Level and influencing factors of transition shock among new nurses in China: A multicenter cross-sectional study

The Mediating Role of Transition Shock on the Relationship Between Leadership Behaviors and Turnover Intention of New Graduate Nurses: A Cross-Sectional Study

The shortage of nurses has made new graduate nurses an essential workforce. Thus, the leadership behaviors of nurse managers are vital in reducing turnover intention among them. This study explored the mediator role of transition shock in the effect of nurse managers' leadership behaviors on turnover intention. A descriptive-correlational study was conducted in six private hospitals affiliated with a foundation university in Istanbul, Türkiye. The study utilized convenience sampling with 275 new graduate nurses. Data were collected using the Personal and Professional Characteristics Form, Nursing Transition Shock Scale, Turnover Intention Scale, and Leadership Behaviors Scale. The transition shock level was positively related to turnover intention and accounted for 9.7% of the variance. Employee-oriented leadership was the strongest predictor of turnover intention, followed by change-oriented and task-oriented leadership. Transition shock partially mediated the effect of leadership behaviors on turnover intention among new graduate nurses. Nurse managers can develop opportunities to enhance professional competencies, create a supportive learning environment, and implement an inclusive culture and innovative transition programs to reduce turnover and the effects of transition shock.

The application of an escape room teaching method on the training for ICU new nurses: a quasi-experimental study

BACKGROUND

There is a severe shortage of intensive care nurses worldwide, and training a qualified ICU nurse is hard since it takes a very long time to accumulate the intensive care knowledge and skills needed. This study aimed to examine the effect of an escape room teaching method on teamwork attitudes and intensive care knowledge of ICU new nurses, their satisfaction with, and willingness to participate in escape room training.

METHODS

A convenience sampling approach was utilized to enlist new nurses from April 2023 to March 2024 in China. ICU nurses with less than two years of experience in the First Affiliated Hospital of Kunming Medical University were involved in our study. Most of them were female (85.71%) with bachelor's degrees (85.71%), and without escape room experiences (92.86%). Teamwork attitudes were collected through the TeamSTEPPS Teamwork Attitudes Questionnaire (T-TAQ) developed by the Agency for Healthcare Research and Quality (AHRQ); intensive care knowledge were collected by researchers-made online intensive care knowledge tests; satisfaction with escape room training, and willingness to participate in the escape room training were collected by researchers-made online questionnaires. Finally, the data were analyzed with SPSS v.26. Descriptive statistics, the paired samples test, the Wilcoxon signed-rank test, multivariate regression, and Pearson correlation were utilized for analysis.

RESULTS

Fifteen groups of new nurses participated in the escape room training. For teamwork attitudes, there were significant differences in the mean T-TAQ total score (p < 0.001) and in the dimensions of teamwork (p < 0.001), leadership (p < 0.001), situation monitoring (p = 0.019), mutual support (p < 0.001), and communication (p < 0.001) before and after the escape room training. For the learning level, the mean intensive care knowledge scores were significantly different before and after the escape room training (p < 0.001). As for the reaction level, the satisfaction of ICU new nurses with the escape room training was high (9.23 ± 0.869), and the majority of them (95.24%) were willing to participate in the escape room training.

CONCLUSION

Implementing the escape room teaching method could promote teamwork attitudes and intensive care knowledge of ICU new nurses, and they were satisfied with and willing to participate in the escape room training. The key limitations in the study are the absence of a control group and data loss, and the results should be taken with caution. Our findings indicate that the escape room can be conducted in clinical practice learning for nursing and medical education settings with some props, and in ways of game playing, which doesn't require expensive equipment and can be conducted conveniently, suggesting that escape room might be a promising method with cost-effectiveness value for nursing and medical education globally.

Transition shock experience of newly graduated nurses: a qualitative study

AIM

This study aims to gain an in-depth understanding of the experience and requirements of newly employed nurses during their transition into professional roles. Furthermore, it aims to analyze the effects of transition shock on these nurses, identify the typical coping mechanisms they employ, and provide a reference for nursing administrators to explore and improve relevant interventions.

BACKGROUND

In the early stages of their careers, newly graduated nurses frequently encounter various challenging situations that might impact their job performance and professional growth. Over the past few years, experts have increasingly focused on transition shock. However, limited studies have been undertaken on the role adaptation factors related to freshly graduating nurses during their transition.

METHODS

The study's design and implementation were guided by the phenomenological method. Purposive sampling and semi-structured in-depth interviews were used to recruit 16 participants. Interviews were transcribed verbatim, and the data were analyzed using thematic techniques assisted by Nvivo coding software.

RESULTS

We analyzed interview data based on Duchscher's transition shock theoretical framework. A total of 3 themes and 12 sub-themes were distilled, which include perceptions and feelings when facing transition shocks (4 sub-themes), impacts of transition shocks (4 sub-themes), and strategies for coping with transition shocks (3 sub-themes).

DISCUSSION AND CONCLUSION

Newly recruited nurses are prone to suffer multidimensional problems and impacts during the transition process, mostly characterized by physical discomfort, psychological anxiety, and the need for social support and career development. Nursing managers should pay attention to the mental health status and changes of new nurses at different stages and proactively investigate and implement personalized interventions.

Navigating transition shock: The role of system thinking in enhancing nursing process competency among early career nurses

BACKGROUND

Building nursing process competency among beginner nurses is a pivotal need in contemporary, complex, fast-paced nursing practice. However, transitioning from the educational phase to practicing as a nurse can be a significant adjustment. New practitioners often experience a period of shock, which may present challenges in developing nurse competency. Fostering system thinking among those nurses could buffer the negative signs of transition shock and cultivate nursing process competencies at earlier times.

AIM

This study explores the relationship between transition shock and nursing process competency among early career nurses and investigates the moderating effect of system thinking on this relationship.

METHOD

This cross-sectional correlational exploratory study was conducted at four large hospitals in Egypt. Data were collected from 393 nurses from the first of February 2024 to the end of April 2024 using the transition shock scale, the competency of nursing process questionnaire, and the system thinking scale. Correlational and hierarchical regression analyses were used to test the study variables.

RESULTS

A statistically significant negative correlation exists between transition shock, nursing process competency, and system thinking among early-career nurses. System thinking is positively associated with nursing process competency. System thinking positively moderates the relationship between transition shock and nursing process competency among early-career nurses. Transition shock and system thinking account for 23.9% of the variance in nursing process competency among early-career nurses.

LINKING EVIDENCE TO ACTION

Transition shock is an inevitable phenomenon among early-career nurses, negatively affecting their competency in the nursing process. System thinking buffers this adverse effect and significantly augments nursing process competency among this set of nurses. Predicting and mitigating transition shock among early-career nurses is pivotal in building nursing process competency. Nurse educators must develop curricula that cultivate system thinking skills among nursing students, which enables them to buffer transition shock after graduation.

Relationship between work readiness, transition shock, and job competency among new nurses in oncology hospitals - A longitudinal study based on a latent growth model

BACKGROUND

Nursing job competency is critical for talent development both globally and in China, relating to work readiness and transition shock. Previous studies, which have typically relied on average measurements at fixed time points, have not provided comprehensive longitudinal insights.

AIM

This study aimed to investigate the developmental trajectories of transition shock in new nurses at oncology specialty hospitals. Furthermore, we sought to explore the longitudinal mediating role of transition shock in the relationship between work readiness and the development of nursing job competency.

DESIGN

Longitudinal follow-up study.

METHODS

We conducted three follow-up surveys over 8 months using the Work Readiness Scale, the Transition Shock Scale, and the Nursing Job Competency Scale to assess 252 novice nurses at two high-volume oncology centers. The surveys were conducted at 0, 4, and 8 months, with demographic information collected during the first survey. Data were analyzed using R 4.1.2 and Mplus 8.0.

RESULTS

(1) Over the 8-month period, transition shock exhibited a linear decrease. Notably, nurses with a higher initial transition shock experienced a slower rate of decline. (2) There were positive correlations between work readiness and nursing job competency at all three measurement points. Conversely, transition shock was negatively correlated with both work readiness and nursing job competency. (3) Transition shock functioned as a longitudinal mediator in the relationship between work readiness and nursing job competency.

CONCLUSION

This study clarified the longitudinal mediating role of transition shock in the relationship between work readiness and job competency in oncology settings. Targeted interventions are necessary to mitigate excessive transition shock, thereby improving the nursing job competency of new nurses in oncology hospitals.

REGISTRATION

23/313-4055.

Examination of Transition Shock and Colleague Violence Among Newly Graduated Nurses: A Cross-Sectional Study

Background: The adaptation process for new nursing graduates is challenging, with transition shock and colleague violence impacting both individuals and institutions. Objective: This study investigates transition shock and colleague violence among newly graduated nurses in Turkey during their adaptation process. Methods: The study involved 235 newly graduated nurses from a state university in Turkey with at least six months of clinical experience. Data were collected using the Nursing Transition Shock Scale and the Exposure to Colleague Violence Scale. Results: Among the participants, 27.23% experienced colleague violence and 56.17% witnessed it. The mean score on the Nursing Transition Shock Scale was 53.62 ± 15.39. Female nurses and younger age groups faced more challenges. Conclusion: Supportive work environments, mentorship programs, and collaborative teamwork are crucial for newly graduated nurses. Updating nursing education programs to prepare students for these challenges is essential. This study underscores the need for targeted interventions.

Relationship among core competency, self-efficacy and transition shock in Chinese newly graduated nurses: a cross-sectional study

OBJECTIVES

To investigate how core competency and self-efficacy of newly graduated nurses affect their experience of transition shock, and to determine the relationship between these factors.

DESIGN

A cross-sectional study.

METHODS

262 newly graduated nurses participated in a cross-sectional study by using demographic data, the transition shock scale, the competency inventory for registered nurses scale and the self-efficacy scale.

RESULTS

Among newly graduated nurses, the score of transition shock was 77.641±24.140, the score of core competency was 125 (109.5, 163.5) and the score of self-efficacy was 2.5 (2,3), all of which were at a moderate level. The core competency and self-efficacy of the newly graduated nurses had a negative impact on the transition shock (β=-0.151, p=0.026; β=-0.379, p<0.001). Additionally, self-efficacy played a mediating role in the relationship between core competency and transition shock, with a mediating effect accounting for 57.34% of the total effect.

CONCLUSIONS

The transition shock of newly graduated nurses was at a moderate level, with the highest level of transition shock occurring within the first year of employment. Self-efficacy plays a mediating role in the relationship between core competency and transition shock. Nursing managers should create standardised training for newly graduated nurses within the first year of employment to reduce their transition shock. This will help improve newly graduated nurses' core competency, enhance self-efficacy and support the graduates. This will alleviate the impact of transition shock on newly graduated nurses, helping them transition smoothly and successfully.