Out in the Real World: Newly Graduated Nurses in Acute-care Speak Out (original) (raw)

Lived Experiences of Newly Graduated Registered Nurses

2021

Attrition rates for first year newly graduated registered nurses (NGRNs) are between 30% to 60%; high level of attrition negatively affects hospital organizations, other nurses, and patient outcomes. Transitioning from student nurse to clinical nurse poses challenges for NGRNs which includes assuming responsibilities for a full patient load, communicating with physicians, and adjusting to shift work. The purpose of this phenomenological study, guided by Kramer’s reality shock theory and Duffy’s quality caring model, was to examine the lived experiences of a first-year cohort of NGRNs working in the acute care setting of a Florida hospital. Thirteen NGRNs were interviewed using open-ended, semistructured interviews about their transitional experiences and their perceptions of the caring behaviors exhibited by nursing leadership and other nursing staff. Emerging themes from the data verified by Raven’s Eye software included transitioning from student nurse to the role of clinical nurs...

Factors influencing the practice of new graduate nurses: A focused ethnography of acute care settings

Journal of Clinical Nursing, 2019

AimTo explore the influence of an acute care setting on competency deployment of new graduate nurses (NGNs) from a competency‐based undergraduate programme.BackgroundIn the last 15 years, nursing education has shifted to competency‐based education (CBE). Few studies have focused on how NGNs from these reformed programmes use the competencies they have developed. To be paradigmatically coherent with the nature of a competence, studies should also examine how context influences nursing practice and competency deployment.DesignA focused ethnography of three acute care units from one academic hospital in Canada.MethodsPurposive and snowball sampling strategies were used to recruit 19 participants: NGNs (n = 4), nurse preceptors (n = 2), clinical nurse specialists (n = 9) and nurse managers (n = 4). Data were collected through individual interviews, focus groups, observation and documentation. Data were analysed according to Roper and Shapira (Ethnography in nursing research. Thousand Oa...

Nurses' Perception toward Hallmarks of the Professional Nursing Practice Environment

Hallmarks are characteristics of the practice setting that best support professional nursing practice and allow baccalaureate and higher degree nurses to practice to their full potential, and assist nursing students educated at the baccalaureate level and above to make the best decision regarding where to practice following graduation. This study aimed to assess Hallmarks of the Professional Nursing Practice Environment as perceived by Bachelor Undergraduate Nursing students, Nurse Interns and nursing staff working/training at Main University hospital, Alexandria University, and conducted at Alexandria Main University hospital, on 336 nurse students, interns and staff nurses from those meeting the inclusion criteria and were available during data collection period. " Hallmarks of the professional nursing practice environment" questionnaire developed by American Association of Colleges of Nursing (AACN 2001) was used to collect data. The study main findings were that the subjects' perception for Hallmarks of the professional nursing practice environment was below the acceptable level, however, above the average. Nurse interns tended to have significantly higher perception for all hallmarks; while staff nurses as well as nurse students tended to have the lowest one. Age and years of experience of the staff nurses were found to be not affecting nurses' perception. Diploma nurses were found to perceive hallmarks more significantly as compared to bachelor nurses. Finally, the overall perception of staff nurses working in special care units was high in comparison to those working in the general wards.

Mastering the professional role as a newly graduated registered nurse

Nurse Education Today, 2013

Professional development is a process starting during undergraduate education and continuing throughout working life. A new nurse's transition from school to work has been described as difficult. This study aims to develop a model describing the professional development of new nurses during their first years of work. To develop this model, constant comparative analyses were performed. The method was a qualitative study of survey data on 330 registered nurses. The results showed that mastering the professional role was the result of an ongoing process building on the nurse's experiences and interactions with the surrounding environment. The professional developmental process involves the following interrelated sub-processes: evaluating and re-evaluating educational experiences, developing professional self-efficacy and developing clinical competence. These sub-processes are influenced by the following factors: social values and norms, healthcare organization, management of new nurses, co-workers, patients and significant others and the nurse's own family and friends. These factors affect professional development directly, indirectly or as mediating influences and can lead to possible outcomes, as new nurses choose to remain in or leave the profession. The results underscore the importance of developing a professional nursing role within the new working context. To facilitate this professional development, new nurses need support from their nursing-school educators and their healthcare employers. The model described here will be the subject of further measurement and testing.

Moving On, Up, or Out: Changing Work Needs of New RNs at Different Stages of Their Beginning Nursing Practice

Online journal of issues in nursing

This article describes the work experience of a national cohort of 229 RNs who participated in a survey on work environment at two different time periods. Survey results of the RNs’ experience within two and a half years of their initial RN licensure (time period two) are described in detail, and comparisons are made to their experiences one year earlier (time period one). Using Krippendorff’s technique for content analysis, six inter-related themes emerged at time period two. Findings indicate that the working environment of RNs impacts both nurses’ satisfaction and their dissatisfaction. Factors associated with dissatisfaction center on the lack of nurse manager leadership, persistent verbal abuse, high patient-to-nurse ratios, and the physical demands of bedside nursing that result in injuries. Suggestions from the nurses themselves are used to guide strategies to improve the work environment and retain nurses.

What newly licensed registered nurses have to say about their first experiences

Nursing Outlook, 2009

To understand factors that promote retention of Newly Licensed Registered Nurses (NLRNs) and those that contribute to turnover, a survey of a national sample of NLRNs was conducted. This article describes the content analysis of 612 NLRN comments about their work life. Using Krippendorff's 1 technique, 5 themes were discovered. Colliding expectations describes conflicts between nurses' personal view of nursing and their lived experience. The need for speed describes the pressure related to a variety of temporal issues. You want too much expresses the pressure and stress NLRNs feel personally and professionally. How dare you describes unacceptable communication patterns between providers. Change is on the horizon suggests optimism for the future as NLRNs speak of transforming the systems where care is provided. This content analysis reveals that the working environment where NLRNs begin their career is in need of reform. Suggestions are offered from the nurses themselves.

Starting Out: A time-lagged study of new graduate nurses’ transition to practice

International Journal of Nursing Studies, 2016

Background: As the nursing profession ages, new graduate nurses are an invaluable health human resource. Objectives: The purpose of this study was to investigate factors influencing new graduate nurses' successful transition to their full professional role in Canadian hospital settings and to determine predictors of job and career satisfaction and turnover intentions over a one-year time period in their early employment. Design: A national two-wave survey of new graduate nurses across Canada. Participants: A random sample of 3,906 Registered Nurses with less than 3 years of experience currently working in direct patient care was obtained from the provincial registry databases across Canada. At Time 1, 1,020 of 3743 eligible nurses returned completed questionnaires (usable response rate = 27.3%). One year later, Time 1 respondents were mailed a follow-up survey; 406 returned a completed questionnaire (response rate = 39.8%). Methods: Surveys containing standardized questionnaires were mailed to participants' home address. Descriptive statistics, correlations, and hierarchical linear regression analyses were conducted using SPSS software. Results: Overall, new graduate nurses were positive about their experiences and committed to nursing. However, over half of new nurses in the first year of practice reported high levels of emotional exhaustion and many witnessed or experienced incivility (24-42%) at work. Findings from hierarchical linear regression analyses revealed that situational and personal factors explained significant amounts of variance in new graduate nurses' job and career satisfaction and Page 5 of 47 A c c e p t e d M a n u s c r i p t 5 turnover intentions. Cynicism was a significant predictor of all four outcomes one year later, while Psycap predicted job and career satisfaction and career turnover intentions. Conclusions: Results provide a look into the worklife experiences of Canadian new graduate nurses over a one-year time period and identify factors that influence their job-related outcomes. These findings show that working conditions for new graduate nurses are generally positive and stable over time, although workplace mistreatment is an issue to be addressed.

Starting Out: qualitative perspectives of new graduate nurses and nurse leaders on transition to practice

Journal of nursing management, 2017

To describe new graduate nurses' transition experiences in Canadian healthcare settings by exploring the perspectives of new graduate nurses and nurse leaders in unit level roles. Supporting successful transition to practice is key to retaining new graduate nurses in the workforce and meeting future demand for healthcare services. A descriptive qualitative study using inductive content analysis of focus group and interview data from 42 new graduate nurses and 28 nurse leaders from seven Canadian provinces. New graduate nurses and nurse leaders identified similar factors that facilitate the transition to practice including formal orientation programmes, unit cultures that encourage constructive feedback and supportive mentors. Impediments including unanticipated changes to orientation length, inadequate staffing, uncivil unit cultures and heavy workloads. The results show that new graduate nurses need access to transition support and resources and that nurse leaders often face or...