Graduate Nurses’ Perceptions of Preparedness for Clinical Practice Nicole Hatzenbuhler, MSN, RN Julie Klein, PhD, RN, CNE

Learner Objectives Recognize the value of scholarly collaboration to prepare graduate nurses to successfully socialize into the nursing workforce. Identify educational experience factors that influence graduate nurses’ perceived levels of preparedness to enter the nursing workforce. Discuss strategies that may be used by nurses in practice, education, and research to enhance graduate nurses’ preparedness to assume professional roles and responsibilities.

Background Graduate nurse turnover Associated with lack of practice readiness among graduate nurses Nursing shortage Preparedness as a priority focus for leaders

Research Purpose Explore graduates' perceptions of preparedness Gain insight into this issue in relation to graduates’ educational experiences Promote successful transitions into practice

Research Question What were the perceptions of registered nurses who had two years or less experience in their professional role regarding the practical application of their educational experiences to prepare them to enter professional practice?

Methodology and Design Qualitative research Interpretative phenomenology Maximum variation sampling Eligibility Criteria Protection of human rights

Data Collection and Analysis Face-to-face interviews Structured using topic guide Thematic analysis

Characteristics of Sample n=Ten BSN-prepared registered nurses Six educational institutions in three states Employed by acute care facilities Six females, four males Practice experience: 13 months to 27 months

Findings from Data Analysis Three main categories Category 1: It’s Hard for Nursing School to Prepare You for Everything Category 2: Being in the Workforce Is Different Category 3: Pearls of Wisdom

It’s Hard for Nursing School to Prepare You for Everything Theme Background knowledge and skills Preparedness for everything not realistic Professional nursing experience invaluable

Being In the Workforce Is Different Theme Difference between roles of student and nurse Lack of preparedness for nurses’ responsibilities Delegation, prioritization, communication/interaction Reality of the job

Pearls of Wisdom Theme Recommendations to better prepare new grads Mentoring Additional practical learning experiences Consistency and progression during orientation Lifelong learning skills

Final Assertion Necessary background Unprepared for reality of nursing profession Differences between roles Value of practical experience as RN Advice for stakeholders

Implications for Nursing Academic institutions Curricula supporting professional skill development Strategies for coping with high stress situations Additional clinical hours/practical experiences Interprofessional education Simulation

Implications for Nursing Health care organizations Graduate nurse residency/mentoring programs Changes to new graduate orientation Internship opportunities Academic-practice partnerships

Implications for Nursing Students/graduate nurses Experiential learning opportunities Seek mentoring from experienced nurses Lifelong learning skills

What strategy did you find most interesting? How could that strategy be used within your organization? What other strategies could be implemented to enhance preparedness among graduate nurses?

Limitations of Study Qualitative research Convenience sampling Acute care context in one city Further research necessary

Conclusion Collaborative approach Safe, high quality patient care Mentoring for graduate nurses Experiential learning for students Lifelong learning skills Safe, high quality patient care

References Hatlevik, I. R. (2012). The theory-practice relationship: Reflective skills and theoretical knowledge as key factors in bridging the gap between theory and practice in initial nursing education. Journal of Advanced Nursing, 68(4), 868-877. doi:10.1111/j.1365-2648.2011.05789.x Laschinger, H. K. S. (2012). Job and career satisfaction and turnover intentions of newly graduated nurses. Journal of Nursing Management, 20(4), 472-484. doi:10.1111/j.1365-2834.2011.01293.x Parker, V., Giles, M., Lantry, G., & McMillan, M. (2014). New graduate nurses’ experiences in their first year of practice. Nurse Education Today, 34(1), 150-156. doi:10.1016/j.nedt.2012.07.003

References Walker, A., & Campbell, K. (2013). Work readiness of graduate nurses and the impact on job satisfaction, work engagement and intention to remain. Nurse Education Today, 33(12), 1490-1495. doi:10.1016/j.nedt.2013.05.008 Watt, E., & Pascoe, E. (2013). An exploration of graduate nurses' perceptions of their preparedness for practice after undertaking the final year of their bachelor of nursing degree in a university-based clinical school of nursing. International Journal of Nursing Practice, 19(1), 23-30. doi:10.1111/ijn.12032 Wu, T., Fox, D. P., Stokes, C., & Adam, C. (2012). Work-related stress and intention to quit in newly graduated nurses. Nurse Education Today, 32(6), 669-674. doi:10.1016/j.nedt.2011.09.002  

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