Hearing the Voices of Newly Licensed Registered Nurses Transition to Practice Experiences

Purpose:
This study sought to describe the newly licensed registered nurses (NLRN) orientation experience and to identify ways to enhance the NLRN orientation experience.

Background/Significance:
In an effort to improve staffing within the hospital environment, healthcare organizations are actively recruiting NLRN. However, despite aggressive recruitment and retention strategies, a high turnover rate of NLRN exists within organizations leading to a shortage of nurses, negative influences impacting the quality and safety of patient care, and a financial burden upon the hospital.

Methods:
In this descriptive, qualitative study, 21 NLRNs were interviewed and audio recordings of the unstructured interviews were transcribed and validated for accuracy. The constant comparative method of data analysis was used. Individual interviews were analyzed into codes and categories. Codes and categories were collapsed into themes and patterns. The use of a journal, interaction with a research team, member checks, and maintenance of documents for audit purposes served to enhance trustworthiness.

Results:
Analysis of interviews resulted in the identification of four constitutive patterns and 10 themes. The first pattern identified was preceptor variability and themes included positive preceptorship and unsatisfactory preceptorship. The second pattern was professional growth and confidence changed with time and themes included learning through experiences, learning to manage time, and learning to communicate. The third pattern was a sense of being nurtured and themes included program support, preceptor support, and unit/peer support. The fourth pattern was enhancements needed to improve the orientation experience and themes included orientation program and human resource enhancements.

Conclusions and Implications for Practice:
The NLRNs provided insight into what were meaningful and helpful to them during their orientation process to ease the transition to practice. Listening to the needs of NLRNs gives organizations a blueprint to implement and tailor successful orientation and on boarding programs for the NLRN.