Factors Influencing Graduate Nurse’s Transition

Running head: LITERATURE REVIEW 1
Literature Review on Factors Influencing Graduate Nurse’s Transition into Practice
Name of the Student
Name of the University
Author Note

LITERATURE REVIEW 2
Literature Review on Factors Influencing Graduate Nurse’s Transition into Practice
Nurses are one of the most important stakeholders in the health care system all across
the globe and have the greatest contribution to the total population of the health workforce.
With the increasing population, there is a significant need for increasing the count of nursing
professionals in health care settings. The new graduate nurses are the student nurse who have
just completed their bachelors or masters in nursing and have 6 months or less of experience
as paid registered nurse (Price et al., 2018). Prior to the transition to a more professional role
of a registered nurse, the student nurses and graduate nurses are given the experience of pre-
registration, which can be deemed as more familiar and comfortable for the student nurses.
However, transitioning to a professional role requires student nurses to acquire more
responsibilities with greater knowledge and relationships. The student nurses are confronted
with huge scope and range of sociocultural, developmental, emotional, intellectual, and, most
importantly, physical changes that may act as mitigating factors during the transition
(Silvestre et al., 2017). Such confrontation is marked with the term transition shock. The
following paper aim at conducting a narrative review of the literature determine the factors
that influence the transition of student nurses in professional practice settings and discuss the
factors elaborately along with main themes, such as transition shock and efficacy of clinical
placements. For the following narrative review of literature, no geographic limitations have
been applied to search for relevant literature.
Background
The transition into professional settings from an academic environment is challenging
for the new graduate student nurses. This is due to the thrust of transitioning between
personal and professional adjustments and alternate between the varying intensity &
fluctuating states of physical, sociocultural, intellectual, and emotional well-being
(Wakefield, 2018). The current knowledge on the topic is limited to the transition experiences

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of the nurses to the contemporary environment. According to Ankers, Barton, and Parry
(2018), the first instance of transition shock was identified in the 1970s, where the new
nurses felt unprepared and overwhelmed by the demands of the clinical practice. Transition
shock is also referred to as reality shock, as this is the first experience of the student nurses
with the actual workload that their peers are used to, but seems to be greater than what the
student nurses have experienced till now. Such experiences require supervision and guidance
from experienced professionals, and the Nursing Professional Development (NPD)
practitioners execute this role by monitoring the conditions of the new registered nurses
(Wierman, 2016). The student nurses are enrolled with clinical placements or pre-registration
workplace experience, which helps them to get an insight into the workload and
environmental conditions of a registered (Kim & Yeo, 2019). Even though such simulations
have proved to be clinically effective in helping the student nurses gain valuable experience,
it is evident that clinical placements fail to offer a complete and real stimulation of work
experience for the student nurses. With the transition into clinical settings for the first time as
a registered nurse, the nurses have to accept a load of work responsibilities and roles, with a
new set of goals to handle a greater number of patients with multiple morbidities and
complex conditions. Such transitions get more difficult for the new nurses with the lack of
experienced coaches and mentors, a substantial increase in performance anxiety, the
incidence of bullying, and generational diversity in the nursing workforce. Other aspects to
take care of while transitioning from student nurse to registered nurse position are
expectations, change of role, blame, or support culture in the health care setting, working
atmosphere, knowledge, and workload. Ineffective strategies to cope with transitions have led
to an increase in the number of new nurses to quit their job, leading to a major issue of the
nursing shortage. Major stakeholders who are responsible for making the transitions easier
for the nurses include experienced professionals, nursing managers, and policymakers, who

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can facilitate the transition process and help the nurses to cope with the consequences. The
negative consequences associated with transition shock include burnout danger, panic, fear,
tension, anxiety, and other endangers, which significantly increases when the higher
authorities fail to understand these changes and undermine the physical and mental health of
the nurses. The end results that may occur due to mismanagement of the consequences of
transition shock are job dissatisfaction, inability to fulfill responsibilities, poor job
motivation, projection, denial, fear, overdependence, and even isolation. The health outcomes
and safety of the patients are also endangered when the nursing individuals are facing such
issues, as such conditions may lead to the instance of medication errors.
Search Strategy
A search protocol is developed and followed to search for literature relevant to the
current research objective, which is to determine the factors that influence the new nurse’s
transition into clinical practice. The medical databases which were utilized to conduct the
search for literature will include PubMed Central, BioMed Central, and Cochrane Database
for Systematic Reviews. The use of specific keywords was ensured to increase the relevancy
of the search results, and the keywords were transition, new graduate nurse, student nurse,
transition shock, registered nurse, professional role, clinical practice, pre-registration, and
clinical placement. The use of Boolean operators was ensured to increase the count of
literature in the search results, and the two operators included ‘AND’ and ‘OR.’ The use of
the Boolean operator ‘AND’ was done to increase the count of literature in the search results,
and the use of operator ‘OR’ was done to refine the search and limit the results to include the
literature, which were highly relevant to the research topic. The advanced search option
available in the databases were used to include inclusion criteria, and only peer-reviewed
articles published in the last five years, that is, between 2016 and 2020, were selected for
final review. Other aspects of inclusion criteria include publishing language to be only