Experiences of New Graduate Registered Nurses in Clinical Practice

This report delves into the critical transition phase of registered nurses from new graduates to clinical practice, emphasizing the significance of structured support programs. It highlights the challenges faced by novice nurses, including increased workloads, complex acute care methods, and communication issues, which can impact the quality of healthcare delivery. Through qualitative data analysis and literature reviews, the report examines the need for transition strategies to improve the experiences of new graduate nurses. It also discusses the importance of supportive environments, training programs, and mentorship to help new nurses adapt to the clinical setting and bridge the gap between theoretical knowledge and practical application. The report evaluates the impact of transition programs on the performance and satisfaction of novice nurses, emphasizing the need for healthcare organizations and professionals to actively support these initiatives. The conclusion underscores the importance of providing social, emotional, and clinical support to ensure nurses deliver high-quality services, and it advocates for the development and delivery of better nursing interventions based on the analysis of nursing experiences during the transition phase.

Experiences of the new
graduate Registered Nurse
transitioning to clinical
practice in an ever-changing
health care environment

ABSTRACT
The article will discuss the need of specific transition programs when new graduate
nurses move to clinical practices.
Background: Novice nurses requires additional support to manage and understand the increasing
workloads, complex acute care methods and advance approaches in practical clinical methods. In
the first year of their practice the clinical supervision, clinical environment and policies greatly
affect the performance of these health carers. Thus, there is need of transition support programs
to improve the experiences of new graduate nurses.
Methods: Conventional content analysis, qualitative data analysis and literature surveys has been
used to analyse the experiences of nurses during transition. Descriptive data is also used to
evaluate the outcomes and evidences for the support of transition strategies.
Findings: The experiences of nurses being represented in various themes. The key findings are
challenges in functioning and managerial activities, communication issues, difficulty to
coordinate with senior professionals as well as lack of experience to manage emergency
situations. These themes show the difficulty faced by new graduates to implement their
theoretical knowledge into practice.
Discussion: The nursing managers and health care providers must make appropriate strategies
for via training programs and assistance so that nurses can develop preparedness for the practical
exposure. The importance of these experiences must be explained to all groups of health care.
Conclusion: Along with the transitional programs nurses in first year of their practice also needs
social, emotional and clinical support. This will help nurses to improve their quality of services.
With the analysis of nursing experience in transition phase from education level to clinical
practice better nursing interventions will be developed and delivered.

TABLE OF CONTENTS
ABSTRACT ....................................................................................................................................2
INTRODUCTION ..........................................................................................................................4
SIGNIFICANCE OF ISSUE ..........................................................................................................4
DISCUSSION .................................................................................................................................5
EVALUATION ...............................................................................................................................6
CONCLUSION ...............................................................................................................................8
REFERENCES ...............................................................................................................................9

INTRODUCTION
The role transition of registered nurses from newly graduates to clinical practice role is an
important phase. Thus, at this stage it is essential that pertinent guidelines must be provided to
these nurses so that they can meet their objectives of health care. The novice nurses lack the
preparedness, functional and managerial experiences which can affect the quality of health care
provided by them (Wright & et.al., 2018). Due to these concerns it becomes necessary to discuss
this issue so that registered nurses and other health service providers can assess these difficulties
which emerge at the beginning stage of nursing practices.
The article will highlight the significance of this issue and the experiences of these newly
graduated health professionals before actually transitioning into clinical practices. It will discuss
the various literature reviews on the issue and how the issue has been addressed. The report will
also evaluate and analyse the strategies which can be introduced in the practice. These practices
will help these new professionals to develop better and more practical understanding for their job
role and duties. The article will also analyse the impact of these guiding strategies on
performance of novice nurses. It will explain how current information guidance about health care
system and practices can give benefits to the nurses so that health care quality is not
compromised due to their lack of experience.
SIGNIFICANCE OF ISSUE
The acute health care settings are becoming complex day by day. According to Lea &
Cruickshank (2015), Australian registered nurses which transition from university to clinical
practices suffers from emotional and workplace stress. It is also observed that these new
graduates are often suffer from the stressful environment at their practice clinic. The new
pressure of managing workloads and expectation the nurses find it difficult to balance their stress
with work. As a result, there are possibilities that they may find it difficult to deliver care
appropriately. As per the views of Chang (2015), factors such as technical advancements and
increasing burden of chronic diseases urge for the rising demand of highly efficient registered
nurses.
However, it quite difficult that new graduated nurses will be able to deliver extreme high
quality services in the first year of their practice. Thus, it is necessary that in the first year they
are provided guidance with issues faced for their successful transition. It will help them to adopt

practical aspects of clinical practices at the earliest and they will be able to deliver services as the
experienced nurses without any difficulties. It will also help novice nurses to deal with their
issues without hesitation or stress.
DISCUSSION
As per discussion in Lima & et.al., (2016), health organisations must ensure that
supportive environment is maintained so that novice nurses can adjust themselves within clinical
environment. It is the responsibility of health professionals and organisations to ensure at
organisational level as well as on ward level these fresh graduates does not face any uncivil
behaviour and stress. However, Ashley. (2017), claims that though initial experience especially
in first year of practice may be stressful for nurses and it can affect the quality of services but
through strategic planning it can be resolved. The supportive approach from clinical environment
and other staff members as well as awareness among nurses regarding this experience can help
them to adjust in the changing clinical environment. The evaluation approaches for concern
issues can effectively deal with the retention of nursing workforce.
According to Bull & et.al., (2015), the new graduates in nursing profession can have both
positive and negative experiences. These experiences builds strong foundation for the future of
excellence nursing care. The evaluation of these experiences can help to identify the changes in
nursing graduates after transition. These changes influences the factors such as confidence level,
satisfaction and effectiveness of nurses. Aggar & et.al., (2018), argue that there is a wide gap
between the nursing training programs and clinical practices. The efficiency can be achieved
only through understanding and guidance. To ensure that quality care is provided to the patients
the understanding and implementation gap between training and clinics must be abolished. It is
possible only if nurses are able to share their experience.
The health authorities and organisation must consider these experiences seriously so that
transition programs can be developed effectively. The transition program and training sessions
for these novice nurses will help them to improve their experiences and to support them with
friendly and qualitative clinical atmosphere. As per the view of Phillips & et.al., (2014), the
biggest challenge faced by nurses is that they find it difficult to implement their knowledge into
practical offers. On the other hand their instructors and managers expects them to apply it with

high efficiency. It creates the pressure and bitter experience for them in their first year of practice
just after their graduation program.
In the same context Logan, Gallimore & Jordan, (2016), argue that Australia is having
slow birth rate and old age population is increasing rapidly. It has created shortage of nursing
staff in primary care. Thus, Australian health care system must focus on practice program which
can promote the novel transition into professional and practical behaviour. Such structured
program which aims at guiding new registered Australian nurses in their early practice period are
effective and plays a key role in tailoring support, knowledge and skills which are necessary for
the nurses so that they can transform from students to nursing staff and can provide more
accurate and qualitative care to the patients.
However, Ashley, Halcomb & Brown, (2016), also states that transition programs were
first of their kind in Australian nursing sector thus it is necessary for health regulating authorities
such as Australian nursing and midwifery federation must support these programs. For example
such programs are not cost friendly, it involves additional cost for employing new graduates as
an employee. Thus, many health organisations believes that there is no need to spend
unnecessary expenses on the program.
Another concern identified is that the existing registered nurses are less willing to support
these programs. The rationale given by them is that they consider that being senior and
experience they already provide training to newly joined nurses so such separate programs will
unnecessary consume time as well as their efforts. Despite several barriers it is analysed that
fresh graduates must be given specific training for their transition from learning phase to
practical implementation phase. Bull & et.al., (2015), explain that it will definitely enhance the
confidence and satisfaction level of new graduates. They will also learn the communication
skills, prioritisation in work practices and leadership skills.
EVALUATION
Australian health ministry supports transition programs which provide practical exposure
of clinical practices to graduate nurses. According to Lima & et.al., (2016), at present there is a
huge gap in funding for the programs which support the transition of graduate nurses. The
transition models differs in their structure, content and cost parameters. There is need to make
these transition programs more supportive. The health professionals and registered nurses do not

provide appropriate support to these programs and are unaware for the purpose and importance
of transition programs. Due to these reasons many graduate nurses hesitate to take responsibility
and to participate in clinics. The excellent performance in transition programs encourages the
permanent job at the clinic.
The 12 month duration transition programs gives opportunity to fresh nursing graduates
to experience the various clinical settings such as ward orientation, clinical supervision and pre-
planned study durations. In Australia different health reforms are also introduced which aims at
addressing challenges associated with nursing (Lea & Cruickshank, 2015). Similarly, Nurse
entry to practice (NETP) programs ensures that transition of nurses must be friendly and
comfortable so that they can easily stimulate with working environment. These programs are
widely implemented in Australia and New Zealand. To ensure the successful learning of the
nurses NETP coordinators are also appointed who monitors and regulate the well-being and
continuous learning of the nurses (NETP: A decade of growth, 2015). During entire one year of
the training sessions nurses are also given salary and preceptors. After the completion of
program if performance of these graduates is satisfactory then they can be given job offer in the
clinic. In this way these programs not only provides an opportunity to nurses to explore their
learnings but are also beneficial for hospitals because they can analyse the performance of
graduated nurses and can recruit the best of them.
According to Australia’s first transition to professional practice in primary care program
for graduate registered nurses: a pilot study, (2017), nurses must enrol in transition support
initiatives as soon as their graduation is completed. These programs must be developed on the
basis of experiences and requirements for the primary care. For example during programs the
clinical rotations are also involved. It helps nurses to be familiar with variety of challenges and
to address them along with the appropriate support to the patients. When these clinical rotations
are planned then nurses are comfortable because they are aware about it. However unplanned
rotation of wards create a challenging task for new graduates and they learn to deal with realistic
situations.
Thus, it is important aspect that health professionals and organisation must support and
encourages such types of programs. It will nourish the skills of new graduate nurses by giving
them realistic experiences. Australian government is supporting such programs by funds and

regulations but these programs cannot achieve their objectives without cooperation of health
organisations (Ashley, 2017). Transition programs and awareness of these programs must be
created among health professionals and nurses so that they can actively and necessarily
participate in such approaches.
CONCLUSION
From the article it can be concluded that mere engagement of nurses into acute care
settings will not deliver the satisfactory results in health care. For achieving qualitative health
standards as per the regulations and instructions of Nursing and midwifery board of Australia it
is essential that after completing learning nurses must be trained enough so that they can
understand the practical and realistic approaches of health care system. The article has explained
the impact and need of transition programs for fresh graduates in nursing. It has focused on the
need of such programs which are effective enough for the nurses so that they can overcome the
factors which prohibits their growth in early years of nursing.
It can also be concluded from the report that for meeting the future needs of acute health
care Australian health department must make specific policies and procedures for the transition
programs. The experiences of nurses in their first year of practice must be evaluated so that root
causes affecting their work efficiency can be identified. The article has successfully discussed
and highlighted the need of orientation programs for newly graduate nurses which are
transitioning into practical health care environment.

REFERENCES
Books and Journals
Aggar, C., Gordon, C. J., & et.al., (2018). Evaluation of a community transition to professional
practice program for graduate registered nurses in Australia. Nurse education in practice.
Ashley, C. (2017). Exploring the Transition of Registered Nurses from Acute Care to Primary
Health Care Settings.
Ashley, C., Halcomb, E., & Brown, A. (2016). Transitioning from acute to primary health care
nursing: an integrative review of the literature. Journal of clinical nursing. 25(15-16).
2114-2125.
Bull, R., Shearer, T., & et.al., (2015). Supporting graduate nurse transition: collaboration
between practice and university. The Journal of Continuing Education in Nursing.46(9).
409-415.
Chang, E. (2015). Transitions in nursing: Preparing for professional practice. Elsevier Health
Sciences.
Lea, J., & Cruickshank, M. (2015). The support needs of new graduate nurses making the
transition to rural nursing practice in A ustralia. Journal of clinical nursing. 24(7-8). 948-
960.
Lima, S., Newall, F., & et.al., (2016). Development of competence in the first year of graduate
nursing practice: a longitudinal study. Journal of advanced nursing. 72(4). 878-888.
Logan, P. A., Gallimore, D., & Jordan, S. (2016). Transition from clinician to academic: an
interview study of the experiences of UK and Australian registered nurses. Journal of
advanced nursing.72(3). 593-604.
Phillips, C., Kenny, A., & et.al., (2014). A secondary data analysis examining the needs of
graduate nurses in their transition to a new role. Nurse Education in Practice. 14(2). 106-
111.
Wright, A., Moss, P., & et.al., (2018). The influence of a full-time, immersive simulation-based
clinical placement on physiotherapy student confidence during the transition to clinical
practice. Advances in Simulation. 3(1). 3.

Online
Australia’s first transition to professional practice in primary care program for graduate
registered nurses: a pilot study, (2017). [Online] Accessed through
<https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-017-0207-5>
NETP: A decade of growth, (2015). [Online] Accessed through <http://nursingreview.co.nz/netp-
a-decade-of-growth/>