Transitioning New Graduates into Practice

Anne Erickson, Boise State University


Graduate nurses face significant challenges associated with transitioning from the role of student to graduate nurse. Consequently, dissatisfaction and turnover ensue, costing institutions lost time, money, and manpower. As turnover rates among new nursing graduates within the first year continue at a rate of 35-60%, it is predicted that the nursing shortage in the United States will exceed 1,000,000 nurses by the year 2020. This has major implications to organizations and, most importantly, patient care.

The focus of this study was to capture baseline data and examine nurse residents' perceptions of decision making, quality of clinical performance, job satisfaction, job stress, and organizational commitment in practice settings with goals to enhance transition into practice and thereby decrease nurse turnover. Social Support Theory provided a useful theoretical framework for this study.

The sample consisted of 35 new nursing graduates working in Idaho hospitals who were affiliated with The Rural Connection of Idaho. Six rural hospitals (25 beds or less) and two urban hospitals (152 and 438 beds) were included in this study.

Baseline data from the current study revealed that a relationship existed between the length of time a resident had previously worked in their current organization and their perception of their ability to teach patients and families, and in providing care in emergency situations and caring for critically ill patients.

Significant differences also existed between associate and baccalaureate prepared nurse residents and how they made clinical decisions, experienced job satisfaction, job stress, and organizational commitment.

Additionally, this study showed that residents who took a professional socialization course in the last year of school perceived that they displayed better self direction, implemented good judgment and performed better and more competently in emergency situations that those who did not take the course.

As the clinical environment continues to rapidly change in response to advances in technology, reimbursement issues, and highly developed information systems, additional resources, both in quantity and quality, and access to colleagues who will mentor and precept residents, will be imperative for successful transitions into practice and retention of nurses.