The first twelve months for newly qualified nurses (NQNs) is a time of transition
producing a myriad of experiences, emotions and personal development. There has
been very little research into the phenomenon that has emanated from the UK and
what is available may no longer reflect contemporary NQNs’ experiences.
Using a pragmatic epistemology, this unique four-phased, mixed methods, cohort
study investigated NQNs’ transition through monitoring stress experiences together
with potentially mediating factors of coping, social support, hardiness and resilience.
Adult branch NQNs (n= 288) completed questionnaires on nursing stress and
mediating factors at the point of qualification (baseline). The original sample were
followed-up at six months (n= 107) and then at twelve months post-qualifying
(n= 86), along with individual interviews (n= 14).
The results indicate transition as a complex process lasting 6-12 months depending
on the NQN’s workplace experience. Multiple stressors included ‘workload’, which
was consistently the most frequently reported, due to factors such as inadequate
The NQNs revealed impressive personal qualities; for example, a forthright
commitment to the high ideals of professionalism and quality standards of patient
care, together with their attention to continued learning and development as a nurse.
Hardiness, resilience, increased age and, most notably, prior healthcare experience,
each mediated the frequency of reported stressors over the first twelve months.
Active support from a ‘good’ team and an inspirational manager were also important
stress-mediators. Personal barriers included extreme fluctuations in confidence,
which was affected negatively by colleagues’ incivility, or mediated through
workplace colleague support.
An integrated model for NQN transition is presented to depict the core elements of
the evolving professionalisation and socialisation process. The model is entwined
with the NQNs’ ability to undertake a cognitive appraisal of the stressors within their
work environment, as the NQN progressed towards adapting to their new status,
roles and work environment. Key recommendations include: the development of a transition preparation process
for pre-registration nurse education; a proposed new model of preceptorship;
improvement of the management of workplace incivility for healthcare organisations
that employ NQNs; and research to further explore the benefits of prior healthcare
experience. These are some of the pragmatic, practical outcomes of this research.