Transition and pathway programs from second to first level nursing: A scoping review.

BACKGROUND: Second-level nurses comprise a large proportion of the nursing workforce in many countries. Despite differences in nomenclature, these nurses work under the supervision of first-level registered nurses and possess a more restricted scope of practice. Transition programs facilitate second-level nurses upgrading their qualifications to become first-level nurses. Globally, the impetus for transition of nurses to higher levels of registration has been to increase the skill mix demands in health care settings. However, no review has sought to explore these programs internationally and experiences of those making the transition. OBJECTIVES: To explore what is known about transition and pathway programs from second to first level nursing. DESIGN: Scoping review informed by the work of Arksey and O'Malley. DATA SOURCES: Four databases were searched, CINAHL, ERIC, Proquest Nursing and Allied Health and DOAJ, using defined search strategy. REVIEW METHODS: Titles and abstracts were uploaded into the online program Covidence for screening, followed by full-text screening. Two members of the research team screened all entries at both stages. Quality appraisal was performed to assess overall quality of research. RESULTS: Transition programs are often undertaken to open up career pathways, job and financial advancement. These programs can be challenging as students seek to maintain dual identities, grapple with academic requirements and juggle work, study and personal demands. Despite their prior experience, there is a need for students to receive support as they adjust to their new role and scope of practice. CONCLUSION: Much of the existing research around second to first-level nurse transition programs is dated. There is a need for longitudinal research to examine students' experiences as they transition across the roles.