‘Struggling to be an insider’: a phenomenological design of new nurses’ transition

Abstract

Aims and objectives. To obtain a comprehensive understanding of the transition process of new nurses in Taiwan. Background. The transition period for new nurses can be a daunting and traumatic experience. The large number of newly graduated Taiwanese nurses who resign from their jobs within three months indicates that this process can be complicated. However, the problems associated with the experiences of new nurses have not yet been recognised. Design. We adopted a phenomenological design using focus group interviews. Methods. Sixteen new nurses (less than one year working experience) participated in eight weekly group interviews lasting two hours each to grasp their experience of ‘being new’. Interview data were analysed according to Sloan’s (2002) three moments, and the whole process of analysis followed the suggestions of Agar (1986), which was performed in a close collaboration between researchers until the consensus about the findings could be reached. Results. The overarching pattern of the transition process of new nurses becoming experienced members of the clinical nursing team was revealed as a journey of ‘struggling to be an insider’. This phenomenon was characterised by four themes, including (1) ‘being new as being weak’, (2) ‘masking myself’, (3) ‘internalising the unreasonable’ and (4) ‘transforming myself to get a position’. Conclusions. While Western culture view abusive indoctrination of new nurses as toxic behaviour, under the Chinese traditions of yield, tolerance and self‐oppression, following the power hierarchy and seeking harmony, the transition of new nurses is interpreted differently. Relevance to clinical practice. Recognition of the journey of ‘struggling to be an insider’ helps nurse administrators to (1) gain a better understanding of what new nurses encounter in their transition process, (2) help new nurses without harm, (3) improve in‐service training programmes and (4) retain future nurses.

Coming ready or not! An integrative review examining new graduate nurses' transition in acute care

“…The statement “nurses eat their young” was used to describe the bullying behaviour and hierarchical culture prevalent in the nursing profession (Pellico et al, ). In western culture, the horizontal violence and bullying is considered “toxic”; however, in Taiwan, it is justified as part of necessary training to improve the new graduates' abilities (Lee et al, ). In another Taiwanese study, Feng and Tsai () found that this exposure to horizontal violence can become endemic, enshrined in an old Chinese proverb, “a daughter‐in‐law who suffers will one day became a mother in‐law,” inferring that those who have suffered may one day become the perpetrators (Feng & Tsai, ).…”

“…They should feel safe to ask questions as their competence develops (Ashton, 2015;Brewington, 2013); however, it was common for new graduate nurses to feel unsupported and undervalued (Brewington, 2013;Clark & Springer, 2012;Fink et al, 2008;Kumaran & Carney, 2014;Parker, Giles, Lantry, & McMillan, 2014;Pellico et al, 2009). Horizontal violence towards new graduate nurses is reported in the literature (Brewington, 2013;Feng & Tsai, 2012;Kumaran & Carney, 2014;Lee, Hsu, Li, & Sloan, 2013;Pellico et al, 2009). The statement "nurses eat their young" was used to describe the bullying behaviour and hierarchical culture prevalent in the nursing profession (Pellico et al, 2009).…”

Factors influencing the implementation of evidence in Chinese nursing practice

“…Second, this study showed a profound influence by the Chinese cultural values, which is characterised as assimilating to the system's culture and seeking harmony, following the power hierarchy and obedience to authority (Delury, ; Farh & Cheng, ; Kim & Oh, ; Lee, Hsu, Li, & Sloan, ). These intraconnected cultural values work interactively behind the scenes of Chinese evidence‐based nursing practice (Cheng et al., ).…”

Experiences of registered nurses transitioning from employment in acute care to primary health care—quantitative findings from a mixed‐methods study

“…The impact of demographic factors (age, years in nursing, previous experience) and situational contributors (location of practice, type of work, access to supports) in influencing transition experiences have been previously identified across different workplaces (Bridges, ; Burns et al., ; Gohery & Meaney, ) and amongst new graduates (Lee, Hsu, Li, & Sloan, ; Missen, McKenna, & Beauchamp, ). In our study, age and years in nursing did not significantly impact on the transition experience.…”