The developing role of Transition to Practice programs for newly graduated mental health nurses

Modifying the clinical reasoning cycle to enhance forensic mental health nursing utility

Forensic mental health nursing is a specialty area of practice requiring specific knowledge and skills to work collaboratively with consumers. The Clinical Reasoning Cycle has been recognised as a potential framework to support nursing practice; however, it has been identified that adaptations are required to enhance utility in a forensic mental health services. The aim of this study was to explore and finalise a version of the cycle for forensic mental health nursing practice. Focus groups and interviews were used to explore adaptations with staff from a state-wide forensic service and forensic mental health nursing academics. Data were thematically analysed. Four main themes were interpreted: (1) allegiance to the Nursing Process, (2) moving the cycle from page to practice, (3) working as a team, or not, and (4) implementation will be a marathon and not a sprint. While nursing academics were more in favour of updating the Nursing Process to ensure contemporary practice is captured, staff from the service were supportive of the adapted cycle but emphasised the need to ensure collaboration with the consumer and their supporters. The adapted cycle was seen to articulate the contribution of forensic mental health nursing care, and support for a nursing-specific cycle was embraced by other disciplines, despite some hesitation from nurses. Prior to implementation there is a need to ensure the merits of the cycle are clearly articulated, along with a range of resources and specific contextual information to ensure the cycle can be successfully applied to enhance nursing practice and consumer care.

Nurses’ experiences of the causes of their lack of interest in working in psychiatric wards: a qualitative study

Background

The shortage of psychiatric nurses is a major healthcare challenge. Lack of interest (LOI) contributes to the shortage of psychiatric nurses. Nonetheless, there are limited studies in this area. The present study was conducted to explore nurses’ experiences of the causes of their LOI in working in psychiatric wards.

Methods

This qualitative study was conducted in 2016–2019 using the content analysis approach. Participants were 27 nurses purposively recruited with maximum variation from the psychiatric wards of three referral hospitals in Iran. Data were collected via unstructured interviews and were concurrently analyzed using the conventional content analysis approach recommended by Graneheim and Lundman.

Results

The causes of participants’ LOI in working in psychiatric wards were grouped into three main categories, namely inadequate professional skills for psychiatric care practice, negative public attitude towards psychiatric nurses, and concerns over patients.

Conclusion

This study suggests that the causes of nurses’ LOI in working in psychiatric wards are not only personal, but also social and organizational. Findings help managers and authorities develop strategies to increase psychiatric nurses’ interest in working in psychiatric wards through improving their work conditions and professional knowledge and skills.

Nurses' experiences of the causes of their lack of interest in working in psychiatric wards: a qualitative study

Background

The shortage of psychiatric nurses is a major healthcare challenge. Lack of interest (LOI) contributes to the shortage of psychiatric nurses. Nonetheless, there are limited studies in this area. The present study was conducted to explore nurses’ experiences of the causes of their LOI in working in psychiatric wards.

Methods

This qualitative study was conducted in 2016–2019 using the content analysis approach. Participants were 27 nurses purposively recruited with maximum variation from the psychiatric wards of three referral hospitals in Iran. Data were collected via unstructured interviews and were concurrently analyzed using the conventional content analysis approach recommended by Graneheim and Lundman.

Results

The causes of participants’ LOI in working in psychiatric wards were grouped into three main categories, namely inadequate professional skills for psychiatric care practice, negative public attitude towards psychiatric nurses, and concerns over patients.

Conclusion

This study suggests that the causes of nurses’ LOI in working in psychiatric wards are not only personal, but also social and organizational. Findings help managers and authorities develop strategies to increase psychiatric nurses’ interest in working in psychiatric wards through improving their work conditions and professional knowledge and skills.

Action learning sets for supporting postgraduate mental health nurses' transition to professional practice: A qualitative study

This paper reports on a qualitative case study of postgraduate mental health nurses participating in a monthly facilitated action learning set (ALS) in order to support them while they transition from PGMHN to independent professional practice. The aim of the study was to determine what the impact of participating in an ALS would have on how they perceived clinical practice issues. The ALS comprised a small group of PGMHN supported by a facilitator in order to explore issues from clinical practice by using Socratic questions to challenge their thinking. Data were collected via a single focus group and a 20-item survey. Focus group textual data were coded line by line, and codes were synthesized thematically. The major theme to emerge from the qualitative results was as follows: 'Learning from doing an action learning set'. Three subthemes were identified: Think outside the box: Developing Socratic questions; there's rarely one right way: Applying action learning to practice; and Not easy to implement: Action plans in action. A 20-item evaluative survey indicated that ALS increased participant's confidence as a mental health nurse. Using critical questions increased participants' confidence to explore different perspectives when engaged in problem-solving.

Newly qualified nurses' perceptions of working at mental health facilities: A qualitative study

WHAT IS ALREADY KNOWN ABOUT THE TOPIC?: Newly qualified nurses often feel overwhelmed by the challenges of the work environment and struggle to transition into healthcare work environments. Nurses require opportunities during the transition period to develop both competence and confidence in their ability to practise independently. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Newly qualified mental health nurses experience fear during their adaptation period, especially when they perceive mental healthcare users as dangerous and the working environment as risky, with little concern for their safety. Nurses new to the mental health environment learn from accepting responsibility, taking on challenges and making adjustments, in order to develop confidence as mental healthcare professionals. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nursing management should ensure a safe and supportive mental healthcare environment. The potential for and consequences of negative stereotyping of patients among mental health nurses should be acknowledged and addressed as it may hinder the smooth adaptation of newly qualified nurses. Although stressful experiences can help mental health nurses to develop confidence and skills to manage future demanding situations, newly qualified nurses need to be given appropriate support and debriefing to ensure challenging situations do not "go the wrong way" and decrease confidence levels. Abstract Introduction Much has been written about the experiences of newly qualified nurses in their first year of employment, yet not much has been heard from the perspectives of newly qualified nurses working in mental health facilities. Aim To explore and describe the adaptation process of newly qualified nurses working in public mental health facilities in South Africa. Method Following a qualitative descriptive design, 11 newly qualified nurses in their first 6-18 months of employment were purposively selected from three public mental health facilities in South Africa. Data collected through unstructured individual interviews were thematically analysed. Results Four themes emerged from the analysis: fear related to the mental healthcare environment; self-doubt upon meeting the expectations of the inter-professional team; ways to adjust to the challenges; and confidence as mental healthcare professionals. Discussion During the adaptation process newly qualified nurses working in mental health facilities need support to overcome their initial fears and develop self-confidence in both managerial and therapeutic realms. Implications for practice Management of mental healthcare facilities needs to be cognisant of the importance of creating a supportive and safe environment that discourages negative stereotyping of patients and fosters newly qualified nurses' adaptation.

From incomer to insider: The development of the TRANSPEC model - A systematic review of the factors influencing the effective rapid and early career TRANsition to a nursing SPECiality in differing contexts of practice

OBJECTIVE

Shortages in the speciality nursing workforce, both nationally and internationally are driving the need for the development of an evidence-based model to inform recruitment and retention into speciality nursing practice. This study aimed to identify the factors influencing rapid and early career transition into speciality nursing practice.

METHODS

A comprehensive systematic review of the literature was undertaken using a convergent qualitative synthesis design where results from qualitative, quantitative and mixed methods studies were transformed into qualitative findings. Databases included CINAHL, Medline, Scopus and PsycINFO. Search terms were: nurse, early career, rapid career, transition, specialty, and Medical Subject Heading terms included: professional development and educational, nursing, and continuing. Using validated tools, papers were independently assessed by a minimum of two reviewers.

RESULTS

Twenty-three research articles were included. There were no randomized control trials. Through thematic analysis and matrix mapping of the results, the TRANSPEC model was developed. The model outlines three phases of transition: pre-entry, incomer and insider. There has been little focus on pre-entry with programs being designed at the incomer and insider phases. Impacting on these phases are three concepts: the self (professional and personal), the transition processes (informal and formal) and a sense of belonging. The overarching theme influencing the phases and concepts is the context of practice. Enablers and inhibitors influence successful transition and therefore impact on recruitment and retention. Each nurse's transition is influenced by time.

CONCLUSIONS

For successful transition, the enablers and inhibitors impacting on the three concepts, phases and the context of practice need to be considered when developing any program. It is apparent that while previous studies have focused on the transition processes, such as curricula, the development of the self and a sense of belonging are also essential to successful transition. Further studies should include the pre-entry phase.

The Iranian Psychiatric Nurses' Perception of Transition in Psychiatric Wards: A Qualitative Study

BACKGROUND

Transition means moving from one period to another and it is usually associated with significant changes in objectives, roles, and responsibilities. Considering the challenges of the psychiatric ward, psychiatric nurses experience numerous problems, especially at the early stages of their job engagement. This study aimed to examine the perception of the Iranian psychiatric nurses in psychiatric wards and their transition period.

MATERIALS AND METHODS

The study was designed as a qualitative content analysis study in three referral hospitals in Mazandaran and Tehran, Iran 2016. Participants included 18 nurses who had experienced transition at the psychiatric ward and had at least 3 months job experience in three referral hospitals of Iran and were selected purposefully. Data were collected using unstructured interviews and analyzed using the inductive approach and conventional content analysis. To ensure the trustworthiness of the data, Guba and Lincoln's criteria were used.

RESULTS

The major themes of transition among the nurses of psychiatric wards included "inadequate preparation," "mental stress," "self-awareness and capabilities," and "the effective role of nurses' full support in adjustment."

CONCLUSIONS

The findings revealed that nurses did not have a decent transition. In this regard, educational systems must provide training courses to prepare nurses to support them in their arrival stage and to facilitate their transition. The findings of this study can help mentally prepare nurses for their preparation to perform their role and improve the quality of care.

Developing a community-based nursing and midwifery career pathway - A narrative systematic review

INTRODUCTION

Community nursing and midwifery is changing in response to a shift in care from hospital to home, brought about by increasing costs to care because of an aging population and increasing chronicity. Until now, community nursing positions and scope of practice has been dependent on service focus and location, which has led to the role being unclearly defined. Lack of appeal for a career in community practice and a looming workforce shortage necessitates a review into how community nursing and midwifery transition to practice is supported.

METHODS

This review sought to identify, assess and summarize available evidence relating to transitioning into community nursing and midwifery practice as a speciality. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach. A narrative synthesis was then undertaken on papers that examined community nursing and midwifery pathway perspectives which define, and enable or inhibit a contemporary pathway. Thematic analysis used a theoretical framework developed for early career and rapid transition to nursing specialty practice.

RESULTS

There is a paucity of research that identifies community nursing and midwifery as a discreet scope of practice. Twelve papers were eventually included in the review. Verbatim findings were extracted from the papers and clustered into categories based on the chosen theoretical framework. Major themes were 'the self' (professional and personal); 'transition processes'; and, a 'sense of belonging'. Sub themes included narrative identifying inhibitors and enablers in each theme.

DISCUSSION

No definition of community practice or pathway was identified in nursing, although midwifery was clearly defined. Community nursing practice was described as generalist in nature although specialist knowledge is required. Being part of the community in the professional sense and personal sense was considered important. The importance of transition was identified where pre-entry exposure to community practice was seen as important. Stages in transition to practice were recognised as pre-entry; incomer; insider; and, a sense of belonging. The process of transition should be planned and individualised acknowledging past experience whilst acknowledging the specialist nature of community-based practice.

Feeling Safe and Taking on Responsibilities: Newly Graduated Nurses' Perceptions and Evaluations of Their Transition Into a Forensic Mental Health Inpatient Setting

Forensic mental health care is faced with serious problems in the recruitment and retention of newly graduated nurses (NGNs). Research into NGNs' experiences of their transition to and evaluations of transition programs in forensic care is sparse, and more studies are called for. This study aimed to investigate the characteristics of NGNs' experiences and perceptions of their transition into a forensic setting and their evaluations of the introduction period. Three focus group interviews were carried out, involving 13 NGNs, lasting 79.68 minutes on average. They were analyzed using thematic analysis. Results show two main themes: "feeling safe" and "taking on responsibilities." If NGNs felt overburdened with clinical responsibilities during their transition, their feeling of safety reduced. The converse also applied; theThe safer they felt, the greater clinical responsibility they felt capable of handling. The more difficult the NGNs perceived the informal transition, the more unsafe they felt, and the more negatively they perceived the responsibilities placed upon them. Tailored programs designed to support both the informal and formal transitions are recommended, along with preceptorship, theoretical training, and role-based support, such as a shift manager, along with early introduction to conflict management and security measures.

An integrative review of graduate transition programmes: Developmental considerations for nursing management

Graduate transition programmes have been developed to recruit new nursing staff and facilitate an effective transition from nursing student to Registered Nurse within the clinical environment. Therefore the aim of this paper was to explore the various elements included in nursing graduate transition programmes. An integrative review was undertaken incorporating a strict inclusion criterion, critical appraisal, and thematic analysis of 30 studies. There are numerous transition programmes available yet there remains a lack of transparency regarding their aims/objectives, course content, support timeframe and the type of support provided. This inconsistency has resulted in a lack of clarity regarding efficacy or superiority of any one programme over another. Innovative multifaceted programs may assist in supporting the graduate registered nurse to transition effectively into the clinical environment. Providing these support programmes may allow nurse managers to recruit new graduates and therefore decrease the staff budget expenditure.

IMPLICATIONS FOR NURSING MANAGEMENT

No graduate programme was shown to be superior to others yet graduate programmes appear to positively influence the experience of the graduate and increase staff recruitment. Comparative research is needed to ascertain the integral components of these programmes.

Graduate-Assistant Athletic Trainers' Perceptions of Professional Socialization in the Collegiate Setting: Part I

CONTEXT

Many newly credentialed athletic trainers (ATs) pursue graduate assistantships, which allow them to gain experience while being supervised by an experienced AT. The graduate-assistant (GA) ATs' perception of their socialization process into the collegiate setting is unknown.

OBJECTIVE

To explore the professional socialization of GAs in the collegiate setting.

DESIGN

Qualitative study.

SETTING

Phone interviews.

PATIENTS OR OTHER PARTICIPANTS

A total of 19 collegiate GAs (15 women, 4 men; average age = 23 ± 0.15 years; National Collegiate Athletic Association Division I = 13, II = 3, III = 2; National Association of Intercollegiate Athletics = 2; postprofessional athletic training program = 6) participated.

DATA COLLECTION AND ANALYSIS

Data were collected via phone interviews and transcribed verbatim. Interviews were conducted until data saturation occurred. Data were analyzed through phenomenologic reduction. Trustworthiness was established via member checks and peer review.

RESULTS

Four themes emerged: (1) role identity, (2) initial entry into role, (3) maturation, and (4) success. Before beginning their role, participants envisioned the assistantship as a way to gain independent experience while being mentored. They perceived themselves as the primary care providers for their athletic teams. Those who were immediately immersed into clinical practice adapted to their role quickly despite experiencing stress initially. Participants felt that a formal orientation process and a policies and procedures manual would have alleviated some of the initial stress. The GAs matured as they practiced clinically and developed confidence as they gained experience. Personal attributes, experience, and peer and supervisor support contributed to perceived success as GAs. Factors that hindered perceived success were lack of confidence, an unsupportive environment, and long hours.

CONCLUSIONS

When looking for graduate assistantships, ATs should seek a position that allows them to practice independently and provides didactic educational opportunities while aligning with their athletic training philosophies.

Exploring the Perceptions of Newly Credentialed Athletic Trainers as They Transition to Practice

CONTEXT

Research is limited on the transition to practice of newly credentialed athletic trainers (ATs). Understanding this transition could provide insight to assist employers and professional programs in developing initiatives to enhance the transition.

OBJECTIVE

To explore newly credentialed ATs' experiences and feelings during their transition from student to autonomous practitioner.

DESIGN

Qualitative study.

SETTING

Individual phone interviews.

PATIENTS OR OTHER PARTICIPANTS

Thirty-four ATs certified between January and September 2013 participated in this study (18 women, 16 men; age = 23.8 ± 2.1 years; work settings were collegiate, secondary school, clinic, and other). Data saturation guided the number of participants.

DATA COLLECTION AND ANALYSIS

Participants were interviewed via phone using a semistructured interview guide. All interviews were recorded and transcribed verbatim. Data were analyzed through phenomenologic reduction, with data coded for common themes and subthemes. Credibility was established via member checks, peer review, and intercoder reliability.

RESULTS

The 3 themes that emerged from the data were (1) transition to practice preparation, (2) orientation, and (3) mentoring. Transition to practice was rarely discussed during professional preparation, but information on the organization and administration or capstone course (eg, insurance, documentation) assisted participants in their transition. Participants felt that preceptors influenced their transition by providing or hindering the number and quality of patient encounters. Participants from larger collegiate settings reported more formal orientation methods (eg, review policies, procedures manual), whereas those in secondary school, clinic/hospital, and smaller collegiate settings reported informal orientation methods (eg, independent review of policies and procedures, tours). Some participants were assigned a formal mentor, and others engaged in peer mentoring.

CONCLUSIONS

Employers could enhance the transition to practice by providing formal orientation and mentorship. Professional programs could prepare students for the transition by discussing how to find support and mentoring and by involving preceptors who provide students with opportunities to give patient care.

Graduate-Assistant Athletic Trainers' Perceptions of the Supervisor's Role in Professional Socialization: Part II

CONTEXT

Many new athletic trainers (ATs) obtain graduate-assistant (GA) positions to gain more experience and professional development while being mentored by a veteran AT; however, GA ATs' perceptions of the supervisor's role in professional development are unknown.

OBJECTIVE

To explore the supervisor's role in the professional development of GAs in the collegiate setting.

DESIGN

Qualitative study.

SETTING

Phone interviews.

PATIENTS OR OTHER PARTICIPANTS

A total of 19 collegiate GAs (15 women, 4 men; average age = 23 ± 0.15 years; National Collegiate Athletic Association Division I = 13, II = 3, III = 2; National Association of Intercollegiate Athletics = 2; postprofessional athletic training program = 5).

DATA COLLECTION AND ANALYSIS

Data were collected via phone interviews and transcribed verbatim. Interviews were conducted until data saturation occurred. Data were analyzed through phenomenologic reduction. Trustworthiness was established via member checks and peer review.

RESULTS

Three themes emerged: (1) GAs' expectations of supervisors, (2) professional development, and (3) mentoring and support. Participants expected their supervisors to provide mentorship, support, and feedback to help them improve their athletic training skills, but they also realized supervisors were busy with patient care responsibilities. Most participants felt their supervisors were available, but others believed their supervisors were too busy to provide support and feedback. Participants felt their supervisors provided professional development by teaching them new skills and socializing them into the profession. Furthermore, they thought their supervisors provided mentorship professionally, personally, and clinically. Supervisors supported the participants by standing behind them in clinical decisions and having open-door policies.

CONCLUSIONS

The graduate assistantship allows new ATs to gain experience while pursuing professional development, mentorship, and support from a supervisor. The extent of development is highly dependent on the supervisor, but most supervisors mentor GAs. When looking for graduate assistantships, future GAs should seek positions in which supervisors actively provide mentoring and professional development.

Graduate nurses' experiences of mental health services in their first year of practice: An integrative review

New graduate nurses have reported negative experiences in mental health settings, particularly during the transitional period of practice. Previous research has focused on addressing the undergraduate preparation of nurses for practice instead of the experiences and outcomes of the transitional period. Recently, there has been growing interest in exploring the experiences of graduate nurses in transition and the implementation of promising interventions to facilitate new graduates' assimilation to practice. Despite these initiatives, the overall shortage of mental health nurses continues to rise, and graduates still report negative experiences in the mental health setting. The purpose of this study was to identify and explore the experiences of new graduate nurses in mental health services in their first year of clinical practice. An integrative review was conducted with 22 studies sourced from the CINAHL, PubMed, Scopus, and PsychINFO electronic databases, as well as through hand-searching the literature. Literature review findings have highlighted negative clinical experiences and increased attrition from mental health services for graduate nurses. These experiences were closely linked with the changes in the training of mental health nurses, role ambiguity, inadequate clinical preceptorship, encountering the reality of mental health services, and the role of health services in transitioning graduate nurses into clinical practice. Established research into organizational cultures demonstrates that negative organizational outcomes result from negative workplace experiences. Therefore, further research into new graduate nurses' experiences of mental health nursing and its culture might clarify the reasons why they might not be attracted to the discipline and/or are leaving early in their career.

Majors in mental health nursing: issues of sustainability and commitment

PURPOSE

Major streams in mental health nursing in undergraduate nursing programs were introduced in Australia as a strategy to address current and projected workforce shortages. Of the 14 programs originally planned or implemented, only five are continuing.

DESIGN AND METHODS

A qualitative exploratory study was conducted involving in-depth interviews with representatives of universities that had ceased the major streams or abandoned plans to introduce them.

FINDINGS

Significant themes from interview material on abandoned programs were efficient use of resources, expertise, and problems with registration. On the programs now terminated significant themes were viability and commitment to mental health nursing.

PRACTICE IMPLICATIONS

These findings suggest demonstrable and sustainable commitment to mental health nursing is a precursor to success of major streams and advancement of the mental health nursing specialty.

New graduate nurses in transition: a review of transition programmes and transition experiences within mental health care

Research on experiences of transition into mental health-care roles seems sparse, but it is vital in order to produce a comprehensive understanding of the transition into mental health-care roles and to serve as a foundation for future research and development. The aim of the present study was to review existing research literature, and in doing so, investigate transition programmes for new graduate nurses (NGN) into mental health care, and their experiences of role transition and evaluations of participation in transition programmes. The literature review spans literature published after the year 2000. The literature search was conducted using the following databases: CINAHL, Psychology and Behavioral Sciences Collection, PsycINFO, and Pubmed. Search results consisting of 14 articles were analysed using thematic analysis. Results from the analysis showed four overall themes: nursing education, transition programmes and evaluations, working environment, and the NGN role. We conclude that it is not possible to produce a comprehensive understanding specifically concerning the transition programmes for NGN into mental health care, and that further research is necessary due to the limitations of this review.

Back to the future? Views of heads of schools of nursing about undergraduate specialization in mental health nursing

Preparation of nursing students for practice in mental health settings in Australia has been criticized since comprehensive education replaced preregistration specialist education. Current and projected workforce shortages have given rise to considering the reintroduction of specialization at preregistration level as a potential solution. Support of heads of schools of nursing would be essential for such an initiative to be considered. A qualitative exploratory study was undertaken involving in-depth telephone interviews with heads of schools of nursing in Queensland. Participants generally favoured the concept of specialization in mental health nursing at undergraduate level. Data analysis revealed the following themes: meeting workforce needs, improving quality of care, employability of graduates, an attractive option for students, and what would have to go. Participants identified many benefits to mental health service delivery and consumer outcomes. How the initiative could be developed within an already overcrowded curriculum was identified as the major barrier. This level of support is encouraging if necessary changes to the educational preparation for mental health nursing practice are to be considered.

Perspectives of Australian nursing directors regarding educational preparation for mental health nursing practice

There is an ongoing global shortage of mental health nurses. Within Australia, the principal strategy of offering a postgraduate education programme with various incentives to encourage nurses back to study has not been successful. This has led to the consideration of radical alternatives, including the return to pre-registration specialisation in mental health. The successful introduction of this strategy would require the full support of industry partners. To date, the voice of industry has not been heard in relation to this issue. The aim of this paper is to present the views of an Australian sample of mental health nursing directors regarding the resources and other factors required, should undergraduate specialist programmes in mental health be developed, to ensure they are relevant and likely to be successful. A qualitative exploratory research project was undertaken to explore the perspectives and opinions of industry partners. In-depth interviews were conducted with nursing directors (n = 12) in Queensland Australia. Five main themes were identified: relationships with universities; clinical placement preparation and support; workplace culture; facilitators and preceptors; and practical student learning. Genuine collaboration between the two organisations was considered crucial for delivering a quality programme and providing the required support for students. Transformative leadership could inform this collaboration by promoting acknowledgement of and respect for differences.

Implementing a major stream in mental health nursing: barriers to effectiveness

Changes to the educational preparation of the nursing workforce in mental health continue to have profound effects on the availability of sufficient numbers of skilled graduates willing to work in this field. The longevity of the problem has focused attention on possible solutions. Introducing a major stream in mental health nursing in undergraduate Bachelor of Nursing programmes was proposed and supported as a potentially beneficial strategy, adopted by some Australian universities. Despite the promise invested in this strategy, systematic evaluations to determine the effectiveness or otherwise of this approach were not initiated. A qualitative exploratory study was undertaken with Australian universities, which had implemented the major stream, regarding their experiences and observed outcomes. In-depth interviews were conducted with a mental health nurse academic from each university. The barriers to the effectiveness of the major in mental health nursing are the specific focus of this paper. Thematic data analysis revealed three main barriers: clinical placements, lack of support from other academics, and integrated curricula. These barriers substantially limited the effectiveness of this strategy - in some instances, leading to the programme's termination - and must be assertively addressed to maximize the potential of the major in mental health nursing.

Newly qualified South African nurses' lived experience of the transition from student to community service nurse: a phenomenological study

BACKGROUND

This study attempted to fill a gap in the published South African literature regarding newly qualified nurses' preparedness for and experience of role transition to a 1-year compulsory commitment of community service nurse.

METHODS

Husserlian descriptive phenomenology, characterized by inductive extraction of units of meaning from transcribed audiotaped recordings, was used to establish the "essence" of the lived experience of role transition. Data were collected from eight participants through two semistructured individual interviews: in July 2011, 2 weeks before the start of community service, and in September 2011, 6 weeks after community service placement.

RESULTS

Findings showed that before placement, participants experienced a sense of achievement in having successfully completed a 4-year diploma program. However, they also experienced uncertainty and fear about the immediate future. In the first month after placement, community service nurses experienced reality shock.

CONCLUSION

Preparation for the role transition from student nurse to graduate community service nurse requires a 4-year structured program that includes training in conflict management, assertiveness, and practical ethics.