‘It was quite a shock’: A qualitative study of the impact of organisational and personal factors on newly qualified nurses' experiences

Abstract

Aims and objectives To explore how newly qualified nurses’ work experiences are constructed through the interplay between self, workplace and home‐life influencing their retention. Background Nurses are critical to achieving the goal of universal health coverage. However, shortages of nursing staff are endemic. Of particular concern, newly qualified nurses are more likely to leave the nursing workforce. The point of transition to working as a newly qualified nurse is a time of vulnerability. Most studies attempt to discover why nurses leave. This study uses the concept of job embeddedness to examine the experience of this transition and first two years of practice to understand what might help newly qualified nurses stay. Design Qualitative approach using semi‐structured telephone interviews. Methods Self‐selecting sample of nurses (n = 23) who participated 1‐year (n = 12) and 2 years (n = 11) post‐qualification. Participants were part of a larger longitudinal cohort (n = 867) study which has followed them since September 2013 when they entered nurse education in two Scottish universities. Thematic analysis was used to understand the interplay between organisation/workplace and the individual. Results Three themes were developed: transition shock; workplace factors and work/life balance. Two further subthemes were developed: experience of support and belonging; and feeling unsupported and alienated. Eight participants had changed job or left, and two were looking to leave nursing. Conclusion This study highlights how the experience of transition shock can be positively or negatively impacted by the workplace environment, and how in turn this impacts the home environment. Ultimately, this impacts retention of newly qualified nurses. Relevance to clinical practice Having adequate support resources, such as staffing, supportive team morale, professional development and family‐friendly work environment, can create a work environment where they feel the purpose and meaningfulness of working as a nurse. This ‘job embeddedness’ can potentially enhance nurse retention. Reporting follows the COREQ checklist.

Nurses' perceptions of quality of work life in private hospitals in Enugu, Nigeria: A qualitative study

“…Caring obligations were critically important to the nurses but were hampered by night shifts, long working hours and reduced vacation opportunities. The findings are in line with previous studies that found that caregiving responsibilities, inflexible shift schedules, long work hours, rotational shifts and loss of vacation time contributed to low QWL among nurses [8] , [13] , [14] . As reported in a preceding work, these factors alter the balance between work and family life, trigger a sense of inadequacy and guilt toward their dependents and hospitals and compel nurses to juggle managing their children, house and self-needs [15] , [16] .…”

“…Work context embodies the practice settings in which nurses work and the impact of the work environment on both nurse and patient systems, including management patterns, style of supervision, resource availability, co-worker relationships, promotional opportunities, feedback and a conducive working environment [5] . Helpfulness and assistance from colleagues were associated with a high quality of nursing work life [13] , [28] , [29] . Nonetheless, blame culture [30] , a lack of sufficient resources [6] , [11] , [18] , [21] , [22] , [29] , [31] , a lack of supportive organizational leadership and policies [3] , [20] , [21] , [28] , [32] , a lack of support from the nursing supervisor [3] , [21] , [31] , medical dominance [6] , [31] , a lack of participatory decision-making [6] , [20] , [32] , a lack of promotion [3] , [32] , few professional training opportunities [32] , a lack of personal protective equipment [19] , [20] , [29] and an unsafe environment [28] , [31] contributed to a low QWL among nurses.…”

“…The evidence indicates that the lack of a support structure for WFB practices negatively impact family and friend relationships [8] , [12] – [14] . Nurses lack energy after work due to exhaustion from high workloads [13] . Caregiving obligations at home are limited by staff shortages, inflexible shift schedules and long work hours [8] , [13] , [14] .…”

“…Nurses lack energy after work due to exhaustion from high workloads [13] . Caregiving obligations at home are limited by staff shortages, inflexible shift schedules and long work hours [8] , [13] , [14] . Loss of vacation time results from inadequate staffing and demands of rotational shifts [8] .…”

Factors influencing the transition and retention of mental health nurses during the initial years of practice: Scoping review

“…Evidence from available literature calls attention to the influence of workplace culture on transition experiences and retention of nurses during their initial years of practice (Hazelton et al, 2011;Ho et al, 2021;Wright et al, 2011). Australian action research on new graduate mental health nurses (Hazelton et al, 2011) Karlowicz and Ternus (2009) also recommended that mentorship programmes for novice nurses assist in team-building and improve retention.…”