The Stressors of Transition from Graduate Nurse to

The Stressors of Transition from Graduate Nurse to

The Stressors of Transition from Graduate Nurse to Practice
Erin Barnaba, MS, RN, OCN, CNL and Harolda Hedd, MS, RN,-BC

Nurse Leadership Institute, University of Maryland School of Nursing
Baltimore, Maryland

Introduction
Nurse workforce is comprised of more than 10% new
graduate nurses (Wu, T., Fox, D.P., Stokes, C.,
Adam, C., 2011)
Nursing has been singled out as a particularly
stressful profession (Suresh, P., Matthews, A., Coyne,
I., 2012)
Research shows that newly graduate nurses describe
traumatic, confusing, and shocking experiences
during their transition from student graduate to the
professional RN (Wu, T., et al, 2011, Chandler, G.E.
2012)
Within the first year of initial employment, 18-50% of
new nurse graduates change jobs and some even
leave their profession (Wu et al., 2011)

Recommendations

Support Strategies
Support Strategies

Positive Outcomes Seen

Internship and Residency
Programs

Confidence
Competence
Knowledge
Job satisfaction
Reduction in stress and
anxiety
High retention rates and low
turnover rates

Graduate Nurse Residency
Programs and Orientation

Confidence
Competence
Knowledge
High retention rates

Barriers of Successful Transition
to Practice

Mentorship and Preceptorship

Competence
Confidence
Reduction in stress
High retention rates

Simulation-Based Graduate
Programs

Confidence
Competence
Knowledge
High retention rates and low
turnover rates

Job stress
Lack of organizational support
Poor nurse-physician relations
Unreasonable workloads
Uncivil work environments
Difficulty transitioning into practice
Daily operational conflicts and stress from not
knowing
Frantic pace of a typical day
Lack of consistent preceptorship
Limited access to professional development for
nursing staff

Being perceived as valued by Job satisfaction and overall
the healthcare team and being
commitment to the profession
perceived as a vital member of
the team

Increase the number of residency programs for
new graduate nurses, per the IOM report
(Institute of Medicine, 2011)
Provide opportunities for lifelong learning related
to:
Communication
Professionalism
Dealing with incivility and bullying
Teamwork
Anticipating, adapting, and leading change
Stress management
Prioritization and delegation
Patient assessment and documentation
Greater availability for the choice of preceptors
and shift selection
Longer transition and orientation period
Long term and effective mentoring
More hands-on experiences while in school

References
Chandler, G.E. (2012). Succeeding in the first year of practice.
Journal for Nurses in Staff Development, 28 (3). 103-107.
Clark, C.M. & Springer, P.G. (2012). Nurse residents first-hand
accounts on transition to practice. Nurs Outlook, 60. E2-E8.
Edwards, D., Hawker, C., Carrier, J., & Rees, C. (2015). A systematic
review of the effectiveness of strategies and interventions to improve
the transition from student to newly qualified nurse. International
Journal of Studies, 52. 1254-1268.
Institute of Medicine; Committee on the Robert Wood Johnson
Foundation Initiative on the Future of Nursing. The Future of Nursing:
Leading Change, Advocating Health. Washington, DC National
Academies Press. Available at: http://www.nap.edu/catalog.
Suresh, P., Matthews, A., & Coyne, I. (2012). Stress and stressors in
the clinical environment: a comparative study of fourth-year student
nurses and newly qualified general nurses in Ireland. Journal of
Clinical Nurses, (22). 770-779.
Wu, T., Fox, D.P., Stokes, C., & Adam, C. (2011). Work-related stress
and intention to quit in newly graduated nurses. Nurse Education
Today, (32). 669-674.

Acknowledgements
Kimmith Jones, DNP, RN, RN-BC
Deborah Smith, MS, RN
Kathryn Montgomery, PhD, RN, NEA-BC
Patricia Franklin, PhD, RN

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