Supporting New Graduates Through Their Transition Balthazar E. Arquillano, BSN, RN-BC

Introduction A new graduate’s successful transition into nursing practice is crucial in ensuring positive outcomes on patients, staff and the organization. However, new nurses often encounter so many challenges that an easy and effective transition into their new roles becomes difficult. Hospitals therefore need to identify the many barriers in their organization that affect newly licensed nurses and actively assist them transition to the practice environment.

Literature Review A successful orientation promotes confidence, competence, and satisfaction. Transition period remains very stressful for many newly licensed nurses because of the absence or lack of support they receive. When not provided with supportive relationships, novice RNs often feel overwhelmed and exhausted, and they may suffer from significant anxiety.

Literature Review Established roles are changing and traditional strategies for recruitment and retention no longer apply. Due to increasing demands on resource utilization and simultaneous cost reductions, adequate attention to ensuring successful transition for the newly licensed nurse may not be appropriately designed, managed, supported or evaluated. 17.5 percent of newly-licensed RNs leave their first nursing job within the first year, and one in three (33.5%) leave within two years.

Literature Review Challenges faced by newly-licensed nurses: Increasing number of patients with complex conditions and multiple comorbidities Lack of access to experienced mentors and coaches Generational diversity in the workforce Performance anxiety Bullying

Literature Review Ways to support newly licensed nurses: Mentoring Residency Programs Academic progression Involvement in Shared Governance Standardized/individualized orientation

Mentoring A type of peer support where the new nurse is paired with a mentor who best matches their personality. The mentor promotes the mentee’s personal and professional growth. It increases new nurses’ intent to stay and retention rates. Fosters a culture of collegiality.

Residency Program A planned program for nurses’ transition to practice. The program is designed to meet the educational needs of nurses during their transition to practice, instill confidence and competence upon entering the clinical setting, standardize orientation, and stabilize retention. The framework of the nurse residency program is evidence-based.

Academic Progression The planning should include flexible scheduling, tuition reimbursement, access to computers, and partnerships with universities to facilitate ongoing educational achievement. Advanced degrees lead to better critical thinking skills and improved decision-making.

Shared Governance A platform to discuss issues that impact their practice. Involving new RNs in making decisions allows them to better manage the complexities of today’s health care environment. Nurses who have an active role in making decisions feel empowered, which has been linked to increased staff engagement.

Standardized Orientation Studies indicated that standardized orientation programs with trained preceptors have shown to be beneficial in recruiting and retaining nurses. A structured orientation can facilitate the transition from new graduate to professional nurse and assist in the retention of qualified nurses and ultimately safe patient care.

Implications for Nurse Leaders The nurse manager is the key driver for ensuring the experience of the newly licensed nurse is successful. There is a need to promote a more individualized orientation with improved mentoring. A preceptor workshop is an effective method for educating the expert nurse to the role and responsibilities of being a preceptor.

References Burns, H. K. & Northcutt, T. (2009). Supporting Preceptors: A Three-Pronged Approach for Success. The Journal of Continuing Education in Nursing, 40 (11), 509 – 513. Delaney, C. (2003). Walking a fine line: Graduate nurse’s transition experiences during orientation. Journal of Nursing Education, 42, 437-443. Eller, L. S., Lev, E. L., & Feurer, A. (2013). Key components of an effective mentoring relationship: A qualitative study. Nurse Education Today, 34(5). Goodwin-Esola, M., Deely, M., & Powell, N. (2009). Progress meetings: Facilitating role transition of the new graduate. The Journal of Continuing Education in Nursing, 40(9), 411 – 415. Hofler, L., & Thomas, K. (Mar-April 2016). Transition of new graduate nurses to the workforce: Challenges and solutions in the changing health care environment. North Carolina Medical Journal, 77(2), 133-136.

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