New nurse transitions: a qualitative study of perceived difficulties

Abstract

The transition from student to registered nurse has proven difficult for new graduate nurses. While organizations have implemented structures and processes to support new nurse transition into practice, new nurse turnover continues. The retention of new nurses is important to sustaining a stable workforce, as they are utilized to fill vacancy gaps in acute care settings. In addition, the retention of new nurses is important to patient safety and quality of care. Current research suggests that turnover rates among new nurses have decreased in some organizations, namely those that have implemented residency programs. Questions remain as to whether the decrease in turnover rates is due to the implementation of these innovative programs or a response to the current economic environment. Both qualitative and quantitative studies identify factors that contribute to the difficulties of the transition. These studies have focused primarily on developmental factors such as competence, confidence and support. This qualitative study utilized van Manen's (1990) phenomenological approach to gain meaningful insight into and understanding of the difficulties new nurses face as they transition from the role of student to practicing nurse. This study is unique in that it provides a comprehensive perspective to fully examine the difficulty of the transition for new nurses. Four major themes emerged from this study's findings: transitioning into the role of professional nurse, applying knowledge to practice, navigating the organization, and building relationships. Nurse executives and leaders as well as nurse educators in academia may find these results useful to further develop and implement innovative strategies that address new nurse transitions from a broader perspective and with a more comprehensive lens.