Newly graduated nurses' commitment to the nursing profession and their workplace during their first year of employment: A focused ethnography

Abstract

BackgroundThe commitment of nurses to their profession and workplace is closely linked to the delivery of high‐quality patient care. Existing literature highlights the positive impact of commitment on care quality and patient outcomes. Conversely, a lack of commitment can lead to nurse burnout and disengagement. However, it remains unclear whether and how cultural beliefs and practices influence newly graduated nurses' commitment to the nursing profession and their workplace.AimTo explore the cultural beliefs and practices influencing newly graduated nurses' commitment to the profession and commitment to their workplace during their first year of employment.DesignA focused ethnographic study.MethodsData consisted of field notes from 94 h of participant observations and 10 semi‐structured interviews with newly graduated nurses working in acute care settings in Denmark. Data were analysed using ethnographic content analysis. Data were collected between March and June 2022.ResultsThe findings reveal a major theme, termed ‘A State of Transience among Newly Graduated Nurses’, consisting of two themes: ‘Newly Graduated Nurses’ Pursuit of Professional Development and Supportive Work Environments' and ‘A Lack of Formal Agreements or Conditions to Meet Expectations for Professional Development.’ConclusionHospitals and nurse managers need to support newly graduated nurses in their first employment after registration by providing a range of clinical experiences through job rotation opportunities within the same organization, deliver on promises for onboarding support and foster a culture of trust. These strategies will help maintain the motivation, commitment and ability of newly graduated nurses to deliver high‐quality patient care, thereby reducing the likelihood of turnover.Relevance for Clinical PracticeA trusting and supportive work environment is fostered by providing diverse clinical experiences and consistent support for newly graduated nurses. To address potential high turnover associated with job rotation, hospitals need to rethink how retention is defined and measured, moving beyond hospital unit‐level models and measures.Reporting MethodThis study reports to the SRQR guidelines.Patient or Public ContributionNo patient or public contribution.

Newly Graduated Nurses’ Direct Care Delivery: A Qualitative Study

“…Within this chapter, the research methodologies employed to address the overall aim are also expounded upon. The thesis rests upon two studies: Study 1 encompasses an overview of existing research syntheses, as detailed in Paper I (Kaldal et al, 2023a), while Study 2 entails an ethnographic study, outlined in paper II (Kaldal et al, 2023b) and paper III (Kaldal et al, 2023c). Subsequently, an explanation of the methodology employed to synthesise the findings of the two studies conducted in this thesis is provided.…”

“…Paper III: To explore the cultural beliefs and practices of newly graduated nurses influencing their commitment to the nursing profession and their workplace during their first year of employment in acute care settings (Kaldal et al, 2023c).…”

“…• 'New graduate nurses' delivery of patient care: a focused ethnography', published in Journal of Clinical Nursing (Kaldal et al, 2023b) • 'Newly graduated nurses' commitment to the profession and their workplace in their first employment: a focused ethnography', published in Journal of Advanced Nursing. (Kaldal et al, 2023c)…”

“…In the initial data analysis, it became clear that the commitment of newly graduated nurses to both their profession and workplace significantly influenced their delivery of direct care. Subsequently, a secondary analysis of the same dataset was conducted, with a specific emphasis on exploring the cultural beliefs and practices that shaped newly graduated nurses' commitment to the nursing profession and their workplace during their first year of employment in acute care settings (Kaldal et al, 2023c). The purpose of study 2 was to gain a comprehensive understanding of the shared beliefs, values, and practices that shape the direct care delivery and the commitment of newly graduated nurses in medical and surgical units in a large Danish University Hospital.…”

“…• What are the cultural beliefs and practices influencing newly graduated nurses' commitment both to the nursing profession and to their respective workplaces? (Kaldal et al, 2023c). • How do these beliefs and practices influence newly graduated nurses' commitment both to the nursing profession and to their respective workplaces?…”