Background. New graduate nurses face immense amounts of stress during their first year of practice related to transition shock, role adjustment, increased acuity of patients and more. All of these concerns lead to job dissatisfaction and intent to leave, increasing the turnover rate.
Significance. With new graduate nurses confronting challenges from the transition of student to nurse, the need for reflection and critical thinking is imperative. Novice nurses need to learn coping skills and reflect on the number of “first” experiences they will endure during their initial 12-months of practice.
Clinical Problem. Turnover rates within the nursing profession are climbing, reaching nearly 16.2%. Residency programs lack the opportunity for open discussion and reflection regarding new graduate experiences. Without the ability to critically reflect on significant experiences new graduates are left feeling stress, lacking confidence, and a feeling of dissatisfaction.
Purpose. The purpose of this study is to increase retention rates, support, satisfaction, and decrease stress within a large faith-based Midwest health system through implementation of reflective practice.
Methods. Facilitator-led reflective discussions will be implemented at the eighth- month mark of a residency program. New graduates will journal personal stories from practice based upon an assigned theme, then within small groups utilize Gibbs reflective cycle to discuss their experiences. Subthemes will be addressed within small groups for qualitative data. The Casey Fink Graduate Nurse Experience Survey© will be utilized for quantitative data collection.
Literature Review. Evidence provides that through reflective writing and facilitator led peer- support discussions novice nurses report increased satisfaction with their job at the end of 12 months. Nurse satisfaction and turnover rates run parallel to one another, therefore increasing retention rates.
Theoretical Framework. Patricia Benner’s From Novice to Expert is used to describe the new graduate transition in the initial stages. Her framework exemplifies the five stages of development a nurse goes through: novice, advanced beginner, competent, proficient, and expert. It is necessary during the novice stage to enhance critical thinking, which can be done through Gibbs Reflective Cycle. This reflective cycle is utilized during many discussion groups for healthcare reflection.
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