Understanding the transition experience of newly graduated nurses using constructivist grounded theory

Abstract

Difficulty in nursing student graduate transition to clinical experience has been reported in previous literature. Lack of confidence, feelings of inadequacy, and limited peer support have been attributed to the stress associated with transition. The purpose of this qualitative, constructivist grounded theory study was to (a) examine the process of transition to clinical practice for newly graduated nurses identifying characteristics in each stage of transition, (b) examine factors that support the transition, and (c) develop a framework (i.e., theory) for educators working with newly graduated nurses. The following research questions guided the study (a.) what framework represents the experience of transition to practice for newly graduated nurses?; (b.) what internal and external factors influence the transition experience of newly graduated nurses?; (c.) what are the unique needs of newly graduated nurses during transition? Academic and clinical partners assisted with purposive sampling by sending a recruitment email to newly graduated nurses. Semi-structured interviews with eight newly graduated nurses were conducted three times with four to six weeks between each of the interviews via Zoom. The sessions were recorded and transcribed verbatim. Data analysis followed steps of constructivist grounded theories using line by line, focused, and thematic coding. Several themes formed from the analysis related to transition staging and critical interventions for enhanced transition success. Stages were identified as Anticipatory, Orientation, Crisis, and Commitment with subthemes within each. Critical interventions for each phase were categorized as Enhancing Clinical Skills, Escorting to Reality, Assisting with Job Placement, Nurturing Preceptor, Clarifying Expectations, Experiencing Reality, Gaining Confidence, and Feeling Supported. The Transition Bridge Model for Newly Graduated Nurses was constructed by merging the themes and subthemes associated with each transition phase. Findings suggest the academic and clinical educators can proactively intervene to support newly graduated nurses in the early phases of their transition from nursing education to clinical practice.