Examining adaptive models of care implemented in hospital ICUs during the COVID-19 pandemic: a qualitative study.

BACKGROUND: The emergence of the COVID-19 pandemic led to an increased demand for hospital beds, which in turn led to unique changes to both the organisation and delivery of patient care, including the adoption of adaptive models of care. Our objective was to understand staff perspectives on adaptive models of care employed in intensive care units (ICUs) during the pandemic. METHODS: We interviewed 77 participants representing direct care staff (registered nurses) and members of the nursing management team (nurse managers, clinical educators and nurse practitioners) from 12 different ICUs. Thematic analysis was used to code and analyse the data. RESULTS: Our findings highlight effective elements of adaptive models of care, including appreciation for redeployed staff, organising aspects of team-based models and ICU culture. Challenges experienced with the pandemic models of care were heightened workload, the influence of experience, the disparity between model and practice and missed care. Finally, debriefing, advanced planning and preparation, the redeployment process and management support and communication were important areas to consider in implementing future adaptive care models. CONCLUSION: The implementation of adaptive models of care in ICUs during the COVID-19 pandemic provided a rapid solution for staffing during the surge in critical care patients. Findings from this study highlight some of the challenges of implementing redeployment as a staffing strategy, including how role clarity and accountability can influence the adoption of care delivery models, lead to workarounds and contribute to adverse patient and nurse outcomes.

Healthcare aide involvement in team decision-making in long-term care: A narrative review of the literature.

AIMS AND OBJECTIVES: To provide an overview and synthesis of the current evidence on healthcare aides' involvement in team decision-making in long-term care. BACKGROUND: Healthcare aides provide the most direct care to residents in long-term care homes and are uniquely positioned to influence the quality of care. Yet, they are not typically included in team decisions for improving resident care. As demand for long-term care increases, it is essential that we have a comprehensive understanding of ways to support healthcare aides' role on the interprofessional team for decision-making about resident care. DESIGN: Narrative review. METHOD: Five electronic databases were searched for articles published in English between 2008 and 2020. Thematic analysis was conducted to synthesise findings using an organising framework. Reporting followed the PRISMA-ScR. RESULTS: Twelve studies were included. Results indicate that work environment factors that influenced (supported or hindered) healthcare aides' involvement in decision-making included information access/availability, hierarchical staffing structures and supervisor support/shared governance. Relational processes that influenced team decision-making included team communication and collaboration, information sharing and exchange, and the quality of work relationships among team members. Strategies are discussed that could address the identified barriers and support healthcare aides' active involvement in team decisions regarding resident care. CONCLUSIONS: This review highlights the pervasive underutilization of healthcare aides, who have the most knowledge of residents to support person-centred care. There remains a paucity of research on healthcare aides' involvement in team decision-making. Research is needed to examine the effectiveness of interventions to support healthcare aides' participation in decision-making and the impact on staff and resident outcomes. RELEVANCE TO CLINICAL PRACTICE: It is crucial that healthcare aides are afforded opportunities to be part of the interprofessional team for information sharing and decision-making for resident care. Managers play a key role in supporting healthcare aides' inclusion in decision-making.

Discovery of compounds that reactivate p53 mutants in vitro and in vivo.

The tumor suppressor p53 is the most frequently mutated protein in human cancer. The majority of these mutations are missense mutations in the DNA binding domain of p53. Restoring p53 tumor suppressor function could have a major impact on the therapy for a wide range of cancers. Here we report a virtual screening approach that identified several small molecules with p53 reactivation activities. The UCI-LC0023 compound series was studied in detail and was shown to bind p53, induce a conformational change in mutant p53, restore the ability of p53 hotspot mutants to associate with chromatin, reestablish sequence-specific DNA binding of a p53 mutant in a reconstituted in vitro system, induce p53-dependent transcription programs, and prevent progression of tumors carrying mutant p53, but not p53null or p53WT alleles. Our study demonstrates feasibility of a computation-guided approach to identify small molecule corrector drugs for p53 hotspot mutations.

NCLEX-RN© preparation resources available online in French: An integrative review.

AIM: This review describes the availability of online French NCLEX-RN© preparation resources for candidates BACKGROUND: One entry to practice requirement for Canadian nurses is to successfully pass a licensing exam upon graduation from their educational program. In 2015, the American NCLEX-RN© replaced the Canadian entry to practice licensing examination which was offered in Canada's two official languages: English and French. The NCLEX-RN© was developed in English and later translated to French. Since its implementation, Francophone candidates and educators in Canada have reported a lack of preparatory resources available in their language and have had substantial lower NCLEX-RN© pass rates, consistently below 50% METHODS: An integrative review using Whittemore and Knafl's framework was conducted between February and May 2019, and updated in September 2020, through online searches of CINAHL, PubMed, Science Direct and Google Scholar databases. Grey literature was included from 2012 onwards. Results are presented narratively. RESULTS: A total of 17 French language preparatory resources were found. These resources were categorised into four main groups: (1) What is the NCLEX-RN© ?; (2) What do I need to do prior to writing the NCLEX-RN© ?; (3) What is assessed through the NCLEX-RN© ? and finally, (4) How can I practice before taking the NCLEX-RN© ? CONCLUSION: Limited French-language NCLEX-RN© preparatory resources exist for Francophone candidates. Furthermore, practice questions in French are few compared to what is available in English IMPLICATIONS FOR NURSING AND NURSING POLICY: Other countries may consider implementing an entry to practice exam such as the NCLEX-RN© because of its availability in both the French and English language, as well as the possibility of translating the exam to other languages, creating a potential market for this test around the globe. The lack of preparatory resources in French is a major concern to Francophone candidates undertaking such a high-stakes examination in their language. Nursing stakeholders and policy leaders should acknowledge that such gaps place Francophone writers in a disadvantaged position in comparison to their Anglophone counterparts.

Development of communication tool for resident- and family-led care discussions in long-term care through patient and family engagement.

BACKGROUND: Effective communication between residents (older adults), families, and the healthcare team supports person-centred care. However, communication breakdowns can occur that can impact care and outcomes. The aim of this paper is to describe a feedback approach to developing a communication tool for residents and families to guide information sharing during care discussions with the healthcare team in long-term care. METHODS: Development of the communication tool included consultation with key stakeholders for their feedback and input. Following initial development of the tool template by our research team, we invited feedback from our study collaborators. Next, individual interviews and a focus group were conducted with family members, followed by individual interviews with selected residents from two long-term care homes in Ontario, Canada. Participants were asked to provide input and feedback on the tool's content and usability and to share ideas for improving the tool. Content analysis was used to analyse the interview data. RESULTS: Feedback from residents and family included suggestions to enhance the tool's content and use of plain language, and suggestions for potential application of the tool. CONCLUSION: Feedback highlighted the value of engaging residents and family members in the development of a communication tool. The communication tool offers a structured format to support participation of residents and families in information sharing for care discussions with the healthcare team.

Commentary: Nursing Workforce Mobility in a Changing Global Landscape.

The sustainability of a country's health human resources depends on the supply and mobility of its healthcare workers. Globally, nursing occupies the largest health professional labour group (59%), with a growth of 4.7 million nurses seen from 2013 to 2018, amounting to a nursing workforce of 27.9 million worldwide (WHO 2020a). Despite this increase, it is estimated that the world will need an additional nine million nurses and midwives by 2030 (WHO 2020b). Given these projections, enhanced nurse mobility can be anticipated and expected.

High gene flow maintains genetic diversity following selection for high EPSPS copy number in the weed kochia (Amaranthaceae).

Kochia, a major weed species, has evolved resistance to four herbicide modes of action. Herbicide resistance appears to spread quickly, which could result in diminished standing genetic variation, reducing the ability of populations to adapt further. Here we used double digest restriction enzyme associated sequencing to determine the level of gene flow among kochia populations and whether selection for glyphosate resistance reduces genetic variation. Canadian Prairie populations show little to no genetic differentiation (FST = 0.01) and no correlation between genetic and geographic distance (r2 = - 0.02 p = 0.56), indicating high gene flow and no population structure. There is some evidence that kochia populations are genetically depauperate compared to other weed species, but genetic diversity did not differ between glyphosate susceptible and resistant populations or individuals. The inbreeding coefficients suggest there are 23% fewer heterozygotes in these populations than expected with random mating, and no variation was found within the chloroplast. These results indicate that any alleles for herbicide resistance can be expected to spread quickly through kochia populations, but there is little evidence this spread will reduce the species' genetic variation or limit the species' ability to respond to further selection pressure.

Hybridization rate and hybrid fitness for Camelina microcarpa Andrz. ex DC (♀) and Camelina sativa (L.) Crantz(Brassicaceae) (♂).

Hybridization between crops and their wild relatives has the potential to introduce novel variation into wild populations. Camelina (Camelina sativa) is a promising oilseed and cultivars with modified seed characteristics and herbicide resistance are in development, prompting a need to evaluate the potential for novel trait introgression into weedy relatives. Little-podded false flax (littlepod; Camelina microcarpa) is a naturalized weed in Canada and the USA. Here we evaluated the hybridization rate between the three cytotypes of littlepod (♀) and camelina (♂), assessed characteristics of hybrids, and evaluated the fitness of hexaploid littlepod and camelina hybrids in the glasshouse and field. In total we conducted, 1,005 manual crosses with diploid littlepod, 1, 172 crosses with tetraploid littlepod, and 896 crosses with hexaploid littlepod. Hybrids were not produced by the diploids, but were produced by the tetraploids and hexaploids at rates of one hybrid for 2,000 ovules pollinated and 24 hybrids for 25 ovules pollinated, respectively. Hybrids between tetraploid littlepod and camelina showed low pollen fertility and produced a small number of seeds. In the glasshouse, hybrids between hexaploid littlepod and camelina also showed significantly lower pollen fertility and seed production than parental lines, but their seeds showed high viability. A similar pattern was observed in field trials, with hybrids showing earlier flowering, reduced biomass, seed production and seed weight. However, seed produced by the hybrids showed greater viability than that produced by hexaploid littlepod and is potentially the result of a shortened lifecycle. The introgression of lifecycle traits into littlepod populations may facilitate range expansion and contribute to crop gene persistence. Consequently, future work should evaluate the hybridization rate in the field, the fitness of advanced generation backcrosses, and the role of time to maturity in limiting hexaploid littlepod's distribution.

A comparative analysis of NCLEX pass rates: Nursing health human resources considerations.

AIMS: To examine performance differences among different writers of the National Council Licensure Examination-Registered Nurse (NCLEX-RN) examination in Canada; to compare Canadian and U.S. writer pass rate data; and to identify if changes in the Canadian nursing workforce can be related to the introduction of NCLEX-RN. BACKGROUND: In January 2015, the entry-to-practice licensing examination changed from the Canadian Registered Nurse Examination to the NCLEX-RN, and pass rates declined. METHODS: This comparative analytic study examined NCLEX-RN pass rate data for 2015, 2016 and 2017 using publicly available data. The Canadian data were compared with that from U.S. nurses taking the examination. RESULTS: Overall year-end pass rates among Canadian writers appeared to improve significantly in 2016 (95% to 96.3%, p < 0.001, from 2015 to 2016) but declined again from 96.3% to 90.4% in 2017 (p < 0.001). Pass rates remain significantly lower for first attempt Canadian writers compared to first attempt U.S. writers (2015: 69.7% vs. 84.5%, p < 0.001). CONCLUSIONS: The change in licensing examination had a major impact on pass rates for new graduates entering the nursing profession and potentially the number of new nurses entering the profession in Canada immediately after graduation. IMPLICATIONS FOR NURSING MANAGEMENT: A loss of entry-level workers to the nursing profession in Canada affects workforce management strategies, particularly with respect to worker shortages.

The Intergenerational Impact of Management Relations on Nurse Career Satisfaction and Patient Care.

OBJECTIVE: This article provides insights into the role of management relations on nurses' career satisfaction across different career stages. BACKGROUND: Managers and positive relations with staff are critical to improving job satisfaction, career development, and retention for new graduates to mid- to late-career nurses. METHODS: Using a descriptive qualitative approach, we conducted a thematic analysis of 18 focus groups held in 8 Canadian provinces with 185 student, early-career, and mid- to late-career nurse participants. RESULTS: Student participants expressed the need for a supportive environment to enable successful transition to practice. Early-career nurses expected effective leadership at the unit level, effective communication, and positive working relationships to enable best care outcomes. Mid- to late-career nurses were most dissatisfied with management interactions and relationships. CONCLUSIONS: Management relations are important across all career stages, affecting patient care and job satisfaction. Findings provide insight into how nurse-manager relations can be enhanced from new graduate support to guidance in career development and ongoing recognition and respect for nurses throughout their careers.

Acute care nurses' perceptions of electronic health record use: A mixed method study.

AIM: The overall aim of this study is to examine nurses' perceptions of electronic health record use in an acute care hospital setting. DESIGN: This study uses a sequential mixed methods design in two phases. METHODS: Phase one consists of a survey of Registered Nurses to understand nurses' perceptions of electronic health record use. Phase two is comprised of focus groups of a subsample from phase one. Data collection occurred from November 2015 - August 2016 and was done in Toronto, Canada. RESULTS: In phase one, navigation was found to be a predictor of nurses' perceptions of electronic health record use. In phase two, participants discussed the following five topics: (1) navigation; (2) functionality; (3) organizational standards; (4) documentation workload and (5) issues of system performance and response time. This study has implications for organizations implementing electronic health records, nursing leaders and electronic health record vendors.

Comparison of response rates on invitation mode of a web-based survey on influenza vaccine adverse events among healthcare workers: a pilot study.

BACKGROUND: Web-based surveys have become increasingly popular but response rates are low and may be prone to selection bias. How people are invited to participate may impact response rates and needs further study as previous evidence is contradictory. The purpose of this study was to determine whether response to a web-based survey of healthcare workers would be higher with a posted or an emailed invitation. We also report results of the pilot study, which aims to estimate the percentage of adults vaccinated against influenza who report recurrent systemic adverse events (the same systemic adverse event occurring successively following receipt of influenza vaccines). METHODS: The pilot study was conducted in November 2016 in Toronto, Canada. Members of a registry of adults (18 years and older and predominantly healthcare workers) who volunteered to receive information regarding future studies about influenza were randomly assigned to receive either an email or postal invitation to complete a web-based survey regarding influenza vaccinations. Non-respondents received one reminder using the same mode of contact as their original invitation. RESULTS: The overall response rate was higher for those sent the invitation by email (34.8%) than by post (25.8%; p < 0.001) and for older versus younger participants (ptrend < 0.001). Of those who responded, 387/401 had been vaccinated against influenza at least once since adulthood. Of those responding to the question, 70/386 (18.1%) reported a systemic adverse event after their most recent influenza vaccine including 22 (5.7%) who reported a recurring systemic event. Systemic adverse events were reported more often by males 18-49 years old than by other groups (p = 0.01). Recurrent systemic adverse events were similar by age and sex with muscle ache being the most commonly reported recurrent reaction. More respondents who reported only a local adverse event (93.1%) planned to be vaccinated again next year than those with a systemic adverse event (69.7%; p = 0.04). CONCLUSIONS: In this convenience sample of registry volunteers, response rates were generally low, but were higher for the emailed than posted invitations and for older than younger adults.

An integrative review of nurses' prosocial behaviours contributing to work environment optimization, organizational performance and quality of care.

AIM: To rigorously review the literature on the prosocial workplace behaviours of nurses. BACKGROUND: Prosocial workplace behaviours, predominantly organisational citizenship behaviours have been theoretically and empirically found to promote individual and group level performance in various industries. However, little consensus exists in the literature regarding the impact of nurses' workplace behaviours on the work environment and organisational performance. EVALUATION: An integrative literature review was conducted on studies between 1980 and 2016. Nineteen articles were included related to nurses' prosocial behaviours and performance. RESULTS: A positive relationship was noted between workplace behaviours and individual level performance and unit level performance. Albeit multifactorial, leadership and the social structure of the work environment are important factors contributing to the workplace behaviour-performance relationship. CONCLUSIONS: Prosocial behaviours influence the social functioning of the work environment and offer insights into the delivery of quality care. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should recognize the influence of leadership style and characteristics in the work environment that encourage employee participation in prosocial behaviours. These additional voluntary efforts by nursing staff may improve organisational effectiveness and quality of care. Inclusion of these behaviours in performance reviews and as cultural norms may help to foster a more collaborative work environment.

Lack of efficacy of transgenic pea (Pisum sativum L.) stably expressing antifungal genes against Fusarium spp. in three years of confined field trials.

Fusarium root rot is a major pea disease in Canada and only partial tolerance exists in germplasm. Transgenic technologies may hold promise but the economic benefits of genetically modified (GM) pea will need to surpass the regulatory costs, time and labor involved in bringing a GM crop to market. European pea (Pisum sativum L.) cultivars expressing four antifungal genes, 1-3 ß glucanase (G), endochitinase (C) (belonging to PR proteins family), polygalacturonase inhibiting proteins (PGIPs) (P) and stilbene synthase (V) have been transformed for disease tolerance and showed disease tolerance under laboratory conditions. Transgenic lines with four antifungal genes inserted either individually or stacked through crossing were tested for their efficacy against Fusarium root rot (Fusarium avenaceum) in confined trials over three years (2013 to 2015) in comparison with two parental German lines and three Canadian lines. Superior emergence, higher fresh weight or lower disease ratings above and below ground, of transgenic lines in presence of disease inoculum were not observed consistently in the three years of field experiments when compared to the parental and Canadian lines in the presence of disease inoculum. No indication of an advantage of stacked genes over single genes was observed. Most transgenic lines had lower relative gene expression in the roots than in the leaves in greenhouse trials suggesting a possible explanation for poor tolerance to Fusarium root rot. Field trials are necessary to verify the agronomic performance and ecological relevance of the promising effects detected under laboratory conditions.

Evolving career choice narratives of new graduate nurses.

This article describes findings from one stage of a longitudinal study of the professional socialization experiences of Millennial nurses as they prepared for graduation and transition to practice. This study employed an interpretive narrative methodology guided by Polkinghorne's theory of narrative identity. Analysis of face-to-face interviews and journal entries by Millennial nursing students uncovered the formal professional socialization experiences over four years of nursing education. Participants include six Millennial nursing student participants (born after 1980) interviewed approximately one-month aftergraduation. These six participants are a voluntary subset of twelve who were interviewed prior to beginning their nursing studies, the analysis of which is captured in Price et al. (2013a) and Price et al. (2013b). Narrative analysis of the post-graduation interviews resulted in three main themes: 'Real Nursing: Making a Difference', 'The Good Nurse: Defined by Practice' and 'Creating Career Life Balance'. Graduate nurses strive to provide excellent nursing care as they transition into the workforce and identify a need for ongoing peer and professional supports to assist their ongoing professional socialization. Ongoing formal socialization and professional development is required to support the transition and retention of new nurse graduates in the workplace and the profession. Millenial generation nurses seek opportunities for career mapping, goal setting and formal mentorship by role models and peers to actualize their professional aspirations.

Intersecting Health Policy and the Social Determinants of Health in Pediatric Type 1 Diabetes Management and Care.

THEORETICAL PRINCIPLES: Type 1 diabetes health technologies are evolving. This is an expensive chronic condition to manage, hence a combination of public and private healthcare funding sources, as well as out-of-pocket payments support disease management. The aim of this paper is to describe two conceptual underpinnings, which can appropriately position the health policy and clinical context of pediatric type 1 diabetes management and care. PHENOMENA ADDRESSED: "The Main Determinants of Health" framework is used to position pediatric T1D management and care within the model's four interconnected layers: the structural environment, social and material conditions, support systems and individual health behaviors. A health policy in Ontario, Canada, the Assistive Devices Program for insulin pump therapy is also discussed relative to the model's outermost layer: the structural environment. Four dimensions of control, which characterize the "street-level bureaucrat" role including "distributing benefits and sanctions; structuring the context; teaching the client role; and, psychological benefits and sanctions" then position the policy context of the diabetes nurse educator role relative to the Assistive Devices Program policy. RESEARCH LINKAGES: These conceptual underpinnings could extend beyond the pediatric T1D landscape to position global research in other nursing practice areas, as well as with other patient populations and professional disciplines such as social work and medicine.

Antifungal genes expressed in transgenic pea (Pisum sativum L.) do not affect root colonization of arbuscular mycorrhizae fungi.

Genetically modified crops have raised concerns about unintended consequences on non-target organisms including beneficial soil associates. Pea transformed with four antifungal genes 1-3 ß glucanase, endochitinase, polygalacturonase-inhibiting proteins, and stilbene synthase is currently under field-testing for efficacy against fungal diseases in Canada. Transgenes had lower expression in the roots than leaves in greenhouse experiment. To determine the impact of disease-tolerant pea or gene products on colonization by non-target arbuscular mycorrhizae and nodulation by rhizobium, a field trial was established. Transgene insertion, as single gene or stacked genes, did not alter root colonization by arbuscular mycorrhiza fungus (AMF) or root nodulation by rhizobium inoculation in the field. We found no effect of transgenes on the plant growth and performance although, having a dual inoculant with both AMF and rhizobium yielded higher fresh weight shoot-to-root ratio in all the lines tested. This initial risk assessment of transgenic peas expressing antifungal genes showed no deleterious effect on non-target organisms.

Glyphosate resistance reduces kochia fitness: Comparison of segregating resistant and susceptible F2 populations.

Glyphosate is considered the world's most important herbicide, but widespread and continual use has resulted in the evolution of resistance. Kochia scoparia (kochia) has evolved resistance via tandem gene amplification of glyphosate's target, 5-enolpyruvylshikimate-3-phosphate synthase (EPSPS) and resistant populations have been reported from the Canadian Prairies and the Northern Great Plains. Here, we evaluated the fitness costs of EPSPS amplification in kochia by comparing susceptible and resistant full siblings from segregating F2 populations generated from within six populations. Kochia was expected to be highly diverse because of strong gene flow; however, six of the seven field-collected parents with higher EPSPS copy number were homozygous. Under competitive greenhouse conditions, the EPSPS type of the line's maternal parent showed persistent effects: delayed emergence, delayed flowering, and reductions in viable seed count and weight overall. High EPSPS copy number individuals had reduced seed count and weight, reduced competitive ability, and reduced final height in mixed stands, but better germination of the F3. However, all characteristics were highly variable and fitness costs were not constant across genetic backgrounds. In the absence of selection from glyphosate, kochia with increased EPSPS copy number will be at a competitive disadvantage in some genetic backgrounds.

Preceptor characteristics and the socialization outcomes of new graduate nurses during a preceptorship programme.

AIM: The purpose of this study was to explore the relationships between preceptor characteristics (emotional intelligence, personality and cognitive intelligence) and new graduate nurse socialization outcomes regarding turnover intent, job satisfaction, role conflict and ambiguity during a preceptorship programme. To date, no studies have explored these relationships. DESIGN: A cross-sectional and multi-site design with purposeful sampling. METHODS: Dyads of preceptors and new nurses were recruited at the end of their preceptorship programme. Pearson's correlational analysis was used to examine the relationships. RESULTS: A sample of 41 preceptors and 44 new graduate nurses participated in this study, making 38 dyads with complete data. The preceptor personality traits of openness, conscientiousness and emotional stability were significantly related to new graduate nurses who reported greater turnover intent, job dissatisfaction, role conflict and ambiguity. No significant relationships were noted between preceptor EI and IQ and the outcome of new graduate nurses.

The socialisation of new graduate nurses during a preceptorship programme: strategies for recruitment and support.

AIMS AND OBJECTIVES: The purpose of this study is to gain greater understanding of new graduate nurses' organisational socialisation and to help inform recruitment and support strategies for this population. To this end, it uses Van Maneen and Schein's theory of organisational socialisation to explore new graduate nurses' perceptions of role conflict, role ambiguity, job satisfaction and turnover intent at the end of their preceptorship programme. BACKGROUND: The literature on new graduate nurses reflects concerns with high turnover rates during early work experiences. Under-preparation of and lack of support for new graduate nurses are often-reported reasons for these high turnover rates. Preceptorship programmes have been implemented to specifically address these challenges. DESIGN: This study uses a cross-sectional multisite design with a survey. METHODS: A sample of 45 new graduate nurses completed a quantitative survey at the end of their preceptorship programme. Descriptive statistics and Pearson's correlation analyses were conducted to explore the relationships. RESULTS: New graduate nurses in this study experienced low role ambiguity, role conflict and turnover intent and high job satisfaction. Their job satisfaction was associated with low role conflict and role ambiguity. Working in their first job of choice was related to less role conflict and role ambiguity. Having previous experience on the unit was not a meaningful variable. CONCLUSIONS: New graduate nurses who reported a greater understanding of their work roles and less role conflict and were working in their first job of choice were generally more satisfied with their job. Previous experience on the unit was not related to any of the socialisation outcomes in this study. However, the transition experienced during clinical placements and early work experiences may be different. RELEVANCE TO CLINICAL PRACTICE: The results of this study provide managers and educators with greater insight into the socialisation of new graduate nurses, as well as concrete strategies for recruitment and support.