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AIMS: To investigate job satisfaction and confidence levels of graduate nurses during their first year of employment and the impact various training programmes have on these factors. BACKGROUND: The transition from nursing student to practising nurse can be a challenging and stressful time for new nurses. Healthcare organizations provide transition programmes to support nurses through this vulnerable time and to assist in increasing graduates' job satisfaction and retention rates. However, no systematic review of transition programme outcomes has been undertaken to determine the impact of these programmes on improving satisfaction levels and on easing the challenges faced by nursing graduates in their new roles as Registered Nurses. DESIGN: Systematic review of effect using narrative synthesis. DATA SOURCES: Quantitative studies published between 2000-December 2012 were identified using electronic databases and reference lists and by searching 'grey literature'. Primary search terms were 'new graduate nurse' and 'transitional programmes'. REVIEW METHODS: The three authors, guided by standardized procedures, performed independent, blinded data extraction and quality assessment. RESULTS: From 338 studies initially identified, eleven studies were included in this review. These studies used a variety of study designs including quasi-experimental and pre- and posttesting. CONCLUSION: Evidence suggests that transition programmes are necessary in creating working environments that support new nurses in the clinical environment and this is demonstrated by increased job satisfaction and retention rates. However, optimum programme length and structure are unclear.
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Background This paper reports on one aspect of a larger doctoral project which investigated the perceptions of qualified nurses on the abilities of newly registered nursing graduates. Aims To explore qualified nurses’ perceptions on national examinations for registration in Australia.
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Background: The transition from nursing student to graduate remains problematic internationally with issues arising concerning graduates’ work readiness upon commencing employment. Aim: This exploratory study specifically investigated perceptions of graduate nurse program coordinators on the work readiness of nursing graduates, with the aims of identifying strengths, weaknesses and challenges that exist. Design: Qualitative descriptive design. Methods: Sixteen graduate nurse program coordinators were interviewed from various healthcare services in the state of Victoria, Australia. Interviews were audio-recorded and transcribed verbatim and thematic analysis was used to disclose reoccurring themes and sub-themes. Findings: This paper reports on one theme, preparation readiness, and three sub-themes associated with this theme; clinical skills deficits, communication issues and transitioning as an enrolled nurse to a registered nurse. Conclusions: There are several areas of weaknesses and challenges for nursing graduates in their preparation for practice. As a poorly understood area, evidence from this study will inform curriculum development and transition programs, not only in Australia, but also internationally.
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Aims: This research explores the challenges that new nursing graduates experience whilst adapting to their new role in their first year of practice. These challenges are presented from the perspectives of Graduate Nurse Program Coordinators in the state of Victoria, Australia, previously not described in the literature. Background: Each year, thousands of new nursing graduates join the workforce in Australia, with many suffering major stressors and dissatisfaction in their first year of practice. Much has been written about challenges faced by this group from their own perspectives, yet nothing has been heard from the perspectives of those who support them; that is, the coordinators of year-long graduate nurse transition programs. Methods: This descriptive qualitative study used individual, semi-structured interviews to access information and perceptions from sixteen Graduate Nurse Program Coordinators about the challenges experienced by nursing graduates in their first year of practice. Transcripts were thematically analysed to reveal reoccurring themes and sub-themes. Results: The interviews provided an insight into various challenges that nursing graduates experience in relation to role adaptation in their first year of practice. Nursing graduates found difficulties with reality shock, work-life balancing and having unrealistic assumptions in their capacity to work, assuming they should be at a higher level despite being a beginner practitioner. Conclusions: This study reinforces the need for education providers to maintain currency in their undergraduate nursing programs and to work closely with health care services in providing a quality clinical experience to all nursing students. It also provides evidence that graduate transition programs are essential, with Graduate Nurse Program Coordinators performing a crucial role in providing appropriately planned strategies to support graduates through this vulnerable time.
Description:
Aims: This research explores the challenges that new nursing graduates experience whilst adapting to their new role in their first year of practice. These challenges are presented from the perspectives of Graduate Nurse Program Coordinators in the state of Victoria, Australia, previously not described in the literature. Background: Each year, thousands of new nursing graduates join the workforce in Australia, with many suffering major stressors and dissatisfaction in their first year of practice. Much has been written about challenges faced by this group from their own perspectives, yet nothing has been heard from the perspectives of those who support them; that is, the coordinators of year-long graduate nurse transition programs. Methods: This descriptive qualitative study used individual, semi-structured interviews to access information and perceptions from sixteen Graduate Nurse Program Coordinators about the challenges experienced by nursing graduates in their first year of practice. Transcripts were thematically analysed to reveal reoccurring themes and sub-themes. Results: The interviews provided an insight into various challenges that nursing graduates experience in relation to role adaptation in their first year of practice. Nursing graduates found difficulties with reality shock, work-life balancing and having unrealistic assumptions in their capacity to work, assuming they should be at a higher level despite being a beginner practitioner. Conclusions: This study reinforces the need for education providers to maintain currency in their undergraduate nursing programs and to work closely with health care services in providing a quality clinical experience to all nursing students. It also provides evidence that graduate transition programs are essential, with Graduate Nurse Program Coordinators performing a crucial role in providing appropriately planned strategies to support graduates through this vulnerable time.
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Objectives This paper reports the quantitative findings of the first phase of a larger program of ongoing research: Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST2ACTTM). It specifically aims to identify the characteristics that may predict primary outcome measures of clinical performance, teamwork and situation awareness in the management of deteriorating patients. Design Mixed-method multi-centre study. Setting High fidelity simulated acute clinical environment in three Australian universities. Participants A convenience sample of 97 final year nursing students enrolled in an undergraduate Bachelor of Nursing or combined Bachelor of Nursing degree were included in the study. Method In groups of three, participants proceeded through three phases: (i) pre-briefing and completion of a multi-choice question test, (ii) three video-recorded simulated clinical scenarios where actors substituted real patients with deteriorating conditions, and (iii) post-scenario debriefing. Clinical performance, teamwork and situation awareness were evaluated, using a validated standard checklist (OSCE), Team Emergency Assessment Measure (TEAM) score sheet and Situation Awareness Global Assessment Technique (SAGAT). A Modified Angoff technique was used to establish cut points for clinical performance. Results Student teams engaged in 97 simulation experiences across the three scenarios and achieved a level of clinical performance consistent with the experts' identified pass level point in only 9 (1%) of the simulation experiences. Knowledge was significantly associated with overall teamwork (p = .034), overall situation awareness (p = .05) and clinical performance in two of the three scenarios (p = .032 cardiac and p = .006 shock). Situation awareness scores of scenario team leaders were low overall, with an average total score of 41%. Conclusions Final year undergraduate nursing students may have difficulty recognising and responding appropriately to patient deterioration. Improving pre-requisite knowledge, rehearsal of first response and team management strategies need to be a key component of undergraduate nursing students' education and ought to specifically address clinical performance, teamwork and situation awareness.
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Over the past decade, many questions have been raised about graduates' clinical competence and fitness for practice upon completion of their undergraduate education. Despite the significance of this issue, the perspectives of registered nurses have rarely been examined. This systematic review explores the perceptions of experienced registered nurses regarding the clinical competence of new nursing graduates. Original research studies published between 2004-2014 were identified using electronic databases, reference lists, and by searching "grey literature." Papers were critically reviewed and relevant data extracted and synthesized using an approach based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis. From 153 studies initially identified, 15 original research papers were included. Four main research themes were identified: clinical/technical skills, critical thinking, interaction/communication, and overall readiness for practice. Areas of concern in relation to the clinical competence of new nursing graduates specifically related to two themes: critical thinking and clinical/technical skills. Further research is required on strategies identified within the literature with the ultimate aim of ensuring new nursing graduates are safe and competent practitioners.
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Aims and objectives: The aim of this study was to explore perceptions of qualified nurses on the abilities of newly registered nursing graduates to perform a variety of clinical skills. Background: Evidence from the literature suggests that undergraduate nursing programmes do not adequately prepare nursing students to be practice-ready on completion of their nursing courses. Design: A descriptive quantitative design was used. Methods: Participants were recruited through the Australian Nursing and Midwifery Federation, Victorian branch. A brief explanation of the study and a link to the survey were promoted in their monthly e-newsletter. A total of 245 qualified nurses in the state of Victoria, Australia participated in this study. A survey tool of 51 clinical skills and open-ended questions was used, whereby participants were asked to rate new nursing graduates' abilities using a 5-point Likert scale. Results: Overall participants rated new nursing graduates' abilities for undertaking clinical skills as good or very good in 35·3% of skills, 33·3% were rated as adequate and 31·4% rated as being performed poorly or very poorly. Of concern, essential clinical skills, such as critical thinking and problem solving, working independently and assessment procedures, were found to be poorly executed and affecting new registered nurses graduates' competence. Conclusion: The findings from this study can further serve as a reference for nursing education providers to enhance nursing curricula and work collaboratively with healthcare settings in preparing nurses to be competent, safe practitioners on completion of their studies. Relevance to clinical practice: Identifying key areas in which new nursing graduates are not yet competent means that educational providers and educators from healthcare settings can focus on these skills in better preparing our nurses to be work ready.
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Aims To describe a funded proposal for the development of an on-line evidence based educational program for the management of deteriorating patients. Background There are international concerns regarding the management of deteriorating patients with issues around the ‘failure to rescue’. The primary response to these issues has been the development of medical emergency teams with little focus on the education of primary first responders. Design/Methods A mixed methods triangulated convergent design. In this four phase proposal we plan to 1. examine nursing student team ability to manage deteriorating patients and based upon these findings 2. develop web based educational material, including interactive scenarios. This educational material will be tested and refined in the third Phase 3, prior to evaluation and dissemination in the final phase. Conclusion This project aims to enhance knowledge development for the management of deteriorating patients through rigorous assessment of team performance and to produce a contemporary evidence-based online training program.
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Aims To describe a funded proposal for the development of an on-line evidence based educational program for the management of deteriorating patients. Background There are international concerns regarding the management of deteriorating patients with issues around the ‘failure to rescue’. The primary response to these issues has been the development of medical emergency teams with little focus on the education of primary first responders. Design/Methods A mixed methods triangulated convergent design. In this four phase proposal we plan to 1. examine nursing student team ability to manage deteriorating patients and based upon these findings 2. develop web based educational material, including interactive scenarios. This educational material will be tested and refined in the third Phase 3, prior to evaluation and dissemination in the final phase. Conclusion This project aims to enhance knowledge development for the management of deteriorating patients through rigorous assessment of team performance and to produce a contemporary evidence-based online training program.
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Background: Evidence from the literature and anecdotally from clinical settings suggests that newly graduated nurses are not fully prepared to be independent practitioners in healthcare settings. Aims and Objectives: The aim of this studywas to explore perceptions of qualified nurses in relation to the practice readiness of newly registered nursing graduates and determine whether these views differ according to specific demographic characteristics, clinical settings, and geographical locations. Design: A descriptive quantitative design was used. Methods: An online survey tool was used to assess how qualified nurses (n = 201) in Victoria, Australia, rated newly graduated nurses' abilities on 51 individual clinical skills/competencies in eight key skill areas. A composite score was calculated for each skill area and a comparative analysis was undertaken on the various cohorts of participants according to their demographic and clinical characteristics using one-way ANOVA and post hoc tests. Results: Newly graduated nurses were found to be lacking competence in two key skill areas and were rated as performing adequately in the remaining six skill areas assessed. Significant differences (p ≤ 0.05) in performance were found according to the age of the nurse, number of years registered, the educational setting in which they undertook their nurse education, their role, and the clinical area inwhich theyworked. There were no significant differences according to whether the nurse worked in the private or public healthcare sector. Few differences were found between nurses working in a metropolitan vs. regional/rural healthcare setting. Conclusion: This is the first study to quantify the scale of this problem. Our findings serve as a reference for both nurse education providers and healthcare settings in better preparing nursing graduates to be competent, safe practitioners in all clinical areas.