A Qualitative Study of the New Graduate Nurse Experience Within an Acute Cardiac Specialty Area Ruhina Rana, RN, BA, BSN, Marie McCoy, RN, BSc, BN, & Alexia Gillespie, RN, BEd, BSN Background •Little research on the New Graduate Nurse (NGN) transition experience within different practice environments and how this may influence retention and patient care •Limited research on NGN transition into specialty areas suggests there may be additional stressors related to these practice environments (Casey, Fink, Krugman, & Propst, 2004) •Successful transition is essential because NGN turnover is approximately $40 000 per nurse (Fink, Krugman, Casey, & Goode, 2008).
Purpose To explore the lived experience of NGNs within the specialty areas of cardiology and cardiac surgery, as well as identify the factors that influence successful transition into a specialty area
Findings •Preliminary analysis finds two major themes:
Challenges & Resources •Sub-themes: Challenges - fear, stress, expectation, acuity Resources - support, relationships •Many specific challenges to transitioning into an acute cardiac specialty area, but with the right resources in place these challenges could be overcome •Most new graduate nurses felt challenged to be better nurses and wanted to meet that challenge •NGNs who felt successful in their transition stated it was because resources were available and they had strong, supportive relationships with their colleagues
•Many of these themes are not cardiac specialty specific (shift work, pressure to perform, or connectedness) •The theme of “Challenges” was perceived as both a potential barrier and passage to high level nursing practice was new •If NGNs are inspired to rise to challenges, then the level of support and encouragement may be directly related to the ease of transition •If additional support was focused on helping NGNs see challenge as a tool for growth rather than a barrier, as well as fostering positive relationships, then we may be able to improve the transition experience in acute specialty areas
Discussion •Limitations: small sample size (5 participants), no exit interviews (3 NGNs left before meeting eligibility), & exact level at which success & failure occurs cannot be pinpointed
Research Question: What is the experience of transition for NGNs on an acute cardiac in-patient unit?
•Transition spanned across the macro level (health authority), meso level (hospital), and micro level (unit/ward)
Methods
•Future studies could compare other acute specialty areas at SPH to a general med/surg area at SPH & a general med/surg area at MSJ
•Phenomenological research design: data collected through semistructured interviews
•Further research to identify factors contributing to retention & attrition over a longer period of time & the benefits of mentorship for NGNs.
•Purposive sampling: all NGNs working on the acute cardiac inpatient units were invited to participate. 5 of 6 NGNs were interviewed •Data analyzed by thematic analysis: transcripts of interviews coded separately by each researcher
Findings
Acknowledgements Heart Centre at St. Paul’s Hospital Practice-Based Research Challenge Joanne Hum - Research Assistant New Graduate Nurses who participated
•We recommend units create opportunities for NGNs to connect with one another at various stages in transition & establish guidelines for appropriate patient assignments for NGNs.