1. The Stressors of Transition from Graduate Nurse to Practice
Erin Barnaba, MS, RN, OCN, CNL and Harolda Hedd, MS, RN,-BC
Nurse Leadership Institute, University of Maryland School of Nursing
Baltimore, Maryland
Introduction
Recommendations
Increase the number of residency programs for new graduate nurses, per the IOM report (Institute of Medicine, 2011)
Provide opportunities for lifelong learning related to:
Communication
Professionalism
Dealing with incivility and bullying
Teamwork
Anticipating, adapting, and leading change
Stress management
Prioritization and delegation
Patient assessment and documentation
Greater availability for the choice of preceptors and shift selection
Longer transition and orientation period
Long term and effective mentoring
More hands-on experiences while in school
Nurse workforce is comprised of more than 10% new graduate nurses (Wu, T., Fox, D.P., Stokes, C., Adam, C., 2011)
Nursing has been singled out as a particularly stressful profession (Suresh, P., Matthews, A., Coyne, I., 2012)
Research shows that newly graduate nurses describe traumatic, confusing, and shocking experiences during their transition from student graduate to the professional RN (Wu, T., et al, 2011, Chandler, G.E. 2012)
Within the first year of initial employment, 18-50% of new nurse graduates change jobs and some even leave their profession (Wu et al., 2011)
Support Strategies
Support Strategies
Positive Outcomes Seen
Internship and Residency Programs
Confidence
Competence
Knowledge
Job satisfaction
Reduction in stress and anxiety
High retention rates and low turnover rates
Graduate Nurse Residency Programs and Orientation
High retention rates
Mentorship and Preceptorship
Reduction in stress
Simulation-Based Graduate Programs
Being perceived as valued by the healthcare team and being perceived as a vital member of the team
Job satisfaction and overall commitment to the profession
References
Barriers of Successful Transition to Practice
Chandler, G.E. (2012). Succeeding in the first year of practice. Journal for Nurses in Staff Development, 28 (3)
Clark, C.M. & Springer, P.G. (2012). Nurse residents’ first-hand accounts on transition to practice. Nurs Outlook, 60. E2-E8.
Edwards, D., Hawker, C., Carrier, J., & Rees, C. (2015). A systematic review of the effectiveness of strategies and interventions to improve the transition from student to newly qualified nurse. International Journal of Studies,
Institute of Medicine; Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing. The Future of Nursing: Leading Change, Advocating Health. Washington, DC National Academies Press. Available at:
Suresh, P., Matthews, A., & Coyne, I. (2012). Stress and stressors in the clinical environment: a comparative study of fourth-year student nurses and newly qualified general nurses in Ireland. Journal of Clinical Nurses, (22)
Wu, T., Fox, D.P., Stokes, C., & Adam, C. (2011). Work-related stress and intention to quit in newly graduated nurses. Nurse Education Today, (32)
Job stress
Lack of organizational support
Poor nurse-physician relations
Unreasonable workloads
Uncivil work environments
Difficulty transitioning into practice
Daily operational conflicts and stress from not knowing
Frantic pace of a typical day
Lack of consistent preceptorship
Limited access to professional development for nursing staff
Acknowledgements
Kimmith Jones, DNP, RN, RN-BC
Deborah Smith, MS, RN
Kathryn Montgomery, PhD, RN, NEA-BC
Patricia Franklin, PhD, RN