Starting Out: A time-lagged study of new graduate nurses’ transition to practice

doi:10.1016/j.ijnurstu.2016.01.005

International Journal of Nursing Studies

Volume 57, May 2016, Pages 82-95

https://doi.org/10.1016/j.ijnurstu.2016.01.005 Get rights and content

Abstract

Background

As the nursing profession ages, new graduate nurses are an invaluable health human resource.

Objectives

The purpose of this study was to investigate factors influencing new graduate nurses’ successful transition to their full professional role in Canadian hospital settings and to determine predictors of job and career satisfaction and turnover intentions over a one-year time period in their early employment.

Design

A national two-wave survey of new graduate nurses across Canada.

Participants

A random sample of 3906 Registered Nurses with less than 3 years of experience currently working in direct patient care was obtained from the provincial registry databases across Canada. At Time 1, 1020 of 3743 eligible nurses returned completed questionnaires (usable response rate = 27.3%). One year later, Time 1 respondents were mailed a follow-up survey; 406 returned a completed questionnaire (response rate = 39.8%).

Methods

Surveys containing standardized questionnaires were mailed to participants’ home address. Descriptive statistics, correlations, and hierarchical linear regression analyses were conducted using SPSS software.

Results

Overall, new graduate nurses were positive about their experiences and committed to nursing. However, over half of new nurses in the first year of practice reported high levels of emotional exhaustion and many witnessed or experienced incivility (24–42%) at work. Findings from hierarchical linear regression analyses revealed that situational and personal factors explained significant amounts of variance in new graduate nurses’ job and career satisfaction and turnover intentions. Cynicism was a significant predictor of all four outcomes one year later, while Psycap predicted job and career satisfaction and career turnover intentions.

Conclusions

Results provide a look into the worklife experiences of Canadian new graduate nurses over a one-year time period and identify factors that influence their job-related outcomes. These findings show that working conditions for new graduate nurses are generally positive and stable over time, although workplace mistreatment is an issue to be addressed.

Section snippets

Background

As the nursing profession ages, new graduate nurses are an invaluable health human resource (Buerhaus et al., 2009). Yet, new graduate nurse turnover rates are high in their first year of employment (Cho et al., 2012), which is costly to organizations and potentially threatens patient care (Duffield et al., 2014, Hayes et al., 2012). New nurse turnover often results from dissatisfaction with working conditions which may tarnish their feelings about the nursing profession in general and

Conceptual framework

The New Graduate Successful Transition and Retention Model, derived from Scott et al.’s (2008) organizational socialization model, provides a logical framework to explore successful transition to practice and was used as the organizing framework for this study (Fig. 1). This framework identifies personal and situational factors that influence retention outcomes through mediating work environment characteristics. Personal factors describe characteristics of individuals, such as psychological

Situational factors

Structural work environment variables such as leadership, empowerment, support for professional practice, and feelings of person-job fit have been shown to influence new graduate nurses’ responses to their work settings. Authentic leadership is characterized by four key behaviours that foster honest, trusting relationships with followers (Walumbwa et al., 2008). These include balanced processing (soliciting feedback and opinions from others prior to resolving important decisions), relational

Sample

The current study was a two-wave national survey of Canadian new graduate nurses. We attempted to obtain a representative sample by seeking samples of up to 400 new graduate nurses with less than three years of experience from each of ten provincial regulatory bodies for Registered Nurses. The final sample size was 3906. In this paper we describe the results of matched data from nurses who responded to both Time 1 and Time 2 surveys (n = 406). Participant characteristics for Time 1 and Time 2 are

Descriptive results

The means and standard deviations for the major study variables at Time 1 and Time 2 and significant paired t-test results over time are provided in Table 3.

Ratings of managers’ authentic leadership (M = 2.64 and 2.51 out of 4), perceptions of structural empowerment (M = 13.73 and 13.39 out of 20), and person-job fit (M = 3.28 and 3.22 out of 5) were moderate at both time points, decreasing significantly over time. At both time points new graduates felt that their work environment supported

Discussion

This is the first national study in Canada to examine changes in personal and worklife factors that influence new graduate nurse retention outcomes over a one year time frame in their first years of practice and the impact of these factors over time on retention outcomes. On the whole, new nurses’ worklife was positive and stable over the first year of practice. Job and career satisfaction were high and job and career turnover intentions were low and did not change significantly over the

Further analyses

The regression analyses revealed which of the proposed predictors of job related outcomes contributed unique variance. Typical of regression analyses with multiple correlated predictors, most theoretically logical predictors did not remain significant when all were included in the model. To further understand how the individual predictors were related to job-related retention outcomes, we examined correlations between these predictors and retention outcomes.

Although most predictors at Time 1

Limitations

The limitations of this study are the use of self-report questionnaires and the relatively low survey response rate. Self-report measures are susceptible to response bias because of individuals’ tendency to respond in socially desirable ways. However, we used a variety of strategies to mitigate these effects, such as ensuring participants of their anonymity and their right to refuse to answer questions. The low response rate at Time 1 and attrition form Time 1 to Time 2 may introduce selection

Conclusions

The results of the current study provide a look into the early worklife experiences of Canadian new graduate nurses over a one-year time period and identify factors that influence job-related retention outcomes over time. Overall, new graduate nurses were positive about their work experiences and committed to nursing, although the burnout and workplace mistreatment results indicate that there is still work to be done to improve working conditions for new graduate nurses. The results add to the

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Starting Out: A time-lagged study of new graduate nurses’ transition to practice

Abstract

Background

Objectives

Design

Participants

Methods

Results

Conclusions

Section snippets

Background

Conceptual framework

Situational factors

Sample

Descriptive results

Discussion

Further analyses

Limitations

Conclusions

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J. Adv. Nurs.

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