Australian new graduate experiences during their transition program in a rural/regional acute care setting
Fiona Ostini
Teacher - Nursing TAFE, Western Institute Orange Campus, Orange, NSW
Ann Bonner
School of Nursing, Queensland University of Technology, Kelvin Grove, QLD
PP: 243 - 253
Abstract
The transition process from student to Registered Nurse has been recognised as an important yet challenging time for newly graduated nurses. Knowledge about this experience from the nurse's perspective, particularly in a rural setting, is limited. This paper reports the findings of a qualitative study of the experiences of newly graduated nurses working in a rural acute care facility in New South Wales. The study examined, from the perspective of the new nurse, the orientation and support which can help to facilitate the transition from student to registered nurse. Four themes emerged which were being supported, being challenged, reflections on being a new graduate, and reflections on a rural new graduate program. These findings contribute to what is know about the transition of new graduates in a rural facility and have implications for program improvements, specifically within the rural acute care environment. The findings are also relevant to students considering rural employment on graduation and for the recruitment and retention of New Graduate Registered Nurses in rural areas.
Keywords
nursing; new graduate; orientation; education; transition; recruitment; retention
Article Text
Registered Nurses within Australia are mainly sourced from newly graduated university students who have successfully completed a Bachelor Degree in Nursing (Australian Institute of Health and Welfare 2008). Recruitment and retention of new graduates is, therefore, of considerable importance to the health care system. New graduate nurses need support in the transition from student to registered nurse, so benefit from employment in a health care facility where such support can be gained. This is underpinned by the assumption that clinical experience results in the development of a nursing professional, achieved through actually participating in or experiencing real clinical practice. Even though students experience clinical practice in a supernumerary capacity as part of undergraduate nursing programs clinical practice cannot be experienced from a registered nurse perspective until nursing students become registered nurses. New graduate programs in Australia aim to provide support for new Registered Nurses when they first begin clinical practice. Examining how well new graduate programs actually do support new nurses is relevant to all areas of nursing practice. New graduates in rural areas face distinct challenges compared to metropolitan areas (Bennett, Brown, Barlow & Jones 2010). This paper reports the findings of a study which sought to investigate experiences of the transition of new graduate registered nurses from student to clinical practice in a rural context and the support provided through a new graduate transition program. The literature review included database searches of CINAHL, Embase, Ovid, Medline, Pubmed, and Proquest.
References
Adlam K (2007) A national frame work for the first year of practice for new graduate nurses, Nursing Praxis in New Zealand 23(1): 2-3.
Australian Institute of Health and Welfare (AIHW) (2008) Nursing and Midwifery Labour Force 2005. National health labour force series no. 39. Cat. No. HWL 40. AIHW, Canberra.
Benner P (1984) From Novice to Expert; Excellence and Power in Clinical Nursing Practice, Prentice - Hall, Upper Saddle River.
Benner P (1984) The Dreyfus model of skill acquisition applied to nursing. In Novice to Expert: Excellence and power in clinical nursing practice, Addison- Wesley, California.
Bennett P, Brown J, Barlow V and Jones D (2010) What do new graduate registered nurses say they want from jobs in remote communities? Australian Journal of Rural Health 18(5): 212-213.
Beyea S, Von Reyn L and Slattery M (2007) A nurse residency program for competency development using human patient simulation, Journal for Nurses in Staff Development 23(2): 77-82.
Bowles C and Candela L (2005) First job experiences of recent RN graduates: Improving the work environment, Journal of Nursing Administration 35(3): 130-137.
Burnard P (1991) A method of analysing interview transcripts in qualitative research, Nurse Education Today 11: 461-466.
Casey K, Fink R, Krugman M and Popst J (2004) The Graduate Nurse Experience, Journal of Nursing Administration 34(6): 303-311.
Chang E and Hancock K (2003) Role stress and role ambiguity in new nursing graduates in Australia, Nursing and Health Sciences 5: 155-163.
Cleary M, Matheson S and Happell B (2009) Evaluation of a transition to practice program for mental health nursing, Journal of Advanced Nursing 65(4): 844-850.
Deverell, C. (2008). Town Booklet. Retrieved September 15, 2011 from http://www.gwahs.nsw.gov.au/CountryCareers/index.php?select=Town_Booklets
de Witt L and Ploeg J (2006) Critical appraisal of rigour in interpretive phenomenological nursing research, Journal of Advanced Nursing 55(2): 215-229.
Duchscher J and Myrick F (2008) The prevailing winds of oppression: understanding new graduate experience in acute care, Nursing Forum 43(4): 191-206.
Ellerton M and Gregor F (2003) A study of transition: The new nurse graduate at 3 months, The Journal of Continuing Education in Nursing 34(3): 103-107.
Engebretson J (1997) A multiparadigm approach to nursing, Advances in Nursing Science 20(1): 21 - 33.
Fink R, Krugman M, Casey K and Goode C (2008) The graduate nurse experience: Qualitative residency program outcomes, Journal of Nursing Administration 38(7/8): 341-348.
Floyd B, Kretschmann S and Young H (2005) Facilitating role transition for new graduate RNs in a semi-rural healthcare setting, Journal for Nurses in Staff Development 21(6): 284-290.
Fussell B, McInerney F and Patterson E (2009) Experiences of graduate registered nurses in aged care: A case study, Contemporary Nurse 33(2): 210-223.
Goh K and Watt E (2003) From 'dependant on' to 'depended on': The experience of transition from student to registered nurse in a private hospital graduate program, Australian Journal of Advanced Nursing 21(1): 14-20.
Gough J, Johnson L, Waldron S, Tyler P and Donath S (2009) Clinical communication: Innovative education for graduate nurses in paediatrics, Nurse Education in Practice 9(3): 209-214.
Graneheim U and Lundman B (2003) Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness, Nurse Education Today 24: 105-112.
Grant B and Giddings L (2002) Making sense of methodologies: A paradigm framework for the novice researcher, Contemporary Nurse 13(1): 10-28.
Halfer D and Graf E (2006) Graduate nurse perceptions of the work experience, Accessed at http://www.medscape.com/viewarticle/541778_print on 9 May 2009.
Halfer D (2007) A magnetic strategy for new graduate nurses, Nursing Economics, Accessed at http://www.medscape.com/viewarticle/555118_print on 9 May 2009.
Happell B and Gough K (2007) Employment through residency programs: A strategy to address the workforce crisis in psychiatric nursing, Archives of Psychiatric Nursing 21(3): 126-131.
Hickey M (2009) Preceptor perceptions of new graduate nurse readiness for practice, Journal for nurses in staff development 25(1): 35-41.
Johnstone M, Kanitsaki O and Currie T (2008) The nature and implications of support in graduate nurse transition programs: An Australian study, Journal of Professional Nursing 24(1): 46-53.
Johnstone M and Kanitsaki O (2008) Patient Safety and the integration of graduate nurses into effective organisational clinical risk management systems and processes: An Australian study, Quality Management in Health Care 17(2): 162-173.
Kelly J and Ahern K (2009) Preparing nurse for practice: A phenomenological study of the new graduate in Australia, Journal of Clinical Nursing 18(6): 910-918.
Kilstoff K and Rochester S (2004) Hitting the floor running: Transitional experiences of graduates previously trained as enrolled nurses, Australian Journal of Advanced Nursing 22(1): 13-17.
Klein G (2009). Beyond orientation: developing and retaining new graduate nurses, Nursing Management 40(1): 10-13.
Kramer M (1974). Reality Shock: Why nurses leave nursing. St Louis: C.V. Mosby.
Lea J and Cruickshank M (2007) The experience of new graduate nurses in rural practice in New South Wales, Rural and Remote Health 7(814): 1-11.
Lee S and Mackenzie L (2003) Starting out in rural New South Wales: The experiences of new graduate occupational therapists, The Australian Journal of Rural Health 11(1): 36-43.
Levett-Jones T and Fitzgerald M (2006) A review of graduate nurse transition programs in Australia, Australian Journal of Advanced Nursing 23(3): 40-46.
McKenna B, Smith N, Poole S and Coverdale J (2003) Horizontal violence: experiences of registered nurses in their first year of practice, Journal of Advanced Nursing 42(1): 90-96.
Morrow S (2009) New graduate transitions: leaving the nest, joining the flight, Journal of Nursing Management 17(3): 278-287.
Nayda R and Cheri J (2008) From enrolled nurse to registered nurse in the rural setting: the graduate nurse experience, Rural and Remote Health 8(900): 1-9.
Newhouse R, Hoffman J, Sufilta J and Hairston D (2007) Evaluating an innovative program to improve new nurse graduate socialization into the acute healthcare setting, Nursing Administration Quarterly 31(1): 50-60.
Newton J and McKenna L (2007) The transitional journey through the graduate year: A focus group study, International Journal of Nursing Studies 44: 1231-1237.
Nugent, E. (2008). Implementing changes in educational strategies based on orientation experience of the new graduate, Journal for Nurses in Staff Development 24(5): E13-E18.
Parker V, Plank A and Hegney D (2003) Adequacy of support for new graduates during their transition into the workplace, International Journal of Nursing Practice 9: 300-305.
Patton M (2002) The Nature of Qualitative enquiry, in Qualitative research and evaluation methods 3rd edn, pp. 3-29, Sage Publications, Thousand Oakes
Punch K (2006) Developing Effective Research Proposals 2nd edn, Sage Publications, London.
Pryjmachuk S (1996) A nursing perspective on the interrelationships between theory, research and practice, Journal of Advance Nursing 2: 679-684.
Roberts C and Burke S (1989) Nursing Research: A Quantitative and Qualitative Approach, Jones and Bartlett, Boston.
Salt J and Cummings G (2008) Increasing retention of new graduate nurses: a systematic review of interventions by healthcare organizations, Journal of Nursing Administration 38(6): 287-296.
Santucci J (2004) Facilitating the transition into nursing practice: Concepts and strategies for mentoring new graduates, Journal for Nurses in Staff Development 20(6): 274-284.
Scott E, Keehner M and Swanson M (2008) New graduate nurse transitioning: Necessary or nice? Applied Nursing Research 21(2), Accessed at http://www.nursingconsult.com/das/article/body/136171672-4 on 9 May 2009.
Sengstock, B. (2008). A grounded theory study of nursing student's experiences in the off-campus clinical setting, Phd thesis, central Queensland University, Australia.
Sim J and Wright C (2000) Research in health care: Concepts, designs and methods, Stanley Thornes (Publishers) Ltd, Cheltenham.
Simmons S (1995) From paradigm to method in interpretive action research, Journal of Advanced Nursing 21(5): 837-844.
Sivamalai S (2008) Desired attributes of new graduate nurses as identified by the rural community, Rural and Remote Health, 8: 938.
Sofaer S (2002) Qualitative research methods, International Journal for Quality in Health Care 14(4): 329-336.
Standing M (2007) Clinical decision-making skills on the developmental journey from student to registered nurse: a longitudinal inquiry, Journal of Advanced Nursing 60(3): 57-269.
Steenbergen K and Mackenzie L (2004) Professional support in rural New South Wales: Perceptions of new graduate occupational therapists, The Australian Journal of Rural Health 12(4): 160-165.
Wainwright S (1997) A new paradigm for nursing: The potential of realism, Journal of Advance Nursing 26(6): 1262 - 1271.
Wangensteen S (2008) The first year as a graduate nurse - an experience of growth and development, Journal of Clinical Nursing 17(14): 1877-1885.
West S, Ahern M, Byrnes M and Kwanten L (2007) New graduate nurses' adaption to shift work: Can we help? Collegian 14(1): 23-30.
Wray K, Whitehead T, Setter R and Treas L (2006) Use of NCLEX preparation strategies in a hospital orientation program for graduate nurses, Nursing Administration Quarterly 30(2): 162-177.
Young M, Stuenkel D and Bawel- Brinkley K (2008) Strategies for easing the role transformation of graduate nurses, Journal for Nurses in Staff Development 24(3): 105-110.
Zinsmeister LB and Schafer DM (2009) The Exploration of the Lived Experience of the graduate nurse making the transition to registered nurse during the first year of practice, Journal for Nurses in Staff Development 25 (1): 28-34.
eContent Home
