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Examining the Transition for New Graduate Professional RN

Kara Solem, Student Nurse
Tammy L. Stuart MS RN
Assistant Professor
School of Nursing
Massachusetts College of Pharmacy and Health Sciences

 
Introduction 

Transition into the role of the professional nurse is cause for great excitement and apprehension for the student nurse. As a soon to be BSN graduate, this author noted a similar theme amongst classmates which provided an opportunity for inquiry to highlight key strategies for successful transition for the entry-level professional nurse.

Background

  Patricia Benner’s (1982) model From Novice to Expert provides a theory of skill acquisition to examine the transition of a novice nurse who is primarily focused on task oriented professional nursing care to the highest level, the professional nurse expert, who is able to multitask, has proficiency in the clinical area, high level of intuition, and analytic ability and can apply these characteristics in new situations by recalling former experiences. There are five stages of the socialization model; novice, advanced beginner, competent, proficient, and expert (Benner, 1982). The new graduate RN enters at novice or advanced beginner depending on clinical exposure during entry level preparation. Using the Benner model as a framework to review transition the author has found common themes to discuss cultural work environment and expectations defined by the new graduate RN.

  Hooper-Kyriakids (2005) utilizing the Benner Model as a framework emphasizes the uneven transition for new graduates. Hooper-Kyriakids (2005) main point for professional RNs is to support the transition by cueing novice and advanced beginners with their clinical decision-making. In addition, nurses should provide a comfortable space and a non-threatening environment to ask questions (Hooper-Kyriakids, 2005, speaker). Hooper-Kyriakids (2005) acknowledges the gap from nursing theory in academia to practice as the professional nurse at the bedside making the transition stressful and difficult (Hooper-Kyrakids, 2005).

  It is well established that nursing retention continues to be a major issue for the nursing profession. Dracup (2007) projects from a survey in 2004 that 55% of respondents had intention to retire from nursing between the years, 2011 and 2020. Another startling fact leads to a 50% turnover rate of professional nurses within this time (Dracup, 2007, p.328). Authors Hardin-Pierce & Butler (2005) site 53% of new graduates changing their job within their first year of work (Hardin-Pierce & Butler, 2005). These high turnover rates combined with the lack of senior or expert nurses make it challenging to support the transition for the new graduate RN. In addition these figures represent an increased demand for nurses and more effective models to streamline new graduate RNs into a ‘competent’ and ‘proficient’ nurse on the patient care unit.

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