Transition is the experience of moving from a familiar environment or role to another. New Graduate Registered Nurses (GRNs) can experience a phenomenon known as transition shock as they enter practice for the first time (Graf et al., 2020). The cause of transition shock is related to a clash of values and expectations between the role of a nursing student and a practicing professional (Duchscher & Hartwig, 2021). Graduate nurses can experience feelings of stress, anxiety, burnout, job dissatisfaction and even intentions to quit.
As an early-career nurse myself, I have been feeling overwhelmed as I experience transition shock in adapting from theory of nursing to professional practice (Duchscher & Hartwig, 2021). I also feel challenges caring for COVID-19 patients. Since the COVID-19 pandemic began at the end of 2019, other graduate nurses I have discussed it with report that they also have been struggling to deal with the infectious disease in addition to transition shock.
How well graduate nurses adapt to the transition from student to practitioner is influenced by how well we have coped with change in the past and the adoption of strategies, as transition shock may affect our psychological and physiological wellbeing (Cao et al., 2021). Therefore, it is imperative to be aware of what transition shock means and provide strategies that will benefit us during this period to help through the recovery and resolution phase of transition shock.
Here are my suggested strategies for health care facilities and how I as a graduate nurse manage the transition period with the additional stress of coping with COVID-19. It is important to note that not all new graduate nurses share the same experiences, however the strategies listed below would be considered beneficial for all new GRNs.
Provide education and professional training
As a newly graduated nurse, I felt afraid and anxious due to the risk of COVID-19 infection. My workplace provided education and training regarding the infectious disease, personal protective equipment (PPE) training and local in-service or continuing professional development, for example, completing an online COVID-19 module, PPE training, mask fit testing before commencing practice. Knowledge-based practice reduces anxiety and increases coping ability (Jang et al., 2022). Posters and resources about COVID-19 are available and well-marked in wards.
Provide professional support
A supportive work team and positive work environment help graduate nurses to cope with the challenges and realise personal and professional growth (Wakefield, 2018). The nurse managers in my workplace demonstrate positive leadership, create a positive working environment and culture, and promote teamwork. Clinical Nurse Specialists (CNS), senior nurses and educators are always accessible for professional and emotional support. For example, one-to-one, everyday support by nurse educators facilitates me to have experiential learning and supported practice in the clinical environment. I benefit greatly from a mentorship program, preceptorship program and debriefing meetings (Van Patten & Bartone, 2019).
Utilise counselling and support resources
An Employee Assistance Program (EAP) is a confidential counselling and support service provided by employers for their staff. Most health care facilities provide this service free of charge to employees as well as their families. Qualified professionals can provide us with counselling and coping strategies, whether the stress comes from the transition to the nursing profession or the pandemic. The Nurse and Midwife Support line (1800667877) can also be accessed which provides confidential advice and support 24/7. Some health care facilities or organisations also provide intranet and related websites relating to professional nursing and mental health resources, such as Australian College of Nursing, Australian Nursing & Midwifery Federation and Ausmed.
Clinical practice strategies
As a new graduate nurse, I am not afraid of asking for help. No question is a silly question. Building a healthy relationship in the workplace and sharing experiences with the team contributes to good performance and mental health (Wakefield, 2018). I take every opportunity to seek new knowledge and skills in my workplace. Appropriate nursing delegation, planning and time management skills help me greatly to relieve the workload pressures. It is important to take time for self-reflection and learn from mistakes or errors (Galutira, 2018).
Self-care and healthy habits
Rest and relaxation, a healthy diet and quality sleep are all important self-care strategies for me. Activities, regular exercise and practicing mindfulness also help me to reduce stress and improve physical and mental health. It is vital to balance my work and personal life. Families and friends play an important role in providing social support during the transition (Cao et al., 2021). If graduate nurses feel overwhelmed in the workplace, it is important to seek help and support from colleagues. We should be aware that we are not alone.
The transition shock during the pandemic can be distressing for new graduate nurses. Supportive and self-care strategies have benefited me through the transition and will get me prepared for a future nursing career, and I hope these strategies help other GRNs.
Lele Xu MACN, RN.
Lele is a graduate registered nurse in Monash Health and Stage One Emerging Nurse Leader. She is passionate about nursing and nursing education. You can follow Lele’s career journey on Linkedin.
Elspeth Wood MACN, RN, BHlthSc(N), MNSt, GCEd(TT), GCRM,.
Elspeth is a lecturer in nursing at James Cook University. She has extensive experience in rural nursing and nurse education in the healthcare system. She is passionate about supporting nurses in their journey through their career and the pursuit their dreams. She values her role as an ACN mentor. LinkedIn
References
Broadbent, J., & Hayden, M. (2015). Health behaviour (2nd ed.). Pearson Australia.
Cao, X., Li, J., & Gong, S. (2021). The relationships of both transition shock, empathy, resilience and coping strategies with professional quality of life in newly graduated nurses. BMC Nursing, 20(65), 1-8.
Duchscher, J. & Hartwig, J. (2021). The experience of transition. In H. Harrison, M. Birks, & J. Mills, Transition to nursing practice: From student to professional. (pp. 98-121). Oxford.
Graf, A.C., Jacob, E., Twigg, D., & Nattabi, B. (2020). Contemporary nursing graduates’ transition to practice: A critical review of transition models. Journal of Clinical Nursing, 29, 3097-3107.
Jang, H., Yang, J., & Shin, Y. (2022). A phenomenological study of nurses’ experience in caring COVID-19 patients. International Journal of Environmental Research and Public Health, 19(2924), 1-14.
Galutira, G.D. (2018). Theory of reflective practice in nursing. International Journal of Nursing Science, 8(3), 51-56.
Van Patten, R.R., & Bartone, A. S. (2019). The impact of mentorship, preceptors, and debriefing on the quality of program experiences. Nurse Education in Practice, 35, 63-68.
Wakefield, E. (2018). Is your graduate nurse suffering from transition shock? Journal of Perioperative Nursing, 31(1), 47-50.
