). Competence for nursing work (Mean=4.20; SD=0.57) was rated the highest among the five dimensions of the scale, while the dimension of balance between work and life (Mean=3.65; SD=0.89) was rated the lowest. Mentored by senior nurses, night shift, attribute of working hospital, educational background, interned in the same department, tertiary general hospital, reasons for choosing nursing and working time can affect the transition status of new nurses, accounting for 17.9% of the variance in transition status (R²= 0.179, P＜0.001).

CONCLUSION

The transition status of newly graduated nurses in China is at a relatively high level, especially in the dimension of competence for nursing work. However, newly graduated nurses are in a relatively poor status of work-life balance. Nurse educators and managers need to pay more attention to the transitional training of highly educated nursing talents and the optimization of clinical transition training programs to prevent talent loss. Experienced tutors should be allocated to provide guidance for newly graduated nurses.

Preceptor's experience in supervising undergraduate nursing students in mental health: A qualitative study

Preceptorship is considered an essential component in undergraduate nursing student's clinical placement, especially those in speciality units such as mental health. During the preceptorship relationship students are granted the opportunity to work alongside experienced nurses in the ward observing their interactions with patients and other professionals. In addition, students are able to build clinical confidence and competence. There is currently a gap in the literature around the preceptorship experience in the mental health clinical environment which warrants further exploration. The aim of this study was to explore the experiences of Registered Nurses precepting undergraduate nursing students during mental health clinical placements. A qualitative, exploratory approach was performed. A total of eight registered nurses working in an acute in-patient mental health unit in a large regional hospital, were recruited and interviewed using a semi-structured interview technique. Thematic analysis was utilised to analyse the data resulting in the development of four overarching themes; (1) Time consuming and additional workload, (2) creating a safe environment, (3) providing and receiving feedback and (4) precepting is not a choice, it is an expectation. The results highlighted that preceptoring students was considered to be an extra workload that required significant time and effort. Preceptors also expressed concerns about student safety, emphasised the importance of feedback and acknowledged preceptorship as an expectation of registered nurses working in mental health. These findings underscore the necessity for further research to delve deeper into the experience of preceptors in mental health settings.

Relationship among core competency, self-efficacy and transition shock in Chinese newly graduated nurses: a cross-sectional study

OBJECTIVES

To investigate how core competency and self-efficacy of newly graduated nurses affect their experience of transition shock, and to determine the relationship between these factors.

DESIGN

A cross-sectional study.

METHODS

262 newly graduated nurses participated in a cross-sectional study by using demographic data, the transition shock scale, the competency inventory for registered nurses scale and the self-efficacy scale.

RESULTS

Among newly graduated nurses, the score of transition shock was 77.641±24.140, the score of core competency was 125 (109.5, 163.5) and the score of self-efficacy was 2.5 (2,3), all of which were at a moderate level. The core competency and self-efficacy of the newly graduated nurses had a negative impact on the transition shock (β=-0.151, p=0.026; β=-0.379, p<0.001). Additionally, self-efficacy played a mediating role in the relationship between core competency and transition shock, with a mediating effect accounting for 57.34% of the total effect.

CONCLUSIONS

The transition shock of newly graduated nurses was at a moderate level, with the highest level of transition shock occurring within the first year of employment. Self-efficacy plays a mediating role in the relationship between core competency and transition shock. Nursing managers should create standardised training for newly graduated nurses within the first year of employment to reduce their transition shock. This will help improve newly graduated nurses' core competency, enhance self-efficacy and support the graduates. This will alleviate the impact of transition shock on newly graduated nurses, helping them transition smoothly and successfully.

Growing Novice Nurses to Perianesthesia Care: Formation of a Post-Anesthesia Care Unit (PACU) Fellowship

PURPOSE

To provide a proof of concept of a structured, replicable perianesthesia fellowship program for nurses with less than 2 years of experience and new graduate nurses.

DESIGN

An immersive learning experience was implemented as a pilot quality improvement project using the Plan-Do-Study-Act method.

METHODS

This 24-week fellowship program used blended learning approaches and the Tiered Skill Acquisition Model (TSAM) to develop foundational Post Anesthesia Care Unit (PACU) skills. Nurse Fellows (4) acquired knowledge in stages, with each week in the program reinforcing and building upon the prior week's learnings. Settings included an initial 10 weeks in the ambulatory PACU, then the acute care PACU (weeks 11-20), and the final 4 weeks were spent in the primary unit where the Fellow would transition into a PACU Staff RN. Through each phase, the Professional Practice Department's Clinical Mentor Nurse promoted preceptor development, facilitated learning experiences and provided bimonthly evaluations of the Nurse Fellow's progress via our institution's clinical rounding tool. We used the Nursing Anxiety and Self-Confidence Associated with Clinical Decision Making (NASC-CDM) scale to assess novice nurses' anxiety and self-confidence associated with making clinical decisions at designated intervals.

FINDINGS

All Nurse Fellows completed the program and remained in PACU positions 2 years post-fellowship. They reported discomfort and increased stress transitioning to different PACUs; however, they later indicated reduced anxiety and greater confidence in clinical decision-making, as noted in subsequent evaluations of the NASC-CDM scale.

CONCLUSIONS

Perianesthesia fellowship programs incorporating blended learning, skill reinforcement, and formal mentoring on a primary PACU unit build confidence and competence in the novice nurse, making this once-excluded population of nurses a viable option for recruitment directly into the PACU environment.

Introduction of the Development Nurse Role to Advance Critical Thinking Skills of New Nurses

This article explores the development and implementation of an innovative method for advancing critical thinking and skill development among new nurses after initial orientation. By creating a development nurse role, this pediatric intensive care unit was able to better train and retain its staff. Features of this program are generalizable to nursing units across various settings. A key for this unit was a structure that allowed for individualization based on each nurse's needs. [J Contin Educ Nurs. 2024;55(4):169-174.].

Effectiveness of a preceptors' social support program to aid novice nurses' error experience on preceptors' skill and novice nurses' perception of social support: A quasi-experimental study

AIM

To evaluate the effectiveness of the preceptors' social support program (PSSP) on preceptors' social support skill-supportive relationships and post-error support-and novice nurses' perception of received social support.

METHODS

This study employed a quasi-experimental pretest-posttest design with a control group of a non-random assigned sample of 47 preceptors and novice nurses and an intervention group of 48 each. Intervention group preceptors received training in building supportive relationships skill and post-error support skills three times in the PSSP over 7 months. Preceptors' social support skill and novice nurses' perception of received social support were measured as primary outcomes. Data were collected at baseline (T0), 1 month after the second session (T1), and 1 month after the last session (T2) and analyzed.

RESULTS

No significant differences in demographics or scores were shown at baseline (T0). Preceptors in the intervention group showed significantly better supportive relationships (T2, 101.6 ± 9 vs. 96.9 ± 7.6, 95% CI [0.95, 8.42], p = .015) and better performance of post-error support (T2, 67.6 ± 5 vs. 62 ± 6.5, 95% CI [2.78, 8.32], p < .001). Intervention group preceptors' social support skill increased or remained stable, while it decreased over time in the control group. Novice nurses in the intervention group received significantly better supportive relationships and post-error support from preceptors (T2, median 112 vs. 101, p = .007; 70.5 vs. 65, p = .028, respectively).

CONCLUSIONS

The PSSP improved preceptors' supportive relationship skills and post-error support performance, leading to novice nurses' perceptions of better supportive relationships and receiving greater post-error support.

Closing the Academic-Practice Gap With Enhanced Preceptor Training

A successful pilot program served as a model for how educators in healthcare organizations can reduce the academic-practice gap by supporting preceptors. Preceptors received enhanced training using self-paced online modules and an asynchronous online problem-based learning. Statistically significant increases in self-efficacy and satisfaction with training were reported. Preceptor training included strategies for teaching prioritization, communication, and clinical judgment. Preceptors experienced sustained resilience, increased awareness of well-being, and more engagement in the precepting role.

Effectiveness appraisal of interventions to increase retention of newly qualified nurses implemented in the final year of pre-registration programmes: A literature review

AIM

To understand the effectiveness of interventions to increase retention of early career nurses, implemented during the pre-registration programme.

BACKGROUND

Retention of nurses is an issue of global concern. The transition period spanning the final year of pre-registration nurse education programmes and the first year of qualified practice is a point of high risk for attrition from the profession.

DESIGN

A systematic review without meta-analysis and a thematic synthesis of wider literature, reported using SWiM and ENTREQ guidelines.

METHODS

A convergent segregated approach was used to capture qualitative and quantitative study designs. A systematic review of quantitative papers reporting intervention and retention data and scoping review of a wider body of literature related to interventions supporting transition to qualified practice were conducted. Searches used Medline and CINAHL databases in October 2021. Data extracted from wider literature were inductively collated into themes relating to the intervention type and synthesised.

RESULTS

Six papers were included in the systematic review and 27 papers were included in the scoping review. Interventions included internships, externships, clinical immersion programmes, capstone projects, preceptorships and psychological wellbeing programmes. There was a lack of consensus about the benefits of implementing interventions during the final year of pre-registration programmes, but some evidence that interventions incorporating preceptors, expose students to the clinical environment and involve academic/clinical collaboration, report positive outcomes related to transition to qualified practice, which potentially has an impact on motivation to stay in the profession.

CONCLUSION

Greater understanding of interventions supporting student nurses to reduce likelihood of leaving once qualified has been achieved. There is some evidence these interventions lead to increases in retention, but this is limited by the quality of the reporting and the scarcity of data. Consideration should be given to maximizing students' exposure to clinical practice and the benefits that interventions with alternative approaches such as psychological wellbeing programmes may bring. This review has potential to influence effective implementation of interventions to increase retention of early career nurses if clinical practice and academic settings review proposed or actual interventions to maximise added value. REPORTING METHOD: the manuscript has been written in adherence with the EQUATOR guidelines following the SWiM reporting guidelines for the systematic review and the ENTREQ guidelines for the scoping review.

Implementation of an Evidence-Based Onboarding Program to Optimize Efficiency and Care Delivery in an Intensive Care Unit

Nationally, nurse turnover is 18.7%, and 24.1% of nurses leave their organization within a year of hire. Onboarding is a key component of a nurse's intent to stay and job satisfaction. This article describes the implementation and results of an onboarding program in a large intensive care unit.

Effects of Career Adaptability and Self-Efficacy on Transition Shock Among Newly Graduated Nurses During the COVID-19 Pandemic: A Survey Conducted in China

BACKGROUND

The coronavirus disease 2019 (COVID-19) outbreak has increased the work pressure of nurses worldwide, and managers must provide support and assistance for the transition period of newly graduated nurses.

METHOD

A cross-sectional design was adopted to collect a sample of 318 newly graduated nurses from six hospitals in China during the COVID-19 pandemic. Data were collected using a questionnaire that consisted of a demographic questionnaire, the Transition Shock Scale (2015), the Career Adapt-Ability Scale (2012), and the General Self-Efficacy Scale (2001).

RESULTS

The transition shock of newly graduated nurses was 3.77 ± 0.48 in China. Regression analysis showed that transition shock among newly graduated nurses was predicted by career adaptability, general self-efficacy, living with one's parents, and education level, which accounted for 37.7% of the variance in transition shock.

CONCLUSION

Newly graduated nurses experienced a relatively high level of transition shock in China during the COVID-19 pandemic. Managers may offer continuing education to reduce the transition shock of newly graduated nurses based on the factors that affect their transition shock. [J Contin Educ Nurs. 2023;54(11):524-532.].

Exploring the gap between school of nursing theoretical foundations and clinical practice

BACKGROUND

Theoretical and practical preparation is essential for developing competent nurses. The clinical setting is the most effective context for learning nursing skills. It gives opportunities for newly qualified nurses to practice clinical decision-making by applying theoretical knowledge. Integrating theory and clinical practice with good supervision improves newly qualified nurses' competencies to care for patients and enhance their self-confidence.

OBJECTIVE

To identify the gaps between theoretical preparation in the schools of nursing and actual hospital clinical work in a public hospital in Bahrain and to suggest possible solutions to overcome these gaps.

METHODS

A qualitative descriptive study design was used in a tertiary public hospital in Bahrain. Ten newly employed registered nurses were recruited using purposive sampling. Semi-structured interviews were conducted, and a thematic analysis was employed.

RESULTS

Two Over-arching themes emerged from the analysis of the responses. The first identified the causes of the gaps that new nurses face in the transition (Lack of autonomy, technology employed in healthcare settings, impact of the COVID-19 pandemic, and lack of clinical exposure). The second provided possible solutions for these gaps (Open communication and collaboration, orientation phase and preceptorship, empowerment and self-confidence, and more clinical exposure).

CONCLUSIONS

Good collaboration between schools of nursing and healthcare care organizations can incorporate suggested solutions given by the study participants to reduce the identified gaps.

Newly qualified intensive care nurses' lived experiences of being a shift leader in a private healthcare institution in Gauteng, South Africa

Objective

Newly qualified intensive care nurses (NQICNs) are expected to execute the shift-leading role immediately after graduation. Critical reasoning, problem-solving, decision-making, and evidence-based clinical judgment are thus essential skills for intensive care nursing graduates. This study aimed to explore and describe NQICNs' lived experiences of being shift leaders.

Methods

This descriptive qualitative study was based on the data collected through semi-structured individual interviews. Five NQICNs in five hospitals from one region in Gauteng, South Africa, were interviewed between September and December 2019. NQICNs working as shift leaders for 10 to 12 months after intensive care training were eligible for inclusion in the study. Data were analyzed using the four steps suggested by Giorgi.

Results

The results revealed three themes and seven sub-themes. NQICNs suffered greatly intrapersonally (NQICNs reported intrapersonal suffering, manifesting as pre-shift anxiety, severe work stress, and post-shift exhaustion; NQICNs employed coping mechanisms and either fought, fled, or froze during conflict or crises; NQICNs lack of shift-leading experience did not match their heavy load of responsibilities and accountability); the NQICNs interpersonally matured and empowered themselves (NQICNs experienced support and challenges on an interpersonal level; NQICNs improved their interpersonal relationships and felt proud of and empowered by their professional growth); NQICNs highlighted various requirements to help them manage the high demands of leading shifts (others should fulfill certain needs to enable NQICNs to handle the shift-leading role; self-awareness as a need to enable NQICNs to embrace the shift-leading role).

Conclusion

A greater understanding of NQICNs and their unmet needs will enable nurse managers, educators, and nurses to better support NQICNs' evolution from novice to competent shift leaders.

Reflective Transition Practice Model: The New Graduate Registered Nurse

Reflection is a strategy that may enhance transition into practice for the new graduate registered nurse (NGRN). If introduced in the early stages of practice, reflection can be used as a tool to continuously evaluate and improve practice. A theory synthesis of Meleis' transition theory and Schon's reflective practice model was developed to support reflection as a tool for new nurses transitioning into the role of professional nurses. Reflection has the potential to improve the NGRNs' perception of their role, decrease feelings of disconnectedness, and improve patterns of response.

Let's Hang On! Ramping Up Nurse Resident Retention Strategies After the Pandemic

The nurse residency program (NRP) was developed as a recruitment strategy for new graduate registered nurses (NGRNs). The 2020 COVID-19 pandemic impacted health care in many ways, including causing a decline in NGRN retention rates. Post-pandemic, the NRP needed to incorporate strategies that would promote nursing retention. Effective collaboration and innovative strategies were found to be key elements in promoting successful NGRN retention. [J Contin Educ Nurs. 2023;54(6):245-247.].

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 relationships between clinical teaching behaviour and transition shock in newly graduated nurses

AIM

To explore the relationships between clinical teaching behaviour and transition shock in newly graduated nurses and significant differences in the northwest and northeast China.

DESIGN

A cross-sectional design.

METHODS

A total of 211 (nurses) and 925 (preceptors) were recruited in six Third-class different hospitals from July to August 2019.

RESULTS

The transition shock is negatively correlated with the clinical teaching behaviour in northwest and northeast China, while the transition shock in the northwest is higher than that in the northeast for the behindhand economy and natural limit.

CONCLUSION

The transition process of newly graduated nurses in northeast China with ethnic minorities and the behindhand economy is more difficult. For newly graduated nurses, personal health and a supportive environment need further improvement. Teaching strategies for preceptors need to be enhanced. Two-way feedback is more useful for both the newly graduated nurses and preceptors to improve quality care, and holistic care.

Effectiveness of an online program using telesimulation for academic-clinical collaboration in preparing nurse preceptors' roles

AIM

To evaluate the effectiveness of an online program on nurse preceptors' knowledge and self-efficacy in their roles to support students' clinical education, and to examine their online experience.

BACKGROUND

Professional development of nurse preceptors is paramount to fostering work readiness of future graduate nurses on entering the workforce. The support from academic institutions in developing preceptors' roles in clinical teaching and assessment is pivotal.

DESIGN

This study employed a mixed-methods design.

METHOD

A total of 59 nurse preceptors from six healthcare institutions participated in an online preceptor program by collaborating with academic educators in facilitating student clinical learning and assessment through telesimulation following web-based instruction. Pre-test and post-tests were administered to evaluate the preceptors' knowledge and self-efficacy in their roles. Survey questionnaires and focus group discussions were conducted to evaluate their online experience. SQUIRE 2.0 guidelines were applied.

RESULTS

The preceptors demonstrated significant improvements (p < .001) in knowledge and levels of self-efficacy in their preceptor roles immediately and 1 month after the program. The following four themes emerged from their learning experiences: 'interactive learning approach', 'academic-practice collaboration', 'better understanding of clinical assessment tool' and 'application of teaching strategies'. The preceptors reported positively on their motivation to learn using the web-based instruction and on their telesimulation experience.

CONCLUSION

The study findings demonstrated effectiveness and feasibility of an online preceptor program to enhance preceptors' roles in supporting nursing students' transition to clinical practice, using a mix of web-based technologies to provide preceptors with self-directed and experiential learning approaches.

RELEVANCE TO CLINICAL PRACTICE

This study contributed to the development of an innovative online preceptor program that provided opportunity for academic-clinical collaboration and has broad applicability. The telesimulation created robust remote simulation experiences for preceptors, allowing them to collaborate with academic educators in facilitating students' clinical practice amid the COVID-19 pandemic.

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.

Assessing the Effectiveness Between Nurse Educator and Clinical Coach Critical Care Training Programs for New Graduate Nurses in the ICU

OBJECTIVE

The aim of this study was to assess the differences in effectiveness between nurse educator-led and clinical coach-led intensive care unit (ICU) training programs for new graduate nurses.

BACKGROUND

New graduate ICU nurses require substantial clinical training, which is often provided by peers serving as clinical coaches who have not been formally trained for an educator role. Our medical center successfully transitioned from a nurse educator-led to clinical coach-led model for initial ICU education after formally training the clinical coaches.

METHODS

Nurses enrolled in nurse educator-led (n = 114) or clinical coach-led (n = 166) ICU clinical training programs were compared on program pass rate, satisfaction, preparedness, turnover, and competence.

RESULTS

There were no statistically significant differences between the groups on any of the identified measures of program effectiveness.

CONCLUSIONS

Both educator-led and clinical coach-led models, with appropriate training, effectively prepared ICU nurses in this setting. Implementing a clinical coaching model for ICU training of new graduate nurses could assuage common resource issues, such as a shortage of nurse educators, as well as address the increasing demand for well-trained ICU nurses.

Clinical support and perceived competency levels of midwifery students: A descriptive analysis

Background

Midwifery students in South Africa place great value on the clinical support they receive from midwifery practitioners. Adequate clinical support should help midwifery students to practice procedures safely and independently, allowing them to be competent upon degree completion.

Aim

To describe the clinical support and perceived competency levels of midwifery students.

Setting

Public hospitals in KwaZulu-Natal.

Methods

The researcher chose a quantitative research method using a descriptive design. An all-inclusive purposive and convenience sampling method was undertaken to recruit midwifery students from an undergraduate nursing programme at a university in KwaZulu-Natal. Gatekeepers permission and ethics approval was obtained from the university's registrar and research ethics committee. A self-evaluation questionnaire describing the clinical support and perceived competency levels was completed by 60 respondents. Data were analysed using International Business Machines Corporation Statistical Package for Social Sciences (IBM-SPSS) Version 27.

Results

The results highlighted that the clinical support midwifery students received, was beneficial to their clinical learning outcomes. Eighty per cent of clinical support offered to midwifery students was obtained through clinical supervision. Ninety-three per cent of respondents revealed that the clinical support they received were from midwifery practitioners (without a speciality qualification). Although students rated themselves as competent in 88.6% of midwifery procedures, poor outcomes were identified in 11.4% procedures.

Conclusion

Midwifery practitioners play a significant role in supporting midwifery students during clinical placement. Advancing the roles of midwifery practitioners through mentorship training is likely to strengthen the quality of clinical support provided and thus improve the competence levels of midwifery students.

Contribution

The findings in this paper are valuable in developing clinical support training guidelines for midwifery practitioners.

The Outcomes of an Interprofessional Simulation Program for New Graduate Nurses

This study explored the learning outcomes of an interprofessional simulation program for new graduate nurses during their training program. It was a single-group, pre-test and post-test research design. Ninety-three new graduate nurses participated in the study. The Nursing Competence Instrument and program satisfaction survey questionnaires were used to evaluate the learning outcomes of the program. Data were collected between 1 July 2019 and 30 June 2020 in a medical center in Taiwan. It was found that four nursing core competencies were significantly higher after the simulation, including advancing career talents (t = 10.12, p < 0.0001), integrating care abilities (t = 10.19, p < 0.001), dealing with tension (t = 6.87, p < 0.0001), and leading humanity concerns (t = 6.86, p < 0.001). The average satisfaction score for the interprofessional simulation training among nurses was 4.42 out of 5. In conclusion, interprofessional simulation education can help novice nurses improve their nursing core competencies. The results of this study provide an important indicator for hospitals and governments when making policy and training programs for new graduate nurses.

Time management disposition and relevant factors among new nurses in Chinese tertiary hospitals: A cross-sectional study

Introduction

New nurses struggled with time management, which was a prominent theme in safety care for patients. However, the transition training of time management for new nurses was complicated and ignored by clinical managers. The purpose of this study was to understand the level of new nurses’ TMD from a nationwide perspective and detect the influencing factors of the TMD.

Materials and methods

A cross-sectional study design with a stratified sampling method was sampled in China. Six hundred and seventy new nurses within the first year of employment were recruited. New nurses’ time management disposition, job stressors, self-efficacy, clinical communication competence, and safety behavior were measured by corresponding scales.

Results

New nurses showed the best sense of time’s value, followed by the sense of time efficacy and time monitoring view for time management disposition. The related factors of time management disposition were communication skills, safety behavior, job stressors, and being without a preceptor. New nurses’ time management disposition was at a moderate level and they performed worse in time allocation. The highest education, with or without a preceptor, the experience of part-time jobs, and class cadre were significantly influencing the time management disposition of new nurses.

Conclusion

Nursing managers should pay attention to new nurses’ time management disposition. Reducing the job stressors, improving communication ability, and safe behavior were important measures to improve the time management disposition.

How nurse preceptors provide help to new nurses influences perceived relationship quality

BACKGROUND

In many hospitals, newly-hired registered nurses (RNs) enter into preceptorships, where they are paired with more experienced nurse preceptors who are responsible for ensuring effective transition to practice. Although high-quality relationships between preceptors and newly-hired nurses facilitate nurses' learning and integration into their medical institutions, preceptors have little guidance for what tactics develop such relationships.

OBJECTIVES

To investigate whether the type of help provided by preceptors (i.e., autonomous or dependent help) influences preceptees' evaluations of relationship quality and psychological safety with their preceptor. Furthermore, we investigate the role of instrumental support and emotional support as explanatory mechanisms.

DESIGN/SETTINGS/PARTICIPANTS/METHODS

Convenience sampling was used to collect data via a cross-sectional survey of 217 in-patient RNs hired between June 2016 and May 2018 to a magnet hospital within the Southwestern United States. Recently hired nurses evaluated their preceptor's help-giving tendencies, and reported on their perceived support, relationship quality and feelings of psychological safety with their preceptor.

RESULTS

Dependent help was positively related to instrumental support. Conversely, autonomous help was positively related to both relationship quality and psychological safety, and these relationships were partially mediated by perceived instrumental support and emotional support.

CONCLUSION

Findings illustrate the multiple benefits of autonomous help for encouraging high-quality relationships between preceptors and preceptees. This study identifies autonomous help-giving as a useful tactic for nurse preceptors (or other organizational insiders, such as mentors or supervisors) to establish high-quality relationships with recently hired nurses.

Associations of Preceptors' Training Needs With Clinical Teaching Experience and Training Received

Background Although training can improve the quality of clinical teaching for nurse preceptors, research on the training needs of junior versus senior preceptors is limited. This study sought to examine the differences in their needs by comparing their clinical teaching experience and the training they received. Method A secondary analysis of a cross-sectional survey was conducted in three hospitals using the Clinical Teaching Behavior Inventory (CTBI). Survey data were analyzed using the chi-square test, the independent t test, and multiple regression analysis. Results The differences (N = 252) in the subscales of building a learning atmosphere and committing to teaching were not statistically significant (p > .05). Generally, the mean CTBI scores of trained junior preceptors were significantly higher than those of untrained senior preceptors (p < .001). Conclusion Training yields more significant improvements in self-perceived clinical teaching behavior than clinical teaching experience. [J Contin Educ Nurs. 2022;53(4):165-170.].

Clinical preceptorship in Ghana in the era of COVID-19 pandemic: an interventional study

BACKGROUND

Innovations in clinical nursing education are critical in enhancing the experiences of students, especially in the era of coronavirus pandemic. This study aimed at investigating nurse preceptors' perceptions of use, intention to use and self-efficacy towards digital technology in preceptorship in the Cape Coast Metropolis of Ghana.

METHODS

A concurrent type of mixed-methods design with a non-randomised interventional study using three-phase multi-methods technique was conducted among nurse preceptors in the Cape Coast Metropolis in the Central Region of Ghana. Forty-five nurse preceptors participated in a pre and post training intervention while seven were purposively selected for the qualitative interview. Complimentarity method of triangulation was used in the analysis. The quantitative data were analysed with STATA version 16 and presented using frequencies, percentages, means with standard deviations and McNemar's test while qualitative data were analysed using the six steps approach to qualitative data analysis by Braun and Clarke.

RESULTS

Perceived usefulness statement "using technology will improve clinical teaching" increased from 19 (42.22%) at baseline to 44 (97.78%) post intervention. Perceived ease of using technology statement "I would find it easy to get this technology to do what I want it to do" also increased from 36 (80.00%) to 41 (91.11%) post intervention. Self-efficacy increased from 40 (88.89%) to 43 (95.56%) after the intervention. There was a statistically significant difference between pre-training and post-training scores regarding tablet (p = 0.016) and experience with online library resources (p = 0.039). The qualitative results yielded three themes, namely: strengths of using technology; constraints in the learning environment; and future of technological approach to clinical teaching.

CONCLUSIONS

The training intervention improved participants intentions, self-efficacy, perceived use and perceived ease of use of technology. However, there are constraints in the clinical learning environment including students and preceptor-related factors, and institutional factors that needs to be addressed as part of efforts to implement technology in clinical teaching in this era of COVID-19 pandemic and beyond.

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.

The best of both worlds - entering the nursing profession with support of a transition programme

BACKGROUND

Transition into clinical practice for newly graduated nurses is a difficult time, with high stress levels defined by a demanding period of personal and professional acclimatisation. Transitions are complicated and multi-dimensional, and to understand this process, it is crucial to identify the factors that facilitate or stand in the way of a healthy transition.

AIM

The phenomenological study aimed to describe newly graduated nurses' expectations of transitioning into the nursing profession at the start of a clinical nursing introduction programme, including education, supervision, and critical reflection with peers.

METHOD

The study was based on seven group interviews with newly graduated nurses. The interviews utilised open-ended and follow-up questions and were carried out as a dialogue to enable reflection on the phenomenon of interest. This was explored and illuminated using the reflective lifeworld research approach, based on phenomenological epistemology.

FINDINGS

"Expectations of transition into the nursing profession via the Clinical Nursing Introduction Programme" is signified by an oscillating movement between uncertainty, security, challenge, and growth on the threshold of a new identity. The phenomenon is constituted by the courage to grow, responsibility and fear, belonging and vulnerability, and support and challenge.

CONCLUSION

Transitioning into the nursing profession via the Clinical Nursing Introduction Programme means having the best of both worlds. Newly graduated nurses have the opportunity to receive education and structured support at the same time as they work independently in clinical practice.

Nurse faculty perceptions of readiness for practice among new nurses graduating during the pandemic

Background

The COVID-19 pandemic caused major changes in nursing education, namely a shift to remote learning and significant reduction of clinical practice experience. It is not known how these changes will affect new graduate nurses transitioning to practice.

Purpose

To provide guidance to transition-to-practice programs, this study quantitatively described and compared nurse faculty perceptions of readiness for practice among students who graduated pre-pandemic and those who will graduate during the pandemic.

Methods

A convenience sample of 116 nurse faculty across North Carolina completed surveys online. Surveys collected information on demographics, professional experience, and teaching changes experienced during the pandemic. The Nursing Practice Readiness Tool was used to measure perceptions of readiness for practice.

Results

Nurse faculty reported a wide range of changes due to the pandemic, with limitations in clinical learning prevalent. There was a statistically significant decrease in practice readiness scores for the total scale, six subscales, and all tool items at p < 0.001 for all paired comparisons.

Conclusions

While there was an overall significant decrease in scores for all competency areas, further analysis of the tool subscales and items can provide guidance for clinical nurses working with new graduates and nurse faculty working with continuing students.

The effectiveness of humanoid diagram teaching strategy on care capacity and retention in novice nurses

AIM

To examine the effectiveness of a Humanoid Diagram Teaching Strategy (HDTS) on care capabilities and retention of novice nurses.

BACKGROUND

Guiding novice nurses in clinical practice is a matter of concern and the use of diagrams in assisting the learning process and to promote learning efficiency has been acknowledged.

DESIGN

This is a quasi-experimental study with asynchronous repeated measurements for the experimental and control groups.

METHODS

The study was conducted in a medical centre in southern Taiwan with 24 novice nurses. The intervention, Humanoid Diagrams Teaching Strategy, contained three parts: the head and neck; trunk; and limbs. The HDTS was applied three time weekly. Each session lasted approximately 30 min and the training lasted 4 weeks. The effectiveness of HDTS was measured using Mini-CEX, CbD and retention rates in the 3rd and 6th months of novice nurses' experience.

RESULTS

After the HDTS, although increases in mini-CEX and CbD scores in the experimental group were greater than the control group, these differences were not statistically significant after considering the time interaction. But the 3rd month and 6th month novice nurses' retention rates were statistically significantly different by comparing the differences under the time interaction effects in both groups.

CONCLUSIONS

The Humanoid Diagram Teaching Strategy is an effective tool for preceptors to use in assisting novice nurses in learning, improving their nursing care knowledge and technical skills and to increase their retention rate.

'Young saplings on fire' newly graduated nurses in the COVID-19 pandemic: A qualitative study

Aim

To explore the experiences of newly graduated nurses during the pandemic.

Background

Newly graduated nurses were employed during the pandemic by several countries to meet the increasing demand for healthcare services.

Methods

A descriptive qualitative study with thematic analysis. The study was conducted with 14 newly graduated nurses.

Results

Themes were systematized into four variables of the system research organization model, and a total of 12 themes were identified. Nurses, who started to work in the beginning months of the pandemic, faced several difficulties in their transition period, including the difficulties of starting employment and the effects of the pandemic on both society and health systems.

Conclusions

During the pandemic, newly graduated nurses faced various difficulties in transition processes, difficulties in starting the employment process and the effects of the pandemic on both society and health systems. In order to reduce these effects, regulations are needed at all stages of the health system.

Implications for Nursing Management

It is the responsibility of health system policymakers, hospital managers, nurse managers and senior nurses to ensure that newly graduated nurses endure these pandemic conditions, which are quite challenging even for senior nurses, without any damage, and continue in the profession.

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.

Transition shock, preceptor support and nursing competency among newly graduated registered nurses: A cross-sectional study

BACKGROUND

Transition shock is highly prevalent among newly graduated registered nurses in their early career. Preceptors are widely used to support them in acquiring clinical nursing competencies and to promote their successful transition to practice. However, the mechanism by which transition shock and preceptor support are linked to nursing competency among newly graduated registered nurses remains unknown.

OBJECTIVES

The aim of the study was to examine the relationship between transition shock, preceptor support, and nursing competency in a sample of newly graduated registered nurses.

DESIGN

A descriptive, cross-sectional design.

SETTINGS

Six tertiary hospitals in the southeast of mainland China.

PARTICIPANTS

Newly graduated registered nurses undertaking their professional role in the first year.

METHODS

Convenience sampling was used to recruit 215 newly graduated registered nurses [184 female, 31 male] from six hospitals. Data on transition shock, preceptor support, and nursing competency were collected using questionnaires from November to December 2019.

RESULTS

The nursing competency of critical thinking/research aptitude (mean = 2.68, SD = 0.63) was scored the lowest among participants. Transition shock (r = -0.21, p < .01) and perceptions of preceptor support (r = 0.56, p < .01) were statistically significantly correlated with nursing competency. Preceptor context, whether the assigned preceptor varied day by day, and the emotional challenges of transition shock were the main predictors of nursing competency (F = 36.86, p = .00), accounting for 34% of the variance in nursing competency.

CONCLUSIONS

Educational programs aimed at increasing critical thinking and research aptitude in the educational stage and the continuing educational stage can benefit newly graduated registered nurses. A well-organized transition program in hospitals including awareness and recognition of transition shock in newly graduated registered nurses is essential to enhance their competency in providing quality nursing. More support and assistance would be useful in promoting the preceptor's role in improving nursing competency of newly graduated registered nurses.

A narrative inquiry approach to understanding senior intensive care nurses' experiences of working with new graduate nurses

AIMS AND OBJECTIVES

To report a qualitative inquiry exploring senior registered nurses' stories of experience working with new graduate nurses in the intensive care unit.

BACKGROUND

While new graduate nurses' perceptions of transitioning into professional practice in the intensive care unit have been examined, few studies have explored the experiences of the senior registered nurses working alongside them.

DESIGN

A narrative inquiry methodology informed by Dewey's (1938) theory of experience.

METHODS

Individual in-depth, unstructured, interactive interviews were conducted with five senior registered nurses. The inquirer co-composed individual narrative accounts with each participant. Narrative inquiry's three commonplaces of temporality, sociality and place formed the lens of analysis. Thematic analysis identified two overarching threads that resonated across the narrative accounts. This inquiry adheres to COREQ checklist reporting.

RESULTS

The overarching threads 'Reverberations' and 'Caring' depict the experiences of senior registered nurses. 'It's Dangerous', 'Patrolling Like Surf Lifesavers', 'We Carry Them', 'Survival Mode' and 'Enjoyable Moments' are minor threads describing the challenges, while 'I've Been There', 'They Must Ask Questions' and 'Not In My Backyard' reveal their insights.

CONCLUSIONS

Working with new graduate nurses increased senior registered nurses' patient surveillance and workload, contributing to stress, pressure and feeling overwhelmed. However, senior registered nurses felt an obligation to care for new graduate nurses, who they perceived as still acquiring the skills to autonomously care for critically ill patients. Therefore, senior registered nurses require support themselves.

RELEVANCE TO CLINICAL PRACTICE

Senior registered nurses perceive workplace constraints as impeding their capacity to provide sufficient support and surveillance to new graduate nurses. The gap between new graduate nurses' clinical capacity and patients' needs underpins senior registered nurses' recommendation that new graduate nurses should not be placed in intensive care units unless additional workforce support is provided, safeguarding their development as well as patient safety.

Three learning modalities' impact on clinical judgment and perceptions in newly graduated registered nurses: A quasi-experimental study

Newly graduated registered nurses face numerous challenges stemming from high patient workload, complicated interpersonal relationships, and a lack of nursing competence, which can lead to transitional shocks. Clinical judgment and confidence are well-known keys to successful role transitions for these nurses. Simulation training is proposed as a new modality for enhancing comprehensive clinical competence of nurses, but current evidence on the impact of different simulations on nurses' clinical judgment and confidence are still limited or inconsistent. This study compared the impact of three types of learning modalities on newly graduated registered nurses' clinical judgment, perceptions of self-confidence, and evaluations of the design features of the learning modalities. A quasi-experimental design was used. Fifty-nine participants were randomly assigned to three groups: (1) high-fidelity simulation, (2) virtual simulation, and (3) case study. Scales were used after the simulation. The virtual simulation group showed a higher level of clinical judgment. The high-fidelity simulation group felt more confident than the virtual simulation and case study groups. Both the high-fidelity simulation group and virtual simulation group reported higher scores in the domain of fidelity.

What influences new graduate nurses' core competencies transformation to clinical in China? A cross-sectional study

BACKGROUND

The core competencies of new graduate nurses (NGNs) have significant health outcomes in the clinical environment. However, these nurses experience a theory-practice gap, which creates a barrier in the transition process when they first enter the clinical workplace.

OBJECTIVE

To understand the general overview of the transition of the core competencies of NGNs to clinical practice in China and the influencing factors.

DESIGN AND SETTING

A cross-sectional study design consisting of a multi-stratified grounded random sample from 31 hospitals in seven regions nationwide.

PARTICIPANTS

2400 NGNs were recruited by email.

METHODS

The Competencies Inventory for Registered Nurse (CIRN) was applied to evaluate NGNs' core competencies.

RESULTS

NGNs performed best on leadership and worst on critical thinking or research aptitude. Core competencies were predicted by depressive symptoms, worked for two-three years, having a nurse-in-charge title, professional values, department, happiness, etc. Besides, the preceptor program also has significant to core competencies.

CONCLUSION

The average level of Chinese NGNs' core competencies was at a moderate level, which wasn't well optimized. It is recommended to adopt appropriate interventions to support NGNs. With an increase in work years and the accumulation of more work experience, the corresponding core competencies of NGNs will also improve. Preceptor institutions, limiting first-degree recruitment, and early ICU or operating room department rotations can be carried out by nursing educators to improve core competencies.

Transitional Shock of Multi-Nationality Newly Graduate Nurses in Kuwait

Introduction

The transitional period of newly graduate nurses became more stressful, different coping mechanisms are essential. Therefore, effective coping with transition-related stress and anxiety is important for the life and professional of those nurses.

Objectives

To examine the transitional shock through assessing the occupational stress and coping mechanism of multi-nationality newly graduate nurses in Kuwait.

Methods

A descriptive correlational design was used to identify the occupational stress of the newly graduate nurses (NGNs) and their coping mechanisms during the transitional period to their professional life. All the NGNs were recruited. The total number of participants was 152 nurses.

Results

Highly significant correlations on almost all stress domains with p-values P < 0.01. We found that "Death and dying" was ranked as the highest stressor with a mean score of 6.20, followed by "uncertainty concerning treatment" with a mean score of 5.59, and in the "Inadequate preparation" was the least stressor with a mean score of 1.64.

Conclusion

"Religious coping" was the highest-ranked coping mechanism. In conclusion, NGNs have to adjust quickly to the new practical atmosphere encountered in the health care settings by using the proper coping mechanisms techniques.

Clinical teaching behaviour effects professional identity and transition shock in new nurses in western china: A cross-sectional study

Aim

To examine the interrelationship between professional identity, clinical teaching behaviour and transition shock for new nurses in Western China.

Design

A cross‐sectional design.

Methods

A total of 779 new nurses were recruited in Gansu province and Lanzhou city from June to July 2019. Each patient was given three questionnaires to complete, and structural equation modelling was used to identify the relationships.

Results

The overall mean scores for the transition shock, professional identity and clinical teaching behaviour were 92.53(SD = 22.17), 89.74(SD = 16.57) 80.12(SD = 12.38), respectively. The most important aspects identified were the Physical aspect, the Sense of Mastery and Committing to Teaching. Professional identity and clinical teaching behaviour were negatively related to transition shock, a better sense of identity coupled with supportive clinical teaching were keys to a smoother journey from new to experienced nurses.