An Examination of Two Different Transition into Nursing Practice Programs in One Healthcare Facility

Tuesday, 13 July 2010

Joy Washburn, EdD, RN, WHNP-BC
Kirkhof College of Nursing, Grand Valley State University, Grand Rapids, MI
Janice Hodges, MSN, RN
Nursing Education and Research, Sparrow Health System, Lansing, MI

Learning Objective 1: The learner will be able to discuss the characteristics of two different transition into nursing practice programs used in one healthcare facility.

Learning Objective 2: The learner will be able to identify preliminary results of the transition into practice experience of the participants in the study.


Transition from student nurse to Registered Nurse is a time of inherent challenges which Kramer (1974) defined as reality shock.  Literature review indicates reality shock impacts job satisfaction and retention of graduate nurses as 35% to 61% of newly licensed RNs will leave their initial position of employment.  This challenges resources, both human and fiscal.  It impacts the organization, the new nurse, the preceptor, and the rest of the nursing staff.                              

Transition into practice programs seek to lessen reality shock for new RNs.  This study examines the characteristics of the transition into practice experience for newly graduated nurses in two different transition programs in one Midwestern healthcare facility.  A traditional orientation is provided as well as a twelve-week rotational program which provides the opportunity to work in various units before accepting a position on a specific unit.  The purpose of this study is to understand if one program impacts the transition process better than the other, or if both programs are equally supportive. 


This non-experimental, descriptive, longitudinal study is documenting the characteristics of the graduate nurse transition experience.  Permission was obtained to use the Casey-Fink Graduate Nurse Experience Survey.  Using convenience sampling, graduate nurses participating in the study complete the survey at three, six and twelve months after hire.  In addition, at six and twelve months after hire, participants answer additional open-ended questions to elicit quantitative information.  


Data collection began in August 2008 and continues through February 2010.  Statistical analysis is in process.  Preliminary results indicate new RNs at this institution feel supported during their transition to practice.


Conclusions are somewhat limited at this time.  One recommendation is that the authors of the survey consider making the tool available in an electronic format, rather than just paper and pencil.