Experiences of New Graduate Registered Nurse Transitioning To Clinical Practice in an EverChanging Health Care Environment

This study analyzes the experiences presented to new graduate RNs as they transit into clinical practice in the ever changing healthcare environment. It identifies workplace bullying, stress and fatigue, increasing number of patients with chronic conditions and an increase in workload as the major challenges faced by new graduate Registered Nurses when transitioning into clinical practice. The study provides strategies to be adopted by stakeholders in the Australian healthcare system to enhance the novice RNs experiences.

Running head: EXPERIENCES OF NEW GRADUATE REGISTERED NURSE 1
Experiences of New Graduate Registered Nurse Transitioning To Clinical Practice in an Ever-
Changing Health Care Environment
Name
Institution

EXPERIENCES OF NEW GRADUATE REGISTERED NURSE 2
Abstract
New graduate Registered Nurses are faced with multiple challenges in their efforts of transiting
from the world of academia into the real environments of clinical practice. The challenges
presented by their workplace environments impose detrimental effects on these novices’ ability
to transition into practice in a successful way. The current study undertakes a critical analysis of
the experiences presented to new graduate RNs as they transit into clinical practice in the ever
changing healthcare environment. based on the analysis new nursing graduates reveal some
levels of inadequacy in their levels of preparedness; an aspect that accounts for the stressful and
problematic procedures experienced by these practitioners as they convert from student to
novice stakeholders in the healthcare industry. The research identifies workplace bullying, stress
and fatigue, increasing number of patients with chronic conditions and an increase in workload
as the major challenges faced by new graduate Registered Nurses when transitioning into clinical
practice. The scholarly material acts as an informative blueprint aimed at guiding new graduate
RNs on the most effective mechanisms of fostering effective transfer of skills acquired by these
practitioners from the world of academia into clinical practice with the aim of attaining the
desired outcomes. A part from the hindrances identified, the commentary plays a pivotal role in
presenting the strategies to be adopted by the stakeholders in the Australian health sector to
ensure that a positive environment is created to foster successful transitions and positive
experiences among graduate novices as they move from the world of academia to clinical
practice.
Keywords: graduate Registered Nurse, transition, experiences, challenges

EXPERIENCES OF NEW GRADUATE REGISTERED NURSE 3
Experiences of New Graduate Registered Nurse Transitioning To Clinical Practice in an Ever-
Changing Health Care Environment
Introduction
The global healthcare environment is ever changing. However, Hoffler and Thomas
(2016) reveal that the need for qualified nurses remains unchanged due to the increasing shortage
in the supply of these critical stakeholders in the medical system. According to Waddell
Spalding, Navarro, Jancar, and Canizares (2015), new graduate nurses entering into clinical
practice are faced with the immense pressure of operating in an environment that calls for
inclusion of lean processes with higher levels of efficiencies. On the other hand, Reem, Kitsantas
and Maddox (2014) demystify that new graduate registered nurses (RNs) transitioning into
clinical practice are faced with critical organizational issues such as diminishing fiscal
compensation, a tighter regulatory regime, and an upsurge in demand for medical services.
Comparatively, Sheppard-Law, Curtis, Bancroft, Smith and Fernandez, (2018) explain that the
demand for new graduate RNs continues to increase as a result of exponential population
growths, an aging workforce, an upsurge in the number of patients with chronic ailments and
inclusion of medical insurance covers targeting the populations that were previously classified as
uninsured and underinsured. However, RNs transitioning from the world of academia into
practice are faced with multiple challenges in their efforts of adapting to the conditions availed
by their environments of practice. The current study seeks to undertake a critical analysis of the
experiences presented to new graduate RNs as they transit into clinical practice in the ever
changing healthcare environment.

EXPERIENCES OF NEW GRADUATE REGISTERED NURSE 4
Significance of the Issue
The current study plays a significant role in reviewing the challenges faced by new
graduate RNs when transitioning to practice in the healthcare environment that is ever-changing.
According to Schroyer, Zellers and Abraham (2016), new nursing graduates reveal some levels
of inadequacy in their levels of preparedness; an aspect that accounts for the stressful and
problematic procedures experienced by these practitioners as they convert from student to novice
stakeholders in the healthcare industry. Mooring (2016) identifies this as a global challenge that
results into an increase in the rates of shortage and attrition. The demand for graduate RNs in the
Australian healthcare system is attributed to the country’s rapid population growth, a rapid
growth in the aging population and an increase in the number of people diagnosed with chronic
sicknesses.
Further, the study acts as an informative blueprint aimed at guiding new graduate RNs on
the most effective mechanisms of fostering effective transfer of skills acquired by these
practitioners from the world of academia into clinical practice with the aim of attaining the
desired outcomes. Missen, McKenna and Beuchamp (2016) explain that the ever-changing
operational environment, dynamisms in the Australian healthcare system and fiscal issues have
imposed multiple challenges among nurses transitioning from student to novice practitioners. By
reviewing these challenges, the study will not only be of great essence in advising new graduate
RNs on the most effective ways of fostering readiness but also act as a reference material for
stakeholders in the field of nursing education such as nurse program coordinators on the most
appropriate ways of preparing their students for the demands presented in the field.

EXPERIENCES OF NEW GRADUATE REGISTERED NURSE 5
Discussion
Challenges faced by new graduate RNs transitioning from student to novice practice
New graduate RNs are faced with multiple challenges when they transition to clinical
practice. Such encounters include workplace bullying, stress and fatigue, increasing number of
patients with chronic conditions and an increase in workload. According to Ellis et al. (2017), the
transition problem is heightened by the fact that most of these challenges occur in a simultaneous
way.
New graduate RNs are exposed to multiple episodes of stress and fatigue when
transitioning from academia to their fields of practice. According to Romano (2018), the
practitioners face the obligations of managing their clients, professional and social relationships
and offering leadership to their inter-professional groups. According to Allen (2016), novice RNs
dealing with patients depicting complex conditions tend to develop a sense of exhaustion due to
the stresses they are constantly exposed to. Further, Gordon, Carmany, Baker and Goliat (2018)
explain that lack of supportive relationships could heighten anxieties; an aspect that leads to
immense attrition.
The Australian healthcare industry has experienced a rapid increase in the rates at which
experienced nurses are exiting their fields of practice as a result of retirement, workload
upsurges, and decline in the supply of fiscal resources, lack of upward mobility, and an increase
in the number of ambulatory opportunities. As a consequence, McNamara, LaVigne and Martin
(2016) demystify that institutions are faced with the challenge of retaining experienced staff that
are meant to play the role of mentoring new graduates. According to Graetz (2016), the current
regime embraces millions of millennials who require adequate coaching for successful

EXPERIENCES OF NEW GRADUATE REGISTERED NURSE 6
transitioning. Monrouxe et al. (2018) reveal that the inability of these organizations to offer their
novices with effective mentorship opportunities leads to an increase in turnover.
Novice RNs experience fatigue when transitioning to clinical practice. According to
Levine and Johnson (2014), role ambiguity contributes to significant levels of burnout among
practicing nurses. On the other hand, Waddell et al. (2015) reveal that professionals are
disconnected from their work and teams in instances where they are faced with workplace
burnout. Further, Fetherstone, Browne, Andrus, and Batt (2017) explain that immense burnout
imposes detached operations among novices. Levine and Johnson (2014) demystify that nurses
depicting stress and detachment from their environments of work yield poor performances which
may affect their patients in an adverse way.
Hoffler and Thomas (2016) describe workplace bullying among new nurses as a
dominant challenge in the global healthcare environment. According to Gordon et al. (2018), the
issue of workplace bullying limits a new graduate nurse’s ability to foster effective socialization.
On the other hand, Allen (2016) reveals that long serving practitioners tend to bully their new
counterparts in order to maintain control. Consequently, Ellis et al. (2017) demystify that leaders
in the health care system are faced with the obligation of providing their employees with an
environment that contributes to their wellbeing; an aspect that calls for inclusion of proper
strategies of minimizing bullying.
The effects of knowledge deficit
Most of the registered graduate RNs transitioning into clinical practice are not well
prepared to face the obligations presented by their workplaces (Romano, 2018). As a
consequence, Reem, Kitsantas and Maddox (2014) reveal that such novices depict professional
gaps in offering their clients with crucial clinical services such as monitoring patients and

EXPERIENCES OF NEW GRADUATE REGISTERED NURSE 7
identifying vital signs. According to McNamara et al. (2016), graduate RNs are overly reliant on
technologies such as the internet when making vital observations rather than advancing the
necessary competencies in this field. Ellisn Wilkinson, Kesten, Anderson, Lyons, and Bondmass
(2017) reveal that such inadequacies limit the ability of these novices to foster professional
adjustments from a student to an independent RN; an aspect that emanates into “transition
shocks”.
Hoffler and Thomas (2016) identify the transiting graduate RNs’ inability to foster
effective communication as a practical social issue experienced by novices. According to
Waddell et al. (2015), graduate RNs are faced with the obligation of interacting with a wider
range of people such as patients, team members and colleagues. Further, Schroyer, et al. (2016)
demystify that graduate novices tend to struggle in their communications with nurse managers
and other healthcare stakeholders due to their inefficient social skills. Such social limitations
expose new graduate RNs to crucial operational vulnerabilities that may compromise with the
safety of their clients.
Evaluation
While novice registered RNs are faced with multiple challenges when they transition to
clinical practice, the current study avails the strategies that need to be applied to position these
new graduates for operational efficiencies in their areas of engagement. The ensuing paragraphs
present the strategies to be adopted by stakeholders in the Australian healthcare system in order
to enhance the novice RNs experiences.
There is need for healthcare organizations to include nurse mentorship dockets aimed at
enhancing graduate novice RNs’ retention rates and intent to stay in their institutions. According
to Missen et al. (2016), incorporation of structured approaches in organizational settings play a

EXPERIENCES OF NEW GRADUATE REGISTERED NURSE 8
significant role in fostering a new nurse’s ability to inculcate competence, autonomy and
confidence in their engagements. According to Gordon et al. (2018), professional advancement
among novices is enhanced through inclusion of a working environment that fosters
collaboration between new entrants and long serving members of the system. Sheppard-Law et
al. (2018) reveal that the competency of graduate RNs increase after they are engaged in a
mentorship program.
The Australian healthcare system is faced with challenges such as an increase in the
complexities depicted by different patient populations and tight regulatory regimes. As a
consequence, new graduate RNs transitioning to clinical practice are faced with the obligation of
ensuring that they are effective in synthesizing evidence-based data by cultivating their critical
thinking skills (Allen, 2016). Further, Monrouxe et al. (2018) reveal that workplace
environments need to be designed in such a way that they enhance the novices’ ability to practice
translational research, enhance their leadership skills, comprehend the changes depicted by the
medical landscape, understand the significance of adopting quality care and develop their
leadership abilities. On the other hand, Hofler and Thomas (2016) reveal that leaders in these
systems must be considerate when setting the processes, goals, and expectations needed to guide
novices.
Healthcare institutions need to engage new RNs in their decision making processes as a
way of building an environment that fosters inclusivity. Graetz (2016) demystifies that proper
engagement of new practitioners in making decisions concerning the issues that affect them in a
direct way plays a crucial role in inculcating their abilities to cope up with workplace stressors.
On the other hand, Fetherston et al. (2017) advocate for inclusion of strategies aimed at
promoting shared governance as a way of bringing forth the platforms needed to foster

EXPERIENCES OF NEW GRADUATE REGISTERED NURSE 9
discussions on the issues that affect the RNs’ practice. According to Waddell et al. (2015), nurses
feel empowered when they are actively involved in the decision making endeavors of their
institutions. On the other hand, Allen (2016) advocates for inclusion of inter-professional
decision making strategies as a way of promoting an atmosphere that enhances confidence and
respect among institutional stakeholders.
Effective communication among new graduate RNs needs to be strengthened through
incorporation multi-disciplinary interactions in their scholarly curricular. Reem et al. (2014)
explain that such a strategy plays a significant role in establishing friendly interactions among
professionals drawn from different areas of practice. Consequently, the graduate RNs will have
the chance of communicating with other members in team settings and transpose the experiences
acquired in clinical settings. On the other hand, Ellis et al. (2017) advocate for inclusion of
systematic communication instruments in transition programs aimed at developing graduate RNs
into effective correspondents when entering into practice.
Conclusion
The study undertakes a critical analysis of the experiences presented to new graduate
RNs as they transit into clinical practice in the ever changing healthcare environment. Based on
the research established, graduate novices experience workplace bullying, stress and fatigue,
increasing number of patients with chronic conditions and an increase in workload as the major
professional challenges. In particular, the research identifies lack of supportive relationships in
healthcare stings as an issue that heightens anxieties and therefore, immense attrition. On the
other hand, the scholarly material identifies knowledge deficit among new RNs as an aspect that
limits their ability to foster healthy interactions.

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Despite the challenging experiences, the study identifies multiple strategies of ensuring
that new graduate RNs enjoy their workplace environments. For instance, the study recommends
that organizations must include nurse mentorship dockets aimed at enhancing graduate novice
RNs’ retention rates and intent to stay in their institutions. Further, medical institutions are faced
with the obligation of engaging new RNs in their decision making processes as a way of building
an environment that fosters inclusivity. Lastly, the research reveals that effective communication
among new graduate RNs needs to be strengthened through incorporation multi-disciplinary
interactions in their scholarly curricular as a way of fostering healthy interactions.

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