Date of Award

12-1-2013

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Nursing

First Advisor

Rachel F. Schiffman

Committee Members

Karen Morin, Regina Smith, Kathleen Sawin, Ann Cook

Keywords

Experienced Nurse, New Graduate Nurse, Nurse in Transition, Schlossberg's Transition Theory

Abstract

Newly hired nurses who do not transition well often leave their first nursing position or nursing prematurely, at great cost to themselves, the profession, the hiring organization and patients. The purpose of this secondary analysis study was to better understand the experience of new graduate nurses (NGNs) and experienced nurses as each group transitions to a new setting in nursing practice and the contribution the preceptor role plays in that transition. Schlossberg's Transition Theory was the framework that guided the study. The original data were collected from 118 newly hired nurses who were predominantly female and Caucasian with the majority being under the age of 30 years and having less than one-year experience. The data available for secondary analysis were collected at three, six and twelve months after the date of hire and included all transcripts from structured debriefing sessions offered at the conclusion of educational offerings that were a part of an extended orientation program. Analytic coding and word count methods were used in the data analysis. Themes were identified and Schlossberg's transition theory was mapped to the themes. Themes that were identified indicate that both groups of nurses rely on Institutional Support for transition. Institutional Support comes in the form of a Human Connection (preceptor, leadership, staff and others and a go to person) and a Process Approach (orientation and consistency). Both groups of nurses have a Sense of Self and a Self-Awareness that allows the nurse to articulate: What I Need, What I Know and Don't Know and What's Real, and Fear. Major findings suggest that preceptors are critical early in the transition of newly hired nurses but a different type of support is needed later on. Experienced nurses want a tailored orientation that takes into consideration prior knowledge and skill. Findings also suggest that newly hired nurses in transition continue to look for support beyond the first year of the transition. Hospitals should consider implementing transition to practice programs that support the newly hired nurse throughout the first year of transition and should also consider a mentorship program of support after the first year of transition. Hospitals need to recognize and acknowledge the experience and skill of the experienced nurse in transition and provide tailored orientation for those individuals. Educational programs need to acknowledge that the transition of new graduate nurses is difficult and design a capstone-nursing course to prepare the graduating nursing student for transition to professional practice. Further research should focus on the transition needs of the experienced nurse, and what type of additional support all nurses need following the first year of transition.

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