Post-Grant Reports


Transitioning From Nursing Student to Professional Registered Nurse: Stressors, Essential Nursing Skills, Lessons Learned, Growth, and Plans for the Future

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Clinical Psychology | Health Services Research | Medicine and Health | Medicine and Health Sciences | Nursing


The health care work environment and expectations of nurses have changed over the years influenced by many factors including the implementation of the 2010 Affordable Health Care Act. The purpose of this study was to determine if the stressors of today’s new nursing graduates are the same as they were over a decade ago and if they experienced any new or different stressors. In summer of 2015 we conducted focus group interviews with a convenience sample of 22 baccalaureate nursing graduates from 2013 and spring 2014. The average number of months in nursing practice was 11.5 with a range from 4 to 20 months. The majority of graduates work in acute care settings. In our previous unpublished study (2003) the most common stressors were: a) problems with communication, especially with physicians, b) lack of support in the work environment, c) feelings of inadequacy, d) lack of control, e) ethical dilemmas, and f) burnout. In the current study three stressors were similar to those found in our previous study: a) desire for more communication, b) organizational culture and the work environment, and c) feelings of inadequacy related to technical skills, time management, and being new. Participants in the current study expressed the communication stressor as a need for more timely, in the moment feedback rather than difficulty talking with physicians. Two different stressors were identified: a) variable work schedules impacting sleep and personal life, and b) dealing with death. While ethical dilemmas and burnout were themes in our previous study, they did not surface in the current study.

Participants also described essential nursing skills, most valuable lessons, how they have changed, and plans for the future. They identified prioritization, teamwork, time management, big picture assessment and knowing your resources as the most essential nursing skills. The most valuable lessons related to personal and patient safety, team support, honoring intuition, using resources, slowing down and accepting patient choices about healthcare. Graduates described how they have grown in confidence, communication, assertiveness, becoming more self-reflective and learning from mistakes. Most of the graduates had plans to engage in graduate study, continue with some education, assume a leadership role, move to a charge nurse position or embrace a new challenge. Findings indicate that our graduates are adapting to the healthcare environment and think that expectations of the organization are realistic. Findings also suggest that nurse educators could better prepare graduates to deal with death. Healthcare organizations could facilitate the transition of new graduates to nursing practice by giving more timely feedback.


This research was conducted as part of a Linfield College Student-Faculty Collaborative Research Grant in 2015, funded by the Office of Academic Affairs.

The student collaborator was Taylor Geertsen.

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