Orientation and transition programme component predictors of new graduate workplace integration.

AIM: To examine the relationships between selected components of new graduate nurse transition programmes and transition experiences. BACKGROUND: Transition support for new graduates is growing increasingly multifaceted; however, an investigation of the effectiveness of the constituent components of the transition process is lacking. METHODS: An online survey was disseminated to new graduates working in acute care settings and included questions related to new graduate transition programmes. The Casey Fink Graduate Nurse Experience Survey was used to quantify the transition experience. RESULTS: New graduate nurses who participated in a formal new graduate (NG) transition programme had significantly higher total transition scores than non-programme nurses. The orientation length and the average number of hours worked in a two week period were significant predictors of transition; the percentage of preceptored shifts was statistically insignificant. CONCLUSIONS: New graduate transition is enhanced with participation in a formal transition programme. Orientation should be at least four weeks in length, and new graduates should work at least 49 hours in a two week period. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers are in key positions to advocate for new graduate nurse transition programmes with adequate resources to support a four week orientation phase and shift scheduling to ensure an adequate number of hours over two week periods to facilitate transition.

New graduate nurse transition programs: Relationships with bullying and access to support.

New graduate nurses are often targets of bullying and horizontal violence. The support offered by new graduate nurse transition programs may moderate the effects of bullying and limit its negative impact on new graduate nurse transition. This study examined the relationships between access to support, workplace bullying and new graduate nurse transition within the context of new graduate transition programs. As part of a mixed methods study, an online survey was administered to new graduates (N = 245) approximately a year from starting employment. Bullied new graduate nurses were less able to access support when needed and had poorer transition experiences than their non-bullied peers. Participation in a formal transition program improved access to support and transition for bullied new graduate nurses. People supports within transition programs positively influenced the new graduate nurse transition experience. Formal transition programs provide support that attenuates the impact of bullying on new graduate nurses and improves transition.

Disparities in new graduate transition from multiple stakeholder perspectives.

The purpose of this qualitative study was to understand multiple stakeholder perspectives of new graduate (NG) transition programs. It was part of a larger mixed-methods study (2011) designed to provide a comprehensive assessment of new graduate nurse transition best practices, across six British Columbia health authorities. Data collection involved individual interviews with academic nurse educators (n=4) and separate focus groups with new graduate (n=48) and front-line nurse leaders (n=69). Disparity emerged as the overriding theme and described differences between stakeholder group perspectives, between expectations and reality, and within and across programs. Four disparities emerged: entry-level education and practice, perspectives on employment and career planning, transition program elements and support. Despite general satisfaction with undergraduate preparation, theory-practice gaps were identified. New Graduates experienced misalignments between their employment expectations and their realities. The employed student nurse program in which many new graduates had participated did not always yield employment, but when it did, differences in transitional expectations arose between new graduates and leaders. There was considerable variation across and within provincial new graduate programs with respect to orientation, supernumerary time and preceptorship characteristics, including lack of training. Disparities arose in the nature, amount of and access to support and the monitoring of new graduate progress. Findings reinforced organizational complexities and the importance of communication across education and practice sectors. This paper uncovers the tensions between the perspectives of new graduates and nurse leaders about transitional programs and opens the opportunity to collaborate in aligning the perspectives.

New Graduate Transition Programs: Relationships With Access to Support and Bullying.

Abstract New graduate nurses are often targets of bullying and horizontal violence. The support offered by new graduate nurse transition programs may moderate the effects of bullying and limit its negative impact on new graduate nurse transition. This study examined the relationships between access to support, workplace bullying and new graduate nurse transition within the context of New Graduate Transition programs. As part of a mixed methods study, an online survey was administered to new graduates (n=245) approximately a year from starting employment. Bullied new graduate nurses were less able to access support when needed and had poorer transition experiences than their non-bullied peers. Participation in a formal transition program improved access to support and transition for bullied new graduate nurses. People supports within transition programs positively influenced the new graduate nurse transition experience. Formal transition programs provide support that attenuates the impact of bullying on new graduate nurses and improves transition.

The helpfulness and timing of transition program education.

The purpose of this study was to examine relationships between transition program education and new graduate nurse transition. Although new graduates preferred hands-on learning, the helpfulness of workshops was associated with better transition. New graduates, many of whom were from the Millennial Generation, liked a variety of educational modalities. Access to support was better for nurse graduates who received education delivered throughout the first year of transition.

Best practices of formal new graduate nurse transition programs: an integrative review.

OBJECTIVES: The aim of this review was to identify best practices of formal new graduate nurse transition programs. This information would be useful for organizations in their support and development of formal transition programs for newly hired nurses. DESIGN: An integrative review of the nursing research literature (2000-2011). DATA SOURCES: The literature search included PubMed (MEDLINE), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Excerpta Medica Database (Embase). Studies that dealt with programs geared toward pre-registration nursing students were removed. At least two researchers evaluated the literature to determine if the article met the inclusion and exclusion criteria. The final number of articles included in this review is 47. REVIEW METHODS: Cooper's (1989) five-stage approach to integrative review guided the process: problem formulation, data collection, evaluation of data points, data analysis and interpretation, presentation of results. RESULTS: Transition program literature was examined according to four major themes: Education (pre-registration and practice), Support/Satisfaction, Competency and Critical Thinking, and Workplace Environment. This included new graduates' retrospective accounts of their undergraduate education and examination of orientation and formal supports provided beyond the traditional unit orientation period. Transition programs included residencies, internships, mentorships, extended preceptorships, and generic programs. Common elements of programs were a specified resource person(s) for new graduates, mentor (mentorship), formal education, and peer support opportunities. The length, type of education, and supports provided varied considerably among programs, yet the presence of a transition program resulted in improved new graduate nurse retention and cost benefits. CONCLUSIONS: The variability in research designs limits the conclusions that can be drawn about best practices in transition programs for new graduate nurses. The presence of a formal new graduate transition program resulted in good retention and improved competency. The stronger evidence suggests that new graduate education should focus on practical skill development, preceptors should receive a level of formal training, formal support should be available at least through the difficult six to nine month post-hire period, opportunities for connection with their peers should be provided, and organizations should strive to ensure clinical units with healthy work environments.

"Finding my own time": examining the spatially produced experiences of rural RNs in the rural nursing certificate program.

CONTEXT: Rural nurses require access to education that exposes them to the most up-to-date information and skill development. However, since most education opportunities are located in urban centers and focused on providing skills to urban nurses, geography effectively acts as a barrier to accessing education that meets the needs of rural nurses. The Rural Nursing Certificate Program is a post-basic education program that addresses these concerns by providing rural-relevant content online, with limited campus sessions. PURPOSE: Does online delivery of rural nursing curriculum overcome challenges related to geography? METHODS: This study employed surveys with some open-ended questions. Analysis included descriptive statistics and content analysis. FINDINGS: Students reported that online delivery improved access. Benefits included not having to relocate; being able to continue working; and, flexibility. Challenges included travel for practical experiences and time management related to staffing shortages, personal-professional overlap and family responsibilities. CONCLUSIONS: Online learning improved access to nursing education. However, the realities of rural nursing made it impossible to completely overcome geography: sense of obligation to work overtime, cost and time of traveling to workshops and practicums, uneven access to the Internet and computer services, and distance from peer and university support remained challenges.

British Columbia interprofessional model for simulation-based education in health care: a network of simulation sites.

The rapid uptake of simulation-based education has led to the development of simulation programs and centers all around the world. Unfortunately, many of these centers are functioning as localized silos and not taking advantage of the potential for collaboration with other regional centers to promote interprofessional education. In the province of British Columbia (BC), Canada, 38 institutions, including health care authorities, universities, colleges, and other health-related organizations, have participated in assessing the use of simulation in BC and in developing a provincial model that enables collaboration and interprofessional learning at the provincial level.This article describes methods and results of a needs assessment and discusses an interprofessional simulation in health care educational model that provides access for all health care professionals in BC regardless of their geographic location and/or institutional affiliation. We anticipate that this information will be useful to and supportive of others in developing simulation collaborations in their respective regions.