Transition to Practice of New Graduate Nurses in the First Year of Employment at a Rural Healthcare System

Background: The nursing workforce crisis has highlighted the need for effective transition to practice (TTP) for new graduate nurses (NGNs). In 2021, only 20% of NGNs in the US were considered practice-ready. The use of Nurse Residency Programs (NRP) was highlighted as the best approach for improving competencies and practice readiness. However, the assessment of NRP effectiveness is limited, particularly in rural hospitals. Purpose: Determine practice readiness for NGNs attending a rural nurse residency program. Theoretical Framework: Duchscher's Stages of Transition Theory provides the theoretical foundation for the study. The theory emphasizes the need to ensure practice readiness through the concepts of physical, intellectual, emotional, developmental, and sociocultural changes while learning mitigation strategies focused on confidence and competency for practice readiness. Methods: The study utilized a prospective, repeated measures design. All NGNs accepting a nursing position at the participating Regional Hospital were invited to participate. Confidence was measured by the Casey-Fink Readiness to Practice Survey, which was given at entry into the program and repeated at three and six months. Competency was measured using the JaneTM Competency System at the same time points. Results: Over six months, NGNs in this nurse residency program did not demonstrate a statistically significant change in their confidence and competency. At baseline, the NGNs did not demonstrate practice readiness. At three months, there was an increase in both confidence and competency but no statistical increase in either confidence or competency at six months. The overall mean of .59 for the new graduates attending this nurse residency program was less than the national norming data baseline and remained essentially unchanged over six months. Conclusions: Nurse residency programs were created in an attempt to improve competencies and practice readiness. The findings suggest little to no improvement in competence or confidence for NGNs attending this rural residency program. The scores for the rural nurse residency attendees' overall confidence mean of 2.87 and overall competency mean of 2.93 reflect similar means to those of new graduates from urban health care centers, which may indicate similar issues with obtaining practice readiness. The slight drop in confidence at six months is reflective of Duchscher’s theory. Their overall competency did not drop, but their clinical judgment did not improve. However, practice readiness did not improve despite being part of a rural nurse residency program and working full-time as a registered nurse. Antecedents from the NGNs reflect frustration and burnout. The results would indicate a need to carefully evaluate this nurse residency program to include the curriculum, the supportive mentorship needed for long-term preceptors, and collaboration with educational and healthcare facilities.

Grantor dc:publisher

University of Kansas

Year dc:date.issued

2024

Author dc:creator

• Woodall, Deena M.

Advisors dc:contributor.advisor

• Christian, Becky J.
• Weis, Karen L.

• Education
• Nurse residency
• Nursing education
• Nursing workforce
• Practice readiness
• Rural nursing
• Transition to practice

Language dc:language.iso

en

Dc Identifier Other

http://dissertations.umi.com/ku:19404

OAI identifier oai:identifier

oai:kuscholarworks.ku.edu:1808/38362