Transitions into Practice: First Patient Care Experiences of Baccalaureate Nursing Students

Monday, 22 July 2013: 11:05 AM

Camille Payne, PhD, RN
Nursing, Kennesaw State University, Kennesaw, GA

Learning Objective 1: Describe the process of transition which beginning baccalaureate nursing students encounter as they enter clinical practice.

Learning Objective 2: Describe actions which will improve the clinical transitional process for beginning nursing students.

Purpose: Creating successful clinical experiences for beginning nursing students is essential to provide a strong foundation in clinical patient care. Ensuring that nursing students receive adequate preparation and skill development are a necessary component of effective performance and patient safety. The purpose of this qualitative research was to gain insight into the first patient care experiences of first year baccalaureate nursing students. Literature supports global recognition of the difficulties experienced by nursing students in their first clinical rotations.

Methods: Data were collected from three cohorts of baccalaureate nursing students (N = 120) in two university settings in the first semester following completion of first patient care experiences. A grounded theory approach was used in the qualitative analysis of written participant narratives.  

Results: Themes and categories of responses emerged through qualitative data analysis.  Data analysis revealed consistent patterns of responses in students, with identification of specific actions from clinical staff or clinical instructors which enhanced or detracted from the quality of their initial experiences. Anxiety and fear before and during the clinical experience were consistently expressed. Students also described reduction in fear at the conclusion of their first patient care experiences, as well as affirmation of their nursing career choice.

Conclusion:  Based on the data, an emerging model for transitioning students into practice will be discussed. Specific recommendations for improving the overall experience in the first clinical setting for beginning baccalaureate nursing students will be suggested through collaboration between education and practice partners. Recommendations will be made for additional nursing research. Improving the quality and nature of first patient care experiences will provide a strong foundation for beginning practitioners, and foster a strong, positive clinical role development.