Contemporary nursing graduates’ transition to practice: A critical review of transition models

Ontological coaching among nursing undergraduates: a pilot randomized controlled (OCEAN) trial

To develop and assess the preliminary effectiveness of Ontological Coaching Intervention for nursing undergraduates. Design: A pilot randomized controlled trial with a two-group pre-test and post-test followed by process-evaluation qualitative interviews. An Ontological Coaching Intervention was developed through an integration of prior literature and the collective the research team's experience, consisting of 4-6 sessions over 6-months, each lasting 30-60 minutes. Sessions encompassed exploring ontological coaching concepts, empowering nursing undergraduates to choose topics, and tailoring sessions to individual needs. Sixty undergraduates were recruited; ten were excluded for not completing the baseline questionnaires. Twenty-one nursing undergraduates were randomly assigned to the intervention group and twenty-nine undergraduates to the control group (standard academic support only). Primary (psychological well-being) and secondary (social support quantity and satisfaction, goal-setting, resilience) outcomes were measured at baseline, 3-months, and 6-months. Semi-structured interviews captured post-intervention experiences. Between-group analyses revealed a significant difference in goal-setting scores at 3-months (U = 325.5, p = 0.013), favoring the intervention group (median = 70.50, IQR = 64.25, 76.75). At 6-months, a significant difference in social support satisfaction scores (U = 114.5, p = 0.028) was found between the intervention (median = 33.00, IQR = 29.50, 35.25) and control (median = 30.00, IQR = 30.00, 35.00) groups. However, no significant between-group differences were noted in other outcome measures. Significant within-group differences were found in goal-setting scores at 3- and 6-months in the intervention group and social support quantity scores at 3- and 6-months in the control group. However, no significant within-group differences were noted in other outcome measures. Three themes were identified: Enhanced Holistic Development, Keys to Successful Coaching, and Future Directions for Successful Coaching. There is urgent need to advance research on Ontological Coaching Intervention, particularly, enhancing study rigor, broadening examinations to diverse healthcare student populations and cultural contexts, and addressing identified limitations.

Trauma-Informed Development and Education: Turning the TIDE on Transition to Practice

BACKGROUND

Transition to practice (TTP), the first year of a nurse's career postlicensure, is widely recognized as a stressful time. Previous trauma exposure and additional workplace trauma exacerbate the stress of this transitional period. Trauma-informed environments are associated with clinician wellness and engagement. Because workforce training for leaders is a necessary precursor to developing supportive environments, we studied changes in trauma knowledge, awareness, and attitudes among TTP leaders.

METHOD

Our mixed methods study included administering the Attitudes Related to Trauma-Informed Care Scale (ARTIC) pre- and posttraining, with additional open-ended questions about the impact of training.

RESULTS

Paired data from participants showed overall mean improvement that was statistically significant, with a large effect size. Statistically significant knowledge gains related to trauma recognition and safety, how to respond to trauma, and how to promote healthy behaviors.

CONCLUSION

Our study underscores the importance of trauma education, which not only increased awareness but also prompted nurse leaders to reflect on enhanced support for early nursing professionals. [J Contin Educ Nurs. 202x;5x(x):xx-xx.].

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

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

The transition of clinical nurses to nurse educator roles - A scoping review

AIM

To explore what is known about the lived experiences of novice nurse educators, including preparation or support strategies that may assist this transition.

BACKGROUND

Despite the crucial role of nurse educators in healthcare, the literature lacks clarity about the role and the preparation and support of nurse clinicians to transition into novice nurse educator roles.

DESIGN

Scoping review METHODS: A scoping review was carried out according to the Joanna Briggs Institute Methodology for Scoping Reviews. The Cumulative Index of Nursing and Allied Health Literature Complete (CINAHL), Medline (OVID), EMBASE, APA PsycINFO and Google Scholar databases were searched for English language sources of evidence between 1992 and 2022. Sources of evidence related to nursing education, transition, lived experience, preparation and support were included.

RESULTS

Fifty-two sources of evidence met the inclusion criteria with most originating in the United States and situated in the academic setting. There were 20 different titles used to identify nurse educators and a lack of clarity relating to the role and its expectations. There was alignment found between the lived experiences of novice nurse educators and Duchscher's transition shock model with a variety of preparation and support recommendations identified to mitigate this transition shock.

CONCLUSION

Clinical nurses transitioning into novice nurse educator roles have a predominantly negative experience that aligns with Duchscher's transition shock model. Although recommendations exist for support and preparation strategies to ease this transition shock, further research is required to establish which of these strategies are effective, especially for novice nurse educators in clinical settings outside of the United States.

Bridging the experience-complexity gap with longitudinal clinical placements

BACKGROUND

Clinical learning is a critical element to prepare nursing students for the profession. There is limited evidence on the experience-complexity gap among novice nursing students entering the workforce.

PURPOSE

This study aimed to implement a novel longitudinal clinical experience program and examined readiness for practice for undergraduate nursing students.

METHODS

We used a prospective cohort design using the Casey-Fink Readiness for Practice survey.

FINDINGS

There have been 2,004 clinical placements filled since the start of the program. Repeated exposure at one organization provided consistency and continuity while allowing students to develop relationships with patients and staff in a variety of settings. The medical-surgical two clinical experience was a pivotal course that influenced students' perception to enter the nursing workforce.

DISCUSSION

Clinical and academic partners must collaborate to provide the necessary competencies required to enter the workforce. Longitudinal clinical programs may improve nursing students readiness for practice.

CONCLUSION

The continous and immersive nature of the longitudinal clinical experience program facilitated the development of critical thinking skills and clinical competence, suggesting that longitudinal clinical placements can bridge the experience-complexity gap in nursing education.

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.

GridlockED as an Intervention for Nurses (GAAIN) Study

BACKGROUND

GridlockED (The Game Crafter, LLC) is a serious game that was developed to teach challenges that face nursing and medical professionals in the emergency department (ED). However, few studies have explored nurses' perceptions of the utility, fidelity, acceptability, and applicability of the serious game modality. This study examined how ED nurses view GridlockED as a continuing education platform.

METHOD

This single-center observational study explored how nurses engage with and respond to Grid-lockED. The convenience sample included participants recruited from a local continuing nursing education day. Participants completed a presurvey, engaged in a full game play session with the GridlockED game for approximately 45 minutes, and immediately completed a post-game play survey.

RESULTS

Of the 48 participants (11 male, 37 female; 44 of 48 were RNs), most (91%) agreed that the workflow reflected in the game was equivalent to the flow in a typical ED. Almost all (96%) found the cases in the game reflective of real ED patients, and most (92%) found the game a useful educational tool to prepare new nurses to transition into the ED environment.

CONCLUSION

The GridlockED game shows potential as a serious game to support nursing education, particularly for new ED nurse orientation and transition to ED practice. [J Contin Educ Nurs. 2024;55(5):231-238.].

The impact of comprehensive licensure review on nursing students' clinical competence, self-efficacy, and work readiness

This study aims to assess the effectiveness of comprehensive licensure reviews and adaptive quizzing assignments on nursing students' clinical competence, self-efficacy, and work readiness-an under-researched topic. Additionally, it seeks to explore the mediating effect of self-efficacy in the relationship between students' clinical competence and work readiness. A quasi-experimental (pre- and post-test), single-group design was employed. The study was conducted in a public university in Saudi Arabia and included a total of 293 senior nursing students in their last year of the bachelor program. An intervention was developed based on the blueprints of the Saudi Nursing Licensing Exam and NCLEX-RN and consisted of a weekly 3-h synchronous comprehensive licensure review bundled with 23 adaptive quizzing assignments over 15 weeks. Data were collected prior to and after the intervention using three scales: clinical competence, self-efficacy, and work readiness. The mean scores of clinical competence, self-efficacy, and two subscales of work readiness (work competence and social intelligence) increased significantly post-intervention. Self-efficacy (β = 0.353, p < 0.001) and clinical competence (β = 0.251, p < 0.001) influenced work readiness (F [5, 226] = 21.03, p < 0.001) and accounted for 31.8% of the explained variability in work readiness. In the mediation analysis, clinical competence had a significant and indirect effect on work readiness through self-efficacy (B = 0.464, p < 0.001, 95% CI 0.250 to 0.699). The proportion of mediation indicated that 37.2% of the total effect of clinical competence on work readiness was due to the indirect effect of self-efficacy. Comprehensive licensure review and adaptive quizzing assignments improve students' perceptions of clinical competence and self-efficacy. Such interventions could ease the transition of senior nursing students to clinical practice.

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.

Program coordinators' perspectives on implementing a transition program for newly graduated nurses: a qualitative interview study

PURPOSE

While transition programs are widely used to facilitate newly graduated nurses transition to healthcare settings, knowledge about preconditions for implementing such programs in the hospital context is scarce. The purpose of this study was to explore program coordinators' perspectives on implementing a transition program for newly graduated nurses.

DESIGN/METHODOLOGY/APPROACH

An explorative qualitative study using individual interviews. Total of 11 program coordinators at five acute care hospital administrations in a south-west region in Sweden. Data was subjected to thematic analysis, using NVivo software to promote coding.

FINDINGS

The following two themes were identified from the analysis: Create a shared responsibility for introducing newly graduated nurses, and establish legitimacy of the program. The implementation process was found to be a matter of both educational content and anchoring work in the hospital organization. To clarify the what and why of implementing a transition program, where the nurses learning processes are prioritized, was foundational prerequisites for successful implementation.

ORIGINALITY/VALUE

This paper illustrates that implementing transition programs in contemporary hospital care context is a valuable but complex process that involves conflicting priorities. A program that is well integrated in the organization, in which responsibilities between different levels and roles in the hospital organization, aims and expectations on the program are clarified, is important to achieve the intentions of effective transition to practice. Joint actions need to be taken by healthcare policymakers, hospitals and ward managers, and educational institutions to support the implementation of transition programs as a long-term strategy for nurses entering hospital care.

Transition shock, future time perspective, professional self-concept, and professional identity among nursing interns: A cross-sectional study

Background

Transition shock is prevalent among nursing interns. Future time perspective helps nursing interns learn and work more effectively and improve their problem-solving skills. Professional self-concept and professional identity play an important central and driving role in nursing interns' career choices and career development. However, the mechanism by which future time perspective, professional self-concept and professional identity are linked to transition shock among nursing interns remains unknown.

Objectives

We assess the degree of transition shock experienced by nursing interns and investigate the connections among transition shock, future-focused viewpoint, professional identity, and professional self-concept.

Design

A descriptive, cross-sectional design was conducted.

Setting

Eight hospitals in Hunan Province, China were included in the study.

Participants

Nursing interns at the studied hospital participated in the study.

Methods

A total of 1090 nursing interns [929 female, 161 male] were recruited from eight hospitals. Data on transition shock, future time perspective, professional self-concept and professional identity among nursing interns were collected using questionnaires from 30 May to June 15, 2022.

Results

On a 4-point rating scale, the participants' felt transition shock had a mean overall score of 2.39 (SD = 0.52). The dimension with the highest score was overwhelming workload (mean = 2.74, SD = 0.58), while the dimension with the lowest score was incongruity between work and personal life (mean = 2.16, SD = 0.70).Professional identity was statistically significantly correlated with transition shock (r = -0.198, p < 0.01). The preferred level of nursing (β = 0.354, p < 00.01), professional self-concept (β = 0.226, p < 00.01), professional identity (β = -0.2576, p < 00.01) and future time perspective (β = 0.119, p < 00.01) were predictors of transition shock.

Conclusions

The development of nursing interns' sense of professional identity and future time perspective should be enhanced during both the education phase and clinical placement to help nursing interns overcome the experience of transition shock.

New Graduate Nurse Transition into Rural Home: A Case Study

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

Supporting the Role Transition of Interim Nurse Managers: Development of an Evidence-Based eManual

Executive nurse leaders may rely on interim nurse managers (INMs) to fill vacated nurse manager positions open for an extended time. To optimize the INM role for future leadership succession planning, ongoing professional development for this role is critical. The authors describe the use of evidence in the creation of onboarding leadership resources to support the role transition of INMs within a healthcare environment over a 100-day period.

Transition shock among nursing interns and its relationship with patient safety attitudes, professional identity and climate of caring: a cross-sectional study

BACKGROUND

Nursing interns often experience lots of challenges during their clinical nursing internships, which can adversely affect career decisions and result in a squandering of nursing education resources. Patient safety attitudes, professional identity and climate of caring may affect nursing interns' clinical experience. However, more evidence is requested to validate these relationships for nursing educators to develop effective education programs and facilitate interns' successful transition.

METHODS

This was a cross-sectional study, which used a convenience sampling method to recruit 387 nursing interns during December 2022 to April 2023 in university affiliated hospital in Hunan province, China. Data were collected using standardized scales. Spearman correlation and multiple regression analysis were employed to examine the relationship between transition shock, patient safety attitudes, professional identity, and climate of caring.

RESULTS

Nursing interns experienced transition shock at a moderate level and the highest levels of transition shock in response to overwhelming practicum workloads, with the second being related to the conflict between theory and practice. Transition shock was negatively correlated with patient safety attitudes, professional identity and climate of caring among nursing interns.

CONCLUSIONS

Nursing managers and educators need to value the transition shock experienced by nursing interns. Our study suggests that developing a strong sense of professional identity and a positive attitude toward patient safety can be effective in reducing the level of transition shock among nursing interns. In addition, a caring climate within the nursing unit can significantly enhance the overall experience of nursing interns. This can be achieved by enhancing the support of clinical mentors, providing patient safety-focused education, and facilitating team communication among nurses.

Being a Newly Qualified Nurse: A Nordic Focus Group Study

Introduction

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

Objective

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

Methods

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

Results

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

Conclusions

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

Path Model of Reality Gap on the Mental Health of Novice School Nurses in Japan

Introduction

Mental health is a serious concern among novice school nurses in Japan. Numerous novice school nurses with various health problems experience high stress levels, affecting their mental health. They may be experiencing reality shock, a known risk factor for burnout and turnover, or its factor, the "reality gap."

Objective

This study aimed to examine the hypothetical model by which the reality gap affects the mental health of novice school nurses.

Methods

This cross-sectional study conducted a self-administered questionnaire survey, and responses were obtained from 102 novice school nurses. A path model was created based on a hypothetical model.

Results

After several revisions on the hypothesis model, a modified path model was generated (CFI = .98, TLI = .93, RMSEA = .06). The path model showed that reality gaps negatively affected work engagement, work engagement positively affected intention to stay, and intention to stay positively affected mental health. Reality gap was also directly negatively associated with mental health. Having various support networks reduced the effects of reality gaps on mental health. Additionally, social support in the workplace boosted work engagement.

Conclusion

Unique from other studies, this study contributed to understanding the effects of reality gaps on mental health. School managers and administrators should establish a support system that enables school nurses to receive various supports from within and outside the school. In addition, novice school nurses should take advantage of networks and support inside and outside school to reduce reality gaps and grow as professionals.

Psychological Well-Being of Nurses with One to Five Years of Clinical Experience

Introduction

Nurses are required to fulfill many roles, including expertise, communication, and leadership and are psychologically vulnerable due to lack of manpower, emotional labor, and shift work. Among them, it is necessary to understand the psychological well-being of new nurses and junior nurses who have a high early resignation rate.

Objective

The purpose of this study was to investigate psychological well-being of nurses and compare psychological well-being of nurses from the first to the fifth years of clinical experience.

Methods

Cross-sectional comparative design and purposive sampling method were used. Data were collected from 148 nurses with one to five years of experience working in tertiary care general hospitals. On November 11, 2021, an online link for the structured questionnaire was sent to the group social networking service accounts for nurses. Psychological well-being was assessed using a Korean version of the Scales of Psychological Well-being including autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance.

Results

The average psychological well-being of nurses was 194.11, with significant differences depending on years of clinical experience (p = .006, F = 3.82) and satisfaction with nursing (p < .001, F = 13.12). It was lowest at 180.08 in the first year, gradually improving, but falling again from the fourth year. Among five subfactors except positive relations with others (p = .389), psychological well-being was related to clinical experiences years using satisfaction with nursing and religion as covariates.

Conclusions

This study that compared psychological well-being from the first to the fifth year according to clinical experience revealed the need for optimized intervention for each year. Nursing managers can improve the psychological well-being of nurses through active and appropriate intervention according to the passage of nursing experience.

Cognitive and Noncognitive Factors Influencing Nursing Students' Academic Success: Structural Equation Model Analysis

AIM

The study aim was to identify and explore relationships among cognitive and noncognitive factors that may contribute to prelicensure baccalaureate nursing students' academic success across their program of study.

BACKGROUND

Nurse educators are challenged to improve students' academic success. With limited evidence, cognitive and noncognitive factors have been identified in the literature as potential factors that influence academic success and may support students' readiness for practice as new graduate nurses.

METHOD

Data sets from 1,937 BSN students at multiple campuses were analyzed using an exploratory design and structural equation modeling.

CONCLUSION

Six factors were conceptualized as contributing equally to the initial cognitive model. The final noncognitive model, with deletion of two factors, yielded the best fit for the four-factor model. Cognitive and noncognitive factors were not significantly correlated. This study provides a beginning understanding of cognitive and noncognitive factors associated with academic success that may support readiness for practice.

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

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

BACKGROUND

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

DESIGN

A cross-sectional survey design was used.

METHOD

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

RESULTS

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

Transition to professional practice: Perspectives of new nursing graduates of Nepal

BACKGROUND

Internationally, the transition from student nurse to practicing nurse is recognized as being the most stressful period. Yet very little is known about how new nursing graduates perceive this transition in Nepal. The study aimed to explore new nursing graduates' perceptions of the transition to professional practice.

METHODS

A qualitative descriptive methodology was used. In-depth semi-structured interviews were conducted with 10 purposively recruited participants from two private hospitals in Nepal. Data were analyzed using inductive thematic analysis. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were used to report the findings of this study.

RESULTS

New nursing graduates perceived the transition to professional practice as an intense experience. Inductive thematic analysis yielded four intrinsically linked themes that encompassed new nursing graduates' transition experiences: 'getting hit by reality', 'losing confidence', 'feeling unsupported', and 'gathering strengths.' The theme 'getting hit by reality' included three sub-themes: 'gap between theory and practice,' 'no protective shield,' and 'plethora of responsibilities', which explains nurses' initial encounter with real-world practice. The theme 'losing confidence' contained three sub-themes: 'being fearful,' 'being ignored,' and 'being accused,' which describes how nurses started losing confidence as they confronted the real side of the profession. The theme 'feeling unsupported' included two sub-themes: 'left without guidance,' and 'limited support from seniors,' which explains how nurses perceived their work environment. The theme 'gathering strength' contained two sub-themes: 'reflecting' and 'asking for help,' which describes how nurses coped with the challenges related to the transition.

CONCLUSION

To facilitate the transition to practice, educational institutions must impart to students a realistic understanding of the transition process, address the theory-practice gap, and collaborate with hospitals. Similarly, hospitals should have realistic expectations from new nurses, assign work according to their capabilities, and allow them sufficient time for role integration. Likewise, well-conceived detailed orientation, mentorship or preceptorship programs, and regular professional development programs are vital to easing the transition. Furthermore, establishing and maintaining a supportive work culture, which promotes equity, respect, and safety among employees, is crucial for positive transition experiences.

An Example of Inquiry-Based Learning in a Transition to Nursing Practice Curriculum

BACKGROUND

Graduate nurses are known to experience transition shock when they enter the workforce. Graduate nurse programs are designed to alleviate aspects of transition shock.

METHOD

Best practice in development and delivery of transition programs is currently limited in the literature, and there are few examples focusing on curriculum design that can be adapted by health services to develop and support new nurses.

RESULTS

An inquiry-based learning approach was used as the underlying andragogy to frame a contemporary transition curriculum to support graduate nurses.

CONCLUSION

Inquiry-based learning can be used to support graduate nurses to improve critical thinking, confidence, and job satisfaction during the most challenging years of their professional lives. [J Contin Educ Nurs. 2023;54(6):268-274.].

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Role transition from education to practice and its impact on the career futures of Omani nurses

AIM

The aim of this study was to examine new Omani graduate nurses' role transition from education to practice. We also sought to describe factors that may affect the effective transition of new Omani graduates to their professional nurse role.

BACKGROUND

There is a substantial literature on the process of transition from graduation to being a professional nurse in countries across the globe; however, little is known about new Omani graduate nurses' role transition from education to practice.

DESIGN

This study had a descriptive cross-sectional design.

METHODS

Data were collected from nurses who at the time of the study had been working for at least 3 months but not longer than 2 years. Role transition was assessed with the Comfort and Confidence subscale of the Casey-Fink Graduate Nurse Experience Survey (Casey et al., 2004). The survey consists of a 24-items that are rated on a 4-point Likert scale. We conducted a multivariate regression analysis to assess the factors that influence nurses' role transition. These factors included participants' demographic information, employment orientation durations, preceptorship duration and length of time before employment.

RESULTS

The total sample consisted of 405 nurses working in 13 hospitals in Oman. Most (68.89%) had worked as a nurse for less than 6 months. The average internship and orientation durations were approximately 6 months (SD = 1.58) and 2 weeks (SD = 1.79), respectively. The number of preceptors assigned to new graduate nurses ranged from none to four. The average score on the Comfort and Confidence subscale was 2.96 (SD = 0.38). Results from the regression analysis demonstrated that age (β = 0.029, SE = 0.012, p = .021), waiting time before employment (β = -0.035, SE = 0.013, p = .007) and employment orientation duration (β = -0.007, SE = 0.003, p = .018) were statistically significant factors influencing role transition experience among newly joined nurses.

CONCLUSION

The results suggest that appropriate intervention strategies at the national level are needed to enhance the transition of nursing school graduates to their professional role. Strategies directed toward shortening the waiting time before employment and improving the internship experience are examples of priority-level tactics that can enhance Omani nursing graduates' transition to their professional role.

Relationship between Transition Shock, Professional Stressors, and Intent to Leave the Nursing Profession during the COVID-19 Pandemic

Background and Objectives: Moving nurses to a COVID-19 department may cause the phenomenon of transition shock, which occurs when already employed nurses change jobs. A set of confusing and uncertain feelings arise due to the unfamiliar work environment, which may lead to their intention to leave the nursing profession. The aim of this study was to examine transition shock and the contribution of both the respondents’ characteristics and the presence of stressors to the occurrence of transition shock in nurses assigned to work in COVID-19 departments. Materials and Methods: A cross-sectional study with 120 nurses employed in COVID-19 departments was conducted. Several linear regression models were used to assess the association between transition shock, personal and professional COVID-19 stressors, and the intention to leave the nursing profession. Results: Nurses who intended to leave the profession showed higher transition shock and higher personal and professional stressors (p < 0.001). Female nurses had lower transition shock (β = −0.16; p = 0.036) and higher personal COVID-19 stressors (β = 0.27; p < 0.001). University education contributes to the lowering of nurses’ transition shock (β = −0.16; p = 0.038). Nurses who did not intend to leave the nursing profession had lower personal COVID-19 stressors (β = −0.15; p = 0.044). Transition shock was associated with personal COVID-19 stressors (β = 0.39; p < 0.001) and professional COVID-19 stressors (β = 0.29; p < 0.001), and vice versa. Conclusions: The phenomenon of transition shock was present after nurses transitioned to working in COVID-19 departments. Transition shock may cause more nurses to leave the profession, which may have a strong impact on the health system in many countries that are already facing a shortage of nurses. Additional education on and preparation for adapting to new working conditions with psychological support could have an influence by lowering the level of nurses’ transition shock.

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

BACKGROUND

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

OBJECTIVE

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

DESIGN

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

DATA SOURCES

Ovid Emcare, PsychInfo, CINHAL, Proquest and Scopus.

METHODS

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

RESULTS

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

CONCLUSIONS

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

The Importance of Graduate Education for Nursing Care

Graduate nursing education faces various challenges linked to research products that must be innovative and have an impact on social well-being. Knowledge transfer is a complex multidimensional process requiring multiple mechanisms, methods, and measurements to be considered in graduate training. Educational institutions must have a support infrastructure and be responsible for preparing interdisciplinary syllabi, coordinating management strategies to address student learning, and providing an environment for harmonized communication among those interested in problem-solving.

The Quality of Care Delivered in a Simulation Center: A Benchmark Study

BACKGROUND

A standardized survey to describe the quality of care received from prelicensure nursing students during simulation can measure simulation program effectiveness.

PURPOSE

The purpose of this study was to compare national Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey data with data received from standardized patients (SPs) using a modified HCAHPS survey.

METHODS

SPs completed a modified HCAHPS survey immediately following each in-person simulated encounter. One year of SP responses (N = 385) from one baccalaureate nursing program was compared with the national HCAHPS survey data from the same time.

RESULTS

All SP responses were less than the national proportions. However, when the level of stringency was adjusted, the responses more similarly aligned to the national proportions.

CONCLUSIONS

Findings suggest HCAHPS data can be used to model correlates of the quality of care SPs receive during simulation events.

Impact of pre-registration extended immersive ward-based simulation on student learning in preparation for clinical placement

BACKGROUND

Graduate nurses commonly experience significant challenges in transitioning to professional practice. The practice readiness of graduate nurses continues to be a concern for nurse educators and industry partners. Introduction of pre-registration extended immersive ward-based simulation can provide opportunities for students to practice the role of registered nurse before graduation. It is not clear if participation in simulation-based learning transfers to increased preparedness for dealing with real-life situations following entry into the workforce.

OBJECTIVE

To report on student views on how ward-based immersive simulation assisted in preparing for clinical placement and graduate practice.

DESIGN

A qualitative, descriptive design was used to conduct a series of face-to-face focus groups.

SETTING

School of Nursing and Midwifery metropolitan Western Australian university.

PARTICIPANTS

Final year baccalaureate nursing students who had participated in six four-hour simulation workshops between February and April 2021 were selected through purposive sampling.

METHODS

Focus group and interview data was transcribed from audio recordings. A six-phase approach was used to analyse data into themes and sub-themes. The study adhered to the consolidated criteria for reporting of qualitative research.

RESULTS

Three focus groups and one interview were conducted. Eight themes emerged. Student learning was identified as occurring in a variety of ways, such as how to work as a team and was influenced by a number of factors, such as the capacity for students to self-reflect.

CONCLUSIONS

Learning opportunities for students to practice how to think and work independently as a registered nurse is something that can be supported by pre-registration extended immersive ward-based simulation. Understanding of what will be expected of them once qualified can make students more prepared for professional practice enabling them to apply knowledge gained from simulated experiences to a similar situation as a graduate nurse.

The experiences of new graduate nurses working in a pediatric setting: A qualitative systematic review

OBJECTIVE

To synthesize the literature regarding the experiences of new graduate nurses working in a pediatric setting.

BACKGROUND

The transition experiences of new graduate nurses can be stressful and challenging. Pediatric settings may cause additional stress due to the unique nature of children's nursing and its' environment.

INCLUSION CRITERIA

Qualitative studies of any design and qualitative components of mixed method studies that explored the experiences of new graduate nurses in a pediatric setting were included in this review: neonatal intensive care units and special care nurseries were excluded.

METHODS

The JBI meta-aggregation approach for synthesizing qualitative data was followed. Databases searched were CINAHL, MEDLINE (Ovid), APA PsycInfo, Scopus, PubMed Central, ERIC, and ProQuest Dissertations and Theses. Studies published between January 2000 and January 2022 inclusive were considered.

RESULTS

2229 records were screened, and nine studies selected. From the nine studies 203 findings were included, resulting in 19 categories and five synthesized findings. The synthesized findings related to support, developing identity and role transition, working conditions and environment, fear and uncertainty, and career and goal planning.

CONCLUSIONS

New graduates in a pediatric setting required support that took account of their development needs with consistent preceptorship. Being considered part of a team and the support of other team members were important in developing identity as a new graduate nurse in a pediatric setting. Working conditions for the new graduate needed to be safe, and new graduates also felt fearful and uncertain when it came to their new accountability and responsibilities.

Simulation-Based Mastery Learning to Facilitate Transition to Nursing Practice

BACKGROUND

Simulation-based mastery learning (SBML) was developed and implemented to facilitate nursing students' transition to clinical practice.

PURPOSE

To evaluate nursing students' perspectives on the impact of SBML on their transition to clinical practice.

METHOD

A descriptive qualitative study using focus group discussions was conducted with final-year nursing students who had completed their clinical practicum and SBML.

RESULTS

Three themes emerged: authenticity of simulations, whereby students were able to draw some parallels between their simulations and clinical experiences; self-efficacy in clinical practice, which was gained through deliberate practice; and application of cognitive tools, which provided mental frameworks to guide clinical performances.

CONCLUSION

This study highlights the need to ensure the fidelity of the simulations to achieve authentic experiences, provide deliberate practice to develop self-efficacy, and use cognitive tools for mental model formation to create a high-quality SBML program to foster better transfer of simulation learning to real-life setting.

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.

Sustaining the Intrinsic Motivations of the "Good Physician": A Content Analysis of Medical Students' and Physicians' Responses from Two National Surveys

OBJECTIVE

Physician motivation has been described as the reason, purpose, and force that drives people to pursue their work, and motivating factors include those that are intrinsic or extrinsic to the work. Social forces may contribute to motivational disparities between medical school and actual practice.

METHODS

A secondary data analysis of two national surveys (medical students and practicing physicians from various specialties) was conducted. Content analysis was performed on open-ended survey items that elicited students' and physicians' responses to meaningful experiences in medicine.

RESULTS

In the medical student sample, four themes were identified as factors intrinsic to medicine: role models, clinical experiences, patient interactions, and peer interactions. In total, intrinsic factors comprised 86.5% (193/208) of coded responses. In the practicing physician sample, five themes were identified as factors intrinsic to medicine: difficult patient interactions, conflict with colleagues or staff, meaningful patient interactions, involvement in medical education-research-academia, and medicine as a calling/mission. In total, intrinsic factors comprised 24.0% (140/582) of coded responses.

CONCLUSIONS

Our findings suggest that the reality of social forces in medicine threatens the ability of practicing physicians to derive meaning from their work, although students and physicians still report intrinsic motivation from establishing meaningful relationships. Further research is needed to explore what strategies enable physicians to wisely navigate the dynamic interactions of intrinsic and extrinsic motivators over various stages of their careers. These strategies could include encouraging reflective spaces in physicians' workplaces that have a specific focus on sustaining intrinsic motivation in medicine.

Interventions to foster resilience in nursing staff: A systematic review and meta-analyses of pre-pandemic evidence

BACKGROUND

Given the chronic work-related stressors experienced by nursing staff in today's healthcare systems, international evidence suggests an elevated risk of developing stress-related mental symptoms. Therefore, identifying effective methods to foster resilience (i.e., maintenance or fast recovery of mental health despite stressor exposure) seems crucial. To date, little is known about the efficacy of these interventions in nurses.

OBJECTIVE

This systematic review aimed at summarizing the evidence on the pre-pandemic efficacy of psychological interventions to foster resilience, to improve mental symptoms and well-being as well as to promote resilience factors in nurses. Based on training programs with evidence for positive effects on resilience and mental health in meta-analyses, we aimed at identifying important and helpful intervention techniques.

DESIGN

Systematic review and meta-analyses based on a Cochrane review on pre-pandemic resilience interventions in healthcare professionals.

DATA SOURCES

MEDLINE, Embase, CENTRAL and 11 other databases were searched until June 2020 to identify eligible randomized controlled trials. Trial registers, reference lists and contact with authors were additional sources.

REVIEW METHODS

Two reviewers independently assessed study eligibility and extracted data. The Cochrane risk of bias assessment tool was used to evaluate the risk of bias of included studies. We conducted random-effects pairwise meta-analyses for five primary outcomes, including resilience. The intervention contents and techniques were narratively synthesized.

RESULTS

Of 39,794 records retrieved, 24 studies were included in the review (N = 1879 randomized participants), 17 in meta-analyses (n = 1020 participants). At post-intervention, we found very-low certainty evidence of moderate effects in favor of resilience training for resilience (standardized mean difference [SMD] 0.39; 95% CI [confidence interval] 0.12-0.66) and well-being (SMD 0.44; 95% CI 0.15-0.72), while there was no evidence of effects on symptoms of anxiety, depression and stress. The improvement of well-being was sustained in the short-term (≤3 months), with additional delayed benefits for anxiety and stress. There was no evidence of effects at later follow-ups, with the caveat of only three available studies. Among nine programs with evidence of positive moderate effect sizes, intervention contents included mindfulness and relaxation, psychoeducation, emotion regulation, cognitive strategies, problem-solving and the strengthening of internal and external resources.

CONCLUSIONS

Given the chronic stressor exposure in nursing staff, our findings may guide both the design and implementation of nurse-directed resilience interventions. To improve the certainty of evidence, more rigorous high-quality research using improved study designs (e.g., larger sample sizes, longer follow-up periods) is urgently needed.

REGISTRATION

PROSPERO 2017 CRD42017082827.

‘A much kinder introduction’: exploring the benefits and challenges of paediatric simulation as a transitioning tool prior to clinical practice

Simulated practice is an opportunity to transition nursing students from on-campus learning to clinical practice. There is limited evidence on simulated practice’s role in assisting this transition at the beginning of a nursing student’s education in terms of benefits, challenges, differences and affordances. This study aimed to research the impact of a simulated practice programme as a transitioning tool for first-year paediatric nursing students.

A participatory action research approach was used to address challenges in student’s transitioning to clinical practice and a lack of clinical placement capacity. A low-technological (physical), high-authenticity (emotional and environmental)-simulated practice programme for first-year paediatric nursing students was implemented. Forty students across two cohorts were recruited, and a qualitative survey was completed post-simulation/pre-clinical practice and post-clinical practice. Reflexive thematic analysis was used to develop the resulting themes.

There was an initial 93% response rate after the simulated practice and 88% after clinical placement. Eight themes (‘bridging’ from simulation to practice and to enhance practice; ‘preparedness’ once on clinical placement; ‘applied learning’ reliably transferred to practice; ‘skill decay’ between simulation and practice; ‘same but different experiences’ between simulation and practice; simulation and clinical ‘practice pace’; ‘safety’ of simulation; and ‘unique affordances’ of simulated practice) were constructed from the data, and an additional nine sub-themes were identified (transference to practice; practice enhancement; slow-motion care; hectic; it is safe; it was safe; feedback and reassurance; practice and practice; and unpressured). Collectively, the themes indicated that simulated practice in this context is conveyed as a well-being tool in addition to having experiential learning and bridging benefits.

This study revealed that simulated practice can assist in transitioning paediatric student nurses to clinical practice. It identified its value in terms of fostering holistic learning, well-being and bridging theory to practice. To ensure long-term effectiveness, simulation maintenance training, booster training and refresher strategies should be included as part of the programme to prevent skill decay. Future studies should consider isolating these key findings for a more in-depth look at their meaning.

Psychological experience among internship nurses at different internship stages: A qualitative study

AIM

Some studies have found that clinical practice has caused great pressure and negative psychological experience to nursing students. Therefore, this study aimed to identify psychological experience at different internship stages among internship nurses.

DESIGN

A qualitative study.

METHODS

In this qualitative study, one-to-one in-depth interviews and mixed data analysis strategies were conducted among internship nurses from May 2018 to February 2019.

RESULTS

The pressure of the initial stage was operational pressure (80.0%), intermediate stage was nurse-patient communication (50.0%), and last stage was employment pressure (70.6%). Nursing students mainly expected to improve their operational and communication skills, and to acquire clinical experience, thinking ability and frontier knowledge. 62.5% students said ambivalent on "let us practice with being monitored," especially in the last stage (88.2%). Clinical nursing teaching should pay attention to this dynamic experience and their factors and take corresponding measures to improve the quality of internship.

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

PURPOSE

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

Addressing the Lack of Professional Values and Behaviors among New Nurses

Professionalism and safety in patient care are concepts nurses are expected to exhibit in practice. High fidelity simulation was explored to assist in teaching students the behaviors needed to succeed in nursing. Nursing leaders identified areas in which graduates struggle, including critical thinking, skills acquisition, time management, role responsibilities, delegation, and effective communication. The project's purpose was to analyze students' perceptions regarding professional nursing values, identify gaps in knowledge concerning professional behavior, and determine perception change of professional values. A pretest post-test simulation intervention was chosen. Improvement in communication and autonomy was noted with statistically significant findings.

A phenomenological exploration of nurse educators' roles in Saudi Arabia's Vision 2030

AIM

The purpose of this study is to examine the roles of nurse educators through the eyes of undergraduate and graduate students at selected Saudi Arabian universities in the context of Vision 2030, an initiative to transform the socio-economic reform plan that is opening Saudi Arabia worldwide based on the following three pillars: a vital society, a thriving economy and an ambitious nation.

BACKGROUND

Nursing education in Saudi Arabia has faced numerous obstacles due to cultural, educational, organizational and work-related factors, discouraging registered nurses and students enrolled in undergraduate and graduate programmes from pursuing career paths in nursing education.

METHODS

Descriptive phenomenology was used as the method. Twenty-two nursing students from selected government and private universities in Saudi Arabia's Eastern Region were recruited through purposive sampling and semi-structured in-depth interviews. The COREQ criteria list was adapted to report the study's findings.

RESULTS

Four themes emerged regarding how nursing students perceived nurse educators' roles, including philanthropists of learning, advocates for patient safety and quality service, proponents of individual transformation and beacons of hope for nursing's future.

CONCLUSION

Despite rapidly changing images, ideologies and perceptions of modernization and worldwide freedom of expression and speech, students continue to have positive perspectives on nurse educators' roles.

IMPLICATIONS FOR NURSING MANAGEMENT

The study's findings will provide an initiative for nurse managers and leaders to revisit the roles of nurse educators in moulding future generations of registered nurses and realign these roles towards the goals and objectives of Saudi Vision 2030.

Nursing students' perception of gender-defined roles in nursing: a qualitative descriptive study

BACKGROUND

Gender stereotypes influence both women and men who work as nurses as well as individuals considering nursing as a profession. The aim of this study was to explore male and female nursing students' experiences and perspectives regarding gender-defined roles as well as how they view their future professional roles.

METHODS

The study used a descriptive qualitative design. A convenience sample included 72 full-time second- and third-year undergraduate nursing students. Data were collected in 2017 using a self-administered qualitative questionnaire consisting of 11 essay-type questions. As an additional data collection method, a drawing method was applied. The data were analysed by content analysis separately for the male and female perspectives.

RESULTS

Altogether, eight themes emerged, with half explaining the male and the other half the female students' perspectives. Students choose nursing for altruistic, opportunistic and organisational reasons. Among the female students, another reason "family and social incentives" was also identified. Female students' vision of their future professional role included altruism and positive representations of 'being a nurse', whereas the male students' vision included management and leadership, and technical aspects of nursing.

CONCLUSIONS

Both male and female nursing students face the limits of their own gender roles, yet they are prepared to challenge these gender-based perceptions. Tackling stereotypes and raising public awareness, using gender-inclusive language and strategies for recruitment, ensuring gender diversity in nursing teams and revising the nursing curriculum where appropriate, are just some of the implications that arise to help overcome gender differences.

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

Background

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

Aim

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

Method

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

Results

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

Discussion

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

Conclusion

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

The Value of Emergency Nursing Mode in the Treatment of Patients with Traumatic Shock

OBJECTIVE

To study the value of emergency nursing mode in patients with traumatic shock.

METHODS

76 patients with traumatic shock in our hospital from March 2019 to February 2021 were selected and divided into study group and control group according to different rescue modes, 38 cases in each group. The study group adopted emergency nursing mode for rescue, while the control group adopted routine nursing mode for rescue. The rescue intervention, emergency stay and preoperative preparation time, rescue success rate, emergency rescue effect, complications, and satisfaction rate of patients and their families for rescue were compared between the two groups.

RESULTS

The rescue intervention, emergency stay and preoperative preparation time of the study group were significantly shorter than those of the control group, and the difference was statistically significant (P < 0.05). The rescue success rate of the study group was 97.37%, which was significantly higher than 84.21% of the control group, and the difference was statistically significant (P < 0.05). The improvement rate of the study group was significantly higher than that of the control group, the disability rate was significantly lower than that of the control group, the overall emergency rescue effect was better than that of the control group, and the difference was statistically significant (P < 0.05). The incidence of complications in the study group was 2.63%, which was significantly lower than 23.68% in the control group (P < 0.05). The satisfaction rate of patients and their families in the study group was 97.37%, which was significantly higher than 84.21% in the control group (P < 0.05).

CONCLUSION

Emergency nursing mode in patients with traumatic shock owns higher rescue value, can buy time for the operation, improve the success rate and effect of rescue, make safety and satisfaction higher. Overall, for patients with traumatic shock, emergency nursing mode is better than conventional rescue nursing.

The status and associated factors of junior nurses' transition shock: A cross-sectional study

AIM

To analyse junior nurses^' transition shock status and its associated factors.

BACKGROUND

When nurses experience transition shock, turnover intentions followed by turnover behaviour are likely, which is unfavourable for the stable development of nursing teams.

METHODS

Using convenience sampling, 1,148 Chinese junior nurses were recruited. Those recruited completed a demographic questionnaire and the head nurses' humanistic care behaviour for nurses, feedback-seeking behaviour and transition shock of nurses scales. Data and associated factors of transition shock were analysed using SPSS and univariate and multivariate analyses, respectively.

RESULTS

Head nurses' humanistic care behaviour and nurses^' feedback-seeking behaviour were significantly and negatively correlated with junior nurses' transition shock (mean score: 2.87 ± 0.85). Income satisfaction, head nurses' humanistic care behaviour, night shift frequency and educational background entered the regression equation.

CONCLUSIONS

Transition shock exists not only in new nurses but also in junior nurses with ≤5-year service. Those dissatisfied with their income have frequent night shifts, and higher education backgrounds have higher levels of transition shock.

IMPLICATIONS FOR NURSING MANAGEMENT

Head nurses need to reduce transition shock of nurses with ≤5-year service by integrating humanistic care into nursing management and creating a friendly environment to stimulate feedback-seeking behaviour.