As a recent Wolters Kluwer whitepaper points out, it takes at least 6 weeks to onboard new nursing graduates and an average of 140 days before they are productive. Challenges facing graduate nurses include lack of confidence, high workloads, orientation issues, fear, frustration, and being overwhelmed. With increasing numbers of novice nurses involved in patient care and the acuity of illness increasing, experts agree that it is critical to support graduates as they transition to practice. Graduate nurses need orientation programs, approachable mentors, constructive feedback, and support to deal with difficult situations such as deteriorating and dying patients.
Finding ways to effectively transition and onboard graduate nurses will be crucial to helping them gain knowledge and confidence, provide high-quality care to patients, and support the needs of the hospital or health facility.
Graduate nurses face a steep learning curve when transitioning into real-world practice. They need support and nurturing so they can contribute to safe, high-quality patient care as quickly as possible. Australia’s increasingly complex healthcare environment is placing additional demands on new nurse graduates. The changing healthcare needs of an aging population, technological innovation, and new medical breakthroughs all create additional demands for graduating nurses.
Effective transitioning and onboarding of graduate nurses are crucial to helping new staff gain professional knowledge and confidence, while also meeting the organisational needs of the hospital or health facility. Yet, as one recent study into the organisational socialisation of recent graduates found, the transition process can be inconsistent and does not give new graduates adequate strategies to build relationships in their new workplace. And, as other studies have shown, lack of confidence, high workloads, orientation issues, fear, frustration, and being overwhelmed can impact patient care and nurses’ overall satisfaction.
In a panel discussion at the 2023 National Nurse Education Conference, Lippincott® Solutions regional sales manager (Australia) Laura Chapman, RN, MACN, MCHSM, said that with increasing cohorts of novice staff in patient care it was important to consider how to support students and graduates, as well as assist the people supporting them.
Recognising the value of graduate nurses
One important pathway to helping graduate nurses transition to the workplace is the use of preceptor nurses, experienced nurses assigned to guide graduate and new staff members within the workplace. Preceptors provide the resources and support new nurses’ need to transition into real-world clinical environments.
During the National Nurse Education Conference panel discussion, Siobhan See, RN, Clinical Education Lead with UnitingCare Queensland, said having enough nurse educators on hand to provide support was crucial.
Fellow panellist, Bernadette Thomson, RN, RM Med, Metro South Health in Queensland, advocates for an intern year to bridge the gap between the third year of studies and being a nurse on the floor, and for further investigation into the ideal ratio of education staff to headcount.
“If we can keep our education staff educating on the floor that takes stress off the staff,” she said. “It also means that our grads are getting the education that they need.”
There are also state programs aimed at supporting this transition. WA initiated a GradConnect program in 2023 to assist graduate nurses with transitioning to practice at participating health providers, which include both public and private hospitals in metropolitan and rural areas, as well as a number of aged care services.
As part of the same Victoria government initiative to support nursing students, the state will offer $20 million to support graduate nurses as they transition to working in hospitals.
NSW Health, meanwhile, has said it will help enrolled nurses to transition into the workforce by offering onboarding and transition programs.
In its recommendations, the Australian College of Nursing proposes several strategies to achieve a positive transition for nurse graduates, including:
- Orientation programs with realistic goals and competencies to achieve technical skills
- Approachable and responsive mentors and senior leaders
- Timely provision of constructive feedback
- Continuing staff development opportunities
- Open communication
- Support when dealing with deteriorating patients, death, and dying.
Two other strategies that can help graduates transition to practice include (1) careful analysis of the onboarding approach as well as (2) centralising the process.
The recent Lippincott paper points to the importance of having better visibility into the strengths and weaknesses of hiring practices, noting that proactive hiring practices using predictive analytics capabilities to estimate the number of graduate hires likely to be needed will lessen the stress on staff and reduce costs.
Additionally, centralising the hiring and onboarding of new graduates can take the pressure off busy nurse managers and makes the hiring process a strategic priority.
Balancing education with practical skills
Providing nursing graduates with an opportunity to apply their skills has been found to be beneficial. A recent research paper found the inclusion of these USiNs (Undergraduate Students in Nursing) at a Queensland paediatric hospital led to the staff nurses perceiving that their workload had lessened and that patient safety and quality of care had increased.
During the recent 2023 National Nurse Education Conference, panellist Bernadette Thomson said that allowing students to learn on site through that USiN program had boosted their confidence. “With the USiN, we know they have a better understanding of what the patient will need, and if we support them, they will then be able to deliver that care,” she said.
Find out more about how Lippincott® Solutions can support graduate nurses transitioning to practice in Australia’s care settings.