Date of Award

12-1-2006

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Teaching & Learning

Abstract

The purpose of this phenomenological study was to investigate the transition experience of new baccalaureate-prepared graduates entering nursing practice as registered nurses. Participants were a convenience sample of six graduates from a midwestem university who were employed as registered nurses from eight to twelve months in acute care nursing practice. Transition theory was used as a guide in designing interview questions. Participants were interviewed and the audio-recorded interviews were transcribed and then analyzed for codes, categories, and themes.

Four themes emerged from analysis of the data. Theme One: Lack of experience contributes to self-doubt for the new graduate nurse. Although participants had previous health care experience, student externships and practicum experiences, and felt prepared to assume their roles as registered nurses, they soon realized they were not ready for the complex, fast-paced, multifaceted work place. Initially, they focused on technical skill competency, time management, organization, and prioritization. They feared making a mistake or missing a sign or symptom that would compromise patient safety. Therne Two: The work environment is a dichotomy of support and dissonance for the new graduate nurse. Participants were immersed into a chaotic work environment, expected to carry full patient loads after six weeks, were left on their own, worked with other staff too busy to help, lacked understanding of the department’s overall operation, easily adapted to patient care technology, and accepted shift work. Preceptor and co-worker support facilitated transition while horizontal hostility was an impedance. Theme Three: Graduates actively use a variety of methods to cope during their transition from new graduate to registered nurse, including problem-focused and emotion-focused coping. Theme Four: The graduate nurse expressed work gratification when recognized positively by patients, peers, and self. Job satisfaction for the new graduate was the patient’s smile and thank you, consultation by co-workers, and the ability to manage patient care situations with understanding and confidence.

The transition from new graduate nurse to professional nurse requires an ongoing, supportive, positive work environment that recognizes the graduate as new to the professional role. Working together, academic and practice institutions can improve the transition process.

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