Nursing Leadership Influence on Male Graduate Nurses Retention Experiences Explored in the Professional Practice Environment

Friday, 28 July 2017

Dianne T. Juliff, MSc (Nsg)
School of Nursing and Midwifery, University of Notre Dame Australia, Fremantle 6959, Australia


To investigate the lived experience of the graduate registered nurses who are male with view of understanding how these newly registered nurses transition into the professional-practice environment and ultimately the nursing profession. Thus opening the discussion on schemes that may assist with future recruitment and sustainability of males entering the nursing workforce.


A qualitative longitudinal phenomenological study, explored the lived experience of nine newly graduated nurses who are male during their first year in their professional-practice environment. Interpretative phenomenological analysis (IPA) was utilized both as the study design and the methodology. The aim of using IPA was to enhance exploration of the lived experiences of newly graduate nurses who are male, by investigating the meaning of such experiences and how these are made sense of. Moreover, the analysis was “committed to understanding how particular experiential phenomena have been understood from the perspective of particular people, in a particular context” (Smith, Larkin, & Flowers, 2009, p. 29). Purposeful sampling, using a snowball technique, ensured expertise was obtained through the voiced experiences of the nine participants who are male and newly graduated registered nurses about to commence the first year in their professional-practice environment.


The findings from the second stage of this study supports Duchscher’s 2007 Transition Stages Model in exposing the likelihood of crisis around the four to six month stage of newly graduate nurses commencement in their new profession (Duchscher, 2008). Leadership and collegial support, moreover the lack of, seeded doubts on whether nursing was the right career for them. Unprofessional nurse to nurse communication and workplace marginalisation of nurses who are male added to their doubts. For the newly graduated men in nursing the added issue focused on the co-cultural aspect of working in a female-dominant profession. The study participants need to fit in, to be part of the team, is consistent with Orbe’s (1998) co-cultural communication model’s ‘outsider within perspective’ in relation to their professional socialisation.

The study participants, as expected and consistent with previous literature, revealed constant pressure, both from within and from others, to 'hit the ground running' (Chernomas, Care, McKenzie, Guse, & Currie, 2010). This feeling of ‘hitting the ground running’ led to the participants repeatedly expressing that they were overwhelmed and afraid of their actions more so then the lack of their actions. Moreover, all of the participants experienced the associated fear of making a mistake and feeling unsafe. This fear, described by Judy Duchscher (2007) as 'Transition Shock' impacts on a new graduate’s confidence and self-image, which became apparent in various degrees by all the study participants. Again the study participants concurred with Duchscher (2007) ‘Transition Stages Model’ where their fear heightened around the four to six month stage known as the ‘Transition Crisis’ (Duchscher, 2008). It was during this crisis stage that the participants reported that nursing leadership is paramount. Without the explicit nursing leadership in the form of collegial support and caring behavior within their professional-practice environment, the majority of them revealed that they would have left the nursing profession. It was this willingness to help from their colleagues, both male and female, and the role modeling of other nurses who are male, of the various communication techniques these nurses utilized to influence the professional-practice environment that persuaded the participants to continue on their nursing journey. They concluded with the essence of helping being at the forefront of nursing, not just in relation to patient care but also towards their nursing fellows and other health care workers, and believed that this can only be achieved through proactive nursing leadership at all levels. Overall, the study participants reinforced that a viable work environment is embedded in role modeling the nursing leadership characteristics of a welcoming, supportive and inclusive culture. Furthermore, this modeling starts with the welcoming of newcomers such as novice nurses including student nurses and graduates into the workplace, through constructive support in their learning and assimilation into a no blame gender-neutral culture. Moreover, the acknowledgment of the new comers’ status and the willingness to support them in their transition into the professional practice setting is important in the retention of a sustainable nursing workforce.


Nursing leadership at all levels is at the forefront of recruitment and retention of nurses. Support for newly graduated nurses in promotion of a proactive and engaging nursing profession and investment in leadership programs, especially of the minority groups such as men, cannot be underestimated