New Nurses' Hopes and Expectations Transitioning Into Practice Phase Two
Repository Posting Date2014-03-05T21:55:43Z
Author DetailsLinda Gwinn MN,RN,PHCNS-BC, CCRN, e-mail email@example.com; Angie Marks MN, RN; Renee Hoeksel PhD, RN
Lead Author Sigma AffliationNon-member
Level of EvidenceQualitative Study, Phenomenology
Research ApproachQualitative Research
Keywordsnursing transition; phenomenological research; Hope; graduate nurses; New Graduate Nurses; Professional Practice
Purposes/Aims: This qualitative study examines the lived experiences of graduating associate degree nurses transitioning into practice.
Rationale Conceptual Basis/Background: The increasing complexity of health care and subsequently of nursing practice is well recognized. Comprehensive approaches are needed to address the gap newly graduated nurses experience as they transition from school into practice settings. As work environments and the job market do not remain static, the importance of listening carefully to the experiences of new nurses is greater than ever.
Methods: A 2-phase longitudinal research study was conducted using an interpretive, hermeneutic, qualitative design. The second phase, reported here, conducted individual interviews of nurses who had been in Phase I focus groups.
Results: Categories were identified from the transcripts of all participants which led to the emerging themes of Facing the Realities, Powerful Relationships, Commitment to Care, Communication Conundrums, and Building a New Nurse. New nurses identified realities of what they described as “shockers” or “the hardest thing…” Workloads seemed more intimidating once they were “on their own”. Each new nurse had a story about the influence of “a great nurse” who served as a role model. Team spirit, climate of trust, nurturing, and caring were highly valued. Each nurse verbalized a commitment to stay in nursing caring for clients, although not necessarily in their current settings. New nurses showed vulnerability for knowing when to ask questions, knowing how to communicate effectively with physicians, and learning ways to overcome communication barriers between shifts and co-workers. These new nurses were clearly “under construction”, building from a novice level of focusing on skill performance to showing appreciation for becoming future managers of care who use critical thinking, clinical judgment, and who recognize the need for lifelong learning.
Implications: Healthy work environments were key to instilling confidence, promoting learning and sharing, building self-efficacy, all which may lead to greater professional satisfaction. Internships or residency programs proved valuable as seen through the eyes of study participants. A few felt “thrown in” to “sink or swim” with extremely short orientations, especially in long term care facilities, and most left those settings within a year. Nurses entered the profession with a strong foundation in psychomotor and intellectual skills formulated in nursing school, but it should be acknowledged that tremendous emotion accompanies this school-to-practice transition. Leaders and experienced nurses can nurture and encourage new graduates by teaching healthy coping skills as well as by being credible resources for provision of care.