New at NTF!

Nursing the Future is your dedicated resource for new graduate nurses, nursing students, and their supporters! As we approach the close of another year, we reflect on the journey you’ve taken and the exciting path that still lies ahead. The needs of students and newly graduated nurses are diverse, and so are the strategies we offer—built upon decades of research and experience. 

We are so pleased to announce our recent partnering with the Canadian Nurses Association, you can expect new resources and collaborations in the near future! 

For students and new graduates, whether you're settling into your new role, seeking advice on clinical practice, or looking for ways to preserve your well-being, we’ve got you covered. 

For those supporting new nurses—managers, educators, preceptors, and mentors—our resources are designed to meet your needs. You’ll find strategies to promote clinical learning, tips for cultivating a positive and supportive work environment, and evidence-based resources to help ease the transition. We recognize the pivotal role you play in shaping the future of nursing, and we're here to support you every step of the way. 

In each issue of our newsletter, you’ll find valuable insights, tips from experienced nurses, resources to help you navigate healthcare’s evolving landscape, and updates on emerging knowledge to guide you into the year ahead. 

Book Club

(https://nursingthefuture.ca/book-club/)

Self-Care for New and Student Nurses by Dorrie K. Fontaine, Tim Cunningham, and Natalie Correll provides practical guidance to help nursing students and new graduates develop habits that foster resilience and prevent burnout. The authors emphasize self-care strategies such as mindfulness, exercise, and work-life balance while addressing emotional intelligence and boundary-setting in personal and professional contexts. With tips for managing stress, improving time management, and fostering effective communication, the book equips nurses with tools to navigate their careers while safeguarding their mental and physical well-being. It’s a vital resource for thriving in a demanding healthcare environment. 

Visit our podbean for our exclusive interview with Tim, and listen to our other great author interviews! https://nursingthefuture.podbean.com/ 

The Interview: Conversations with Nurses on the Frontline

(https://nursingthefuture.ca/the-interview/)

Ever wonder if mental health nursing (forensics, corrections or addictions) is for you? Join us for this overview on the distinctions and synergies between the various arms of this specialty area from experts in the area. Go HERE to view the video. 

Our Voices

(https://nursingthefuture.ca/our-voices/)

In a recent interview with Gessica Hulse and Hong Huynh, co-owners of BCI Clinic, we explored their journey from nursing to business ownership in medical aesthetics. Both passionate about patient care, they shared how their diverse nursing experiences—ranging from cardiology to critical care—have shaped their approach to medical aesthetics. They emphasize the importance of self-care, ongoing education, and mentorship in navigating the complexities of this evolving field. With a shared commitment to providing high-quality care, they offer valuable insights for new graduates considering a career in aesthetic nursing.  

Masterclass Series

(https://nursingthefuture.ca/greenhouse-master-class/)

We are excited to present the next session in our unfolding seminar series on the State of Nursing in Canada, with experts in the field of supporting Internationally Educated Nurses. Cynthia Johansen (Registrar and CEO of BCCNM), Dr. Edward Cruz (University of Windsor), Esther Benjamin (CEO, ED of WES), Dr. Ruth Lee (CARE), Leah Watts (CASN). Join us in this timely, and in-depth Masterclass! 

Supporter Spotlight

(https://nursingthefuture.ca/awards/)

At NTF, we are passionate about recognizing and celebrating excellence. When we discover a Rising Star among new graduate nurses or their supporters, we are eager to share their successes with our community! 

If you know someone who deserves to be celebrated for their achievements, please let us know by emailing us at newgraduates@nursingthefuture.ca OR go directly to https://nursingthefuture.ca/awards/ and submit your nomination! Your nominations help us shine a spotlight on those who are making a difference in the nursing profession. 

Let's Talk Transition!

You gain strength, courage and confidence by every experience in which you really stop to look fear in the face. You are able to say to yourself, 'I have lived through this horror. I can take the next thing that comes along.' You must do the thing you think you cannot do. 

- Eleanor Roosevelt 

As we talked about in a prior newsletter (October, 2024), the 2nd stage of professional role transition for the newly graduated nurse is characterized by overwhelming exhaustion as the new graduate becomes more comfortable with practice competencies, starts to ‘settle in’ to their new practice culture, and begins processing everything that happened in the whirlwind of Stage 1. The tremendous energy that was directed toward all the new situations and relationships introduced during their initial 4 months of practice, combined with the stress of taking responsibility for clinical decisions in challenging scenarios that they may have had little to no experience with as students, results in a level of terminal exhaustion from which they now need to recover. This can be a stage of significant ‘flux’ for new nurses—a time of ‘awakening’ to all that IS and all that IS NOT. Restoring a sense of equilibrium is the name of the game in this stage, marked by: 1) searching, 2) questioning, 3) doubting, 4) examining, and 5) revealing.  

So let’s begin: SEARCHING for the newly graduated nurse is motivated by the confusion, doubt and frustration that characterized the initial stage of transition. It is the attempt by the new professional to gain some separation from the intensity of their initial energy consuming stage of transition. During this period they are focused on exploring, and attempting to ‘right’, their professional and personal values balance and make sense of (and perhaps even make tenable) the disparities or inconsistencies they have witnessed – clearly the more congruent their practice is with what they came to expect as students will ease or aggravate this period. 

Feelings of ‘energy drain’ are common during this period. Truth be told, the new grad may be just noticing their lack of energy now, but the 1^st stage of transition was more likely where it was depleted. While it can be frustrating, the exhaustion felt by new nurses at this stage is a normal and healthy part of the disengagement process. The exhaustion essentially FORCES them to make the separations necessary to gain back their equilibrium and in doing so, motivates the creation of a larger ‘whole’ that can encompass the multiple and complex dimensions of real life. 

“I value my personal life over my work—that’s changed. Sometimes I get frustrated because nursing should be my career and I like to believe that it is my career but sometimes it is just a job. Some days I go in and it is just a job—sometimes you’re so drained and everyone’s been working overtime and you go in and just do your job. It’s unfortunate that my patients are on the other end of that because I’m not giving my 110% but sometimes I just do the tasks that I need to do to get through the day and then go home….I really am enjoying the fact that I’ve got a fulfilling career and I’m paying off my student loans and able to have a nice lifestyle for the first time. I’m developing a relationship with my husband and so I’m not prepared to give up the time…I like being with my husband and I like keeping my house in order. I go to work because I like being a nurse but I also know that there are other things that define me so when I’m not at work, I don’t really think about it very much.” 

To cope with the drain on their energy they may seek refuge by ‘returning’ to their personal lives and de-emphasizing their professional focus. This desire for distance from that which is stressing them (their work essentially) may express itself in a need for separation from their work environment (e.g. they may refuse overtime or may call in sick to avoid having to face the workplace) or a need to put distance between themselves and their colleagues (e.g., choosing to forego staff functions or isolating themselves during breaks).  

“I don’t mind going to work but I think that sometimes maybe I’m taking too many shifts and it’s starting to catch up with me.  Once you’re there, you’re there and you just go and you work, but on my days off I think I can really feel it….After awhile, I wasn’t interested in making friends at work. I just wanted to come, do my job, and leave….It was too much work to try and build new relationships with the strain I was under from being a new grad.” 

An important adjustment for new professionals in a workplace is social. There are times, particularly if they are working shift, when their schedule will be opposite to those with whom they regularly interacted, making getting together for support or just fun much more challenging. Having been accustomed to engaging with friends and family on weekends or statutory holidays as a student, the inability to do so with any regularity can throw quite a wrench into their social life. Given that this is happening at a time when they MOST NEED that social support, and given that GenZ is highly social may add to the strain of their situation. 

“Working nights and weekends when a lot of your friends are out having fun or going to bed for a good nights sleep when you are only going to work can leave you feeling sad and left out. There are times when it is hard to go to work because you are going to miss out on stuff you would really like to do. Simple things like going to the gym, grocery shopping, and even cleaning the house and getting errands done become more difficult. You struggle with finding a routine that works for you, IF (participant emphasis) you can even call it a routine, but you will learn to get organized in a hurry because when you work 3 or 4 shifts in a row, not much gets done.” 

Fundamental to this stage is an increased awareness of themselves professionally—they begin searching: 1) for more insight into the role of the nurse relative to other health care professionals and, 2) to understand the influence of the nurse within the larger ‘system’.  

Equally fundamental to this stage is finding a balance between their personal and professional lives.  

“It’s stressful. Obviously, I still really enjoy it. I always have, but I don’t think this is something I want to do forever—not ward nursing.  I’m enjoying it. It’s more comfortable. I like it. I see that I need this experience and you know, it’s great experience but I just can’t imagine myself when I think of the future, I don’t see myself anywhere. I don’t know exactly where I see myself and that’s sort of another issue. Nursing’s a hard job and a very different job. I was discussing with some friends about the differences even just between my fiance’s job and my job and that he can go out for his lunch break and, you know, do a few errands or he can leave if he has to or if he sleeps in he can come in late and stay a bit longer. It’s so much more flexible—like we can’t go to work in our job and say ‘I don’t feel like working today.’” 

During the initial half of this stage (4-6 months post-orientation), the new nurse becomes increasingly comfortable with their roles and responsibilities as a nurse. This comfort may permit them to begin an examination of the underlying rationale, appropriateness and effectiveness of what they are doing. While this stage is initially about disengaging from the intensity of their workplace (pulling back), another intensity soon takes its place—the latter 2 months of this stage (6-8 months post-orientation) inspire a transition crisis for the new professional. They begin to question the motives and rationale behind their work and workplace, searching for meaning in what they do as a nurse, and trying to recover the physical, emotional, spiritual and intellectual strength that might have dissipated during the first stage. This is a very precarious time for the new graduate and often one in which they are crystallizing their future work intentions. 

“I really have tried to not let myself get so worked up before I go to work. I’ve just been able to put it aside and just deal with it as it comes that day. Like if I thought that I was going to be in the observation unit one day I would be fretting about it all week or worrying about it and I wouldn’t sleep the night before. Now I’m just like, ‘Whatever, I’ll deal with it tomorrow when it comes and we’ll see’ you know?’” 

“Well I just…I don’t want my job to ruin my life because my outside life’s really important to me: my family, my friends, my boyfriend. They’re all really important and I just don’t want to become one of those nurses who are crabby and hate their job and don’t like the work and complain everyday. I don’t want to become that, I want to love my job and I want to work with people and enjoy it so if I find myself becoming one of those nurses then I’ll have to make a change because I just don’t want to become that. That’s not who I am.” 

As noted in previous descriptions of the transition experience, the relative presence of consistency, predictability, familiarity and stability in the new graduate’s work will dictate how they ‘recover’ from the initial stage of transition. To minimize the delay in moving through the stages of transition, it is recommended that they seek (and we provide) a clinical environment that offers time with consistent and experienced colleagues and care demographics (the types of clinical situations they are exposed to, and the roles and responsibilities they are expected to perform), predictable work expectations (some control over the intensity, scope and conditions within which they work), some familiarity with the work expected of them (working with the same colleagues and seeing similar clinical situations repeatedly), and a stable practice context (limiting the extreme ranges in the clinical situations presented to them that carry an inherent risk of ‘disaster’ or ‘crisis’). 

Research and Education:

The breadth of nursing knowledge extends to the pursuit of evidence through programs, initiatives, and research. Join us as we highlight and discuss what emerging findings mean for the contemporary field of professional nurse transition, and the profession as a whole. 

Beckhard’s Model for Organizational Change

Richard Beckhard is remembered as an individual who has made significant contributions to the field of organizational development. He first worked as an actor and later became a Broadway stage manager for troops in the Pacific. He was intrigued by how the troops seamlessly adapted to changes and wanted to delve deeper into the subject. In the 1950s, he began collaborating with Professor Douglas McGregor, the individual who established the Organization Studies Department at the Sloan School of Management. The two later collaborated with Dewey Balch to commence a project aimed at helping organizations manage their change processes. In 1963, he became an Adjunct Professor at the Massachusetts Institute of Technology (MIT) Sloan School of Management. He collaborated again with Warren Bennis and Edgar Schein to launch the Addison-Wesley Organization Development Series. Dr. Beckhard achieved prominence in the field of organizational development by focusing on widespread organizational changes, then an emerging field. The first training program for specialists in Organizational Development was launched by Beckhard in 1967. In 1970, he established an organization purposely for supporting family-owned businesses and named it the Family Firm Institution. The author of numerous books and articles, Beckard retired from academia in 1986 but continued to disseminate his work to managers, business executives and anyone who desired to be a change agent. After his retirement, the faculty of MIT Sloan School of Management instituted the Richard Beckhard Memorial Prize to recognize him for his contributions to the field. Though Dr. Beckhard passed away in 1999, his legacy of understanding how individuals and organizations adjust and adapt to change continues to contribute to organizational effectiveness.  

Summary of Beckhard’s Model for Organizational Change

Beckhard asserted that existing organizations are often compelled to alter how they conduct their affairs as a result of the rapid ongoing changes occurring around them. Managers who are usually at the helm have the daunting task of ensuring that these changes are implemented seamlessly, even though the process may require multiple adjustments in various aspects of the organization. A myriad of considerations must be made by the manager to guarantee the change initiative's success. Further, the manager must have the requisite knowledge and skill set to decipher what the current state of affairs of the organization is, have a clear image of what the desired future should look like, know the actions that must be undertaken to accomplish the desired future and have an idea of how things should be in the interim before the desired future is reached.  

This ‘interim phase’ between the present state and the desired state is what Beckhard called the transition state. He suggested that the desired future will be attainable if the transition state is managed properly. According to Beckhard, a manager must first understand the exerting environmental factors and their impact on the outcomes before initiating any organizational change. This awareness ensures that the best strategies are selected for the impending change.  

The current state is the starting point of every transition process and representative of what the organization wants to shift away from. Environmental factors often trigger the desire to effect a change initiative. Organizations must sometimes adjust in order to meet a set of defined expectations. Beckhard recommended that an initial detailed analysis of the present state be conducted to minimize unforeseen interruptions and interferences with the transition. This involves knowing the specifics of the changes to be made in the present state in relation to the human resources and organizational structures. Actions can then be defined around these specifications. Beckhard added that managers should ascertain whether there are any impediments to reaching the desired future and address them prior to engaging in the transition process.  

The various facets of an organization must be assessed for readiness and capability when undertaking a change. This can be determined by utilizing a formula first introduced by David Gleicher. Beckhard introduced this formula as a means to determine the organization’s readiness and capability for impending change. This formula is diagnostic and helps to identify problem areas that require redress. The formula is C = (ABD) > X, where C = Change, A = Level of dissatisfaction with the status quo, B = Clear desired state (well-defined goal to be attained), D = Practical first steps toward a desired state (an awareness of initial steps to be taken to reach the desired state), and X = Cost of change. Inferring from the formula, people are less likely to resist a change when they are dissatisfied with the current state, desire a new state, and are on board with the practical first steps to reach the desired state. 

The transition state is the phase where the change is actively occurring and is considered a dynamic period. It is marked by notable changes in the organization and involves a cycle of learning and unlearning. The transition period is characterized by considerable confusion due to the many ongoing adjustments in the organization. These adjustments must be managed effectively. A plan showing how to reach the desired end state and an outline of strategies to foster a commitment to the organization’s change agenda must be in place. Some useful strategies Beckhard has suggested include providing educational and training support, redesigning organizational structures to accommodate ongoing change, creating an awareness of the importance of the change, maintaining open communication lines, identifying critical starting points for the change, assigning roles and responsibilities, clearly defining job descriptions and expectations, and identifying influential individuals to champion the change agenda. An independent system must be established to oversee and monitor the progress of the change process. 

The future state is the desired outcome or endpoint of the change process. Beckhard recommended that this phase be viewed as dynamic as well, in that although the desired future may have been attained, it is not uncommon to have systems regressing to old patterns. New systems must be in place to ensure that the desired state is continuously evolving to meet the changing times. Feedback channels should be kept open to facilitate the flow of information within the organization. 

Application of Model to New Graduate Nurse Transition

Upon graduation, new graduate nurses transition into practice contexts that exist within complex healthcare systems. Applying Beckhard's model to this process helps position the healthcare organization in readiness to support the integration of the new nurses. Managers can navigate this process by first conducting a thorough analysis of the organization to identify potential barriers or facilitators to the new nurse integration process. A comprehensive action plan can then be developed on how to support the new nurses to succeed in the profession and the organization. Well-planned programs such as orientation sessions, onboarding courses, and mentorships can be incorporated into the integration experience to improve their outcomes. The process must be continuously monitored, and adjustments to the support systems made as needed to ensure that new nurses receive the guidance needed to succeed in developing confidence and competence. 

References

Beckhard, R., & Harris, R. T. (1977). Organizational transitions: Managing complex change. Addison-Wesley. 

Massachusetts Institute of Technology. (2000, January 26). Sloan Adjunct Professor Richard Beckhard dies at age 81. MIT News. Retrieved from https://news.mit.edu/2000/beckhard-0126 

Massachusetts Institute of Technology. (2021, September 8). The 2021 Richard Beckhard Memorial Prize. MIT Sloan Management Review. Retrieved from https://sloanreview.mit.edu/article/the-2021-richard-beckhard-memorial-prize/ 

Opex Learning. (2019, February 3). Richard Beckhard and his contributions to organization development. Retrieved July 26, 2024, from  https://opexlearning.com/resources/27874-2/27874/ 

Wikipedia contributors. (2023, May 13). Richard Beckhard. Wikipedia. https://en.wikipedia.org/wiki/Richard_Beckhard 

Image source: Hartwell, J. & Roth, G. (2010). Doing More with Less at Ariens: A Leadership and Transformation Case Study. Organization Management Journal. 7. 10.1057/omj.2010.16

Coming Soon!

Our popular seminar series NTFLive is back with another amazing seminar planned!  Join us in the live session discussing all things NCLEX November 27 at 2pm EST with Shelly Luhning, Owner and CEO of NCLEX Education! Don’t miss this informative and fun session designed to explain the testing process and how you can best prepare! Be sure to bring your questions!! Watch our Social Media and become an NTF subscriber for updates and your FREE tickets! Be sure to share these events with your new graduate peers, coworkers, and senior students!