New at NTF!

We are welcoming a new year at Nursing the Future, and remain dedicated to supporting new graduate nurses, nursing students, and the individuals and organizations who guide them! As January 2025 begins, it’s a perfect time for us to reflect on the great opportunities we have had to support the professional role transition of nurses in Canada. 

We’re excited to share that our recent partnership with the Canadian Nurses Association has led to some great upcoming collaborations! In late January, you can look for tickets to the latest in our popular NTFLive series, Meet the CNA! This event is a must see, as we will dive into the role of CNA and benefits of membership, geared especially to student and early-career nurses, and those who support them. Follow our social media to stay up to date with this and other great events! 

We’d like to remind our readers that we offer tailored tools and strategies to help students and new graduates navigate their new roles and clinical practice, and maintain their well-being as they embark u[on their nursing journey. 

For supporters, including managers, educators, preceptors, and mentors, we provide resources and free workplace consultation to enhance clinical learning support, create positive work environments, and ease the transition for new nurses. We strongly believe that supporters are essential, and we are committed to supporting you every step of the way! 

As always, each edition of our newsletter is filled with practical insights, tips from experienced nurses, and updates on emerging knowledge to help you navigate the evolving healthcare landscape.  

Let’s make 2025 a year of growth, connection, and success! 

The Interview: Conversations with Nurses on the Frontline

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

In our latest NTF Interview, Dr. Duchscher met with Satvir Kaur, an internationally educated nurse currently practicing as a Registered nurse in Ontario, Canada. Satvir came to Canada in 2017 in pursuit of advanced education studies and in 2020 graduated with a Master of Nursing from Thompson Rivers University with a focus on understanding resilience for newly graduated nurses. Satvir is passionate about the issues around the experience of transition to practice for new nurses, watch the unfolding of their in-depth conversation here! https://nursingthefuture.ca/ntf-live/   

Emerging Career Series

(https://nursingthefuture.ca/emerging-career-series/)

This month we are so pleased to be featuring an in-depth article focused on the career journey of Chrystal Stevens, who works as a Foot Care nurse! Not only does this interview explore how Chrystal became certified in this specialty but also how international education in the field has led her to participation in innovative technology-involved care! Read it here! https://nursingthefuture.ca/emerging-career-series/  

Masterclass Series

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

In our latest Masterclass series session, Dr. Duchscher explores the Paradox of Practice with Jodi Kerr, Sara Fung, Angela Wignall, Satvir Kaur and Don Leidl. In this segment of the ‘State of Nursing in Canada’ series, we discuss the challenges to maintain nursing practice standards and lead in practice while addressing and working within the limitations and restraints of the system

NTF Live

(https://nursingthefuture.ca/ntf-live/)

Did you miss our recent NTFLive When Things Go South? This session was focused on predicting and responding to a declining patient status, with expert advice on critical care, new graduate perspectives of complex care, and clinical debriefing and communication. This session was so well-received by attendees, be sure to watch the recording if you missed it live!

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!

As we outlined in the last newsletter (December, 2024), we are now exploring the 2nd stage of professional role transition for the newly graduated nurse. This is the time for a SPA TREATMENT 😉 (all genders included….) because it 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. This is 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.  In the last newsletter we spoke about searching. Now let’s dive into #2 – questioning! 

As one NG suggested, the initial segment of this second stage feels like being “caught up in a turn.”  

“I remember coming home and telling my husband I made my own decisions and acted on them without asking anybody and it was the right one and to me that was a turning point. I did it without asking anybody else and I had a favorable outcome so then it was, ‘You know, it’s OK to try again.’” 

“Life’s a dance you learn as you go….that pretty much sums it up. I accepted the dance, am caught up in a turn at the moment, but as this crazy dance continues, I will learn the steps and be able to not feel so awkward…I HOPE!?%! If I sit down now and don’t finish the dance, I fear I will never try it again. The question is, how long is the dance and when will I learn the steps?” 

These new professionals are keenly aware that something is different, but it may still take several months for them to feel like a ‘real’ nurse. Because they have arrived at a greater level of overall comfort and familiarity with work and role expectations, some may find themselves questioning why they left the comforts of their established school routine only to expose themselves to the daily onslaught of daunting responsibility that sometimes leaves them feeling incompetent, inadequate, exhausted, disappointed, devalued, frustrated, and powerless.  

“I don’t know. When I talk to other new graduates, a lot of them seem to be thinking to the future right now, and I don’t know, they’re not happy where they are or with the job they’re in. And so I’m thinking, ‘OK…do I want to do this for the rest of my life? What am I going to do?” 

“This isn’t acceptable—this is not who I am. I am not mean, short, [grumpy], so why can’t I stop acting that way? Can you burn out after 8 months? I’ve certainly go the cynicism and attitude part down-pat! And what’s that, ‘Oh, because I look young and am a somewhat new face to you, you think that is a license to treat me like an insolent child?’ And thus perpetuates your cycle of being frustrated with new nurses all the time. But who is going to stay when you treat them like that? I wonder what would really happen if I treated people with the level of respect that they treat me with? I would really love to—it’s not how my momma raised me, but it may be coming soon….Wow, this is all really negative—but it is how I have been feeling. It’s not the best place for me. I am starting to feel like my job is less an extension of myself and more just something I do. Something I am competent at but I know this can also make me cold toward people, patient and families.” 

These feelings can motivate a downward spiral during which the NG may start withdrawing from their surroundings in an attempt to protect their energy and focus on re-establishing a sense of control over their life. It is not uncommon for new grads to long for stable and familiar patient situations that require less thought and energy to care for and new grads may seek casual employment at this time so they can choose the work hours they want. Most grads are simply TIRED of the constant ‘newness’ and are looking to escape the barrage of learning, growing and changing they have experienced to this point. 

At this point in their transition, the NG is likely able to ‘lift their gaze’ from what is directly in front of them, with a NATURAL progression to questions that seek to understand what happened and move forward: 

1. Why did I go into nursing at all? 

· It is normal for NGs at this point to feel a lack of certainty in themselves and their decision to become a nurse. This is still a time of learning and new professionals may not yet be sure of what they offer to this profession when compared to those they see around them—they may sense (or see) levels of disempowerment in their role as nurses and question why; 

2. Am I capable of reaching the level of expertise I see in my experienced colleagues and mentor(s)? 

· Witnessing what may appear to be innate and seemingly ‘effortless’ abilities and skills in their experienced colleagues becomes the yardstick against which they measure their own, as yet unrefined, fluctuating and often tenuous abilities—this can undermine their growing confidence; 

· NGs may draw relationships between their ‘confidence’ and their ‘competence’, thinking that because they do not feel CONFIDENT that they are not COMPETENT;  

· Frequent debriefing with a mentor, an experienced colleague or just someone they TRUST that understands their experience is essential to cultivating a ‘truthful’ perspective about their nursing work. 

3. Will I ever experience the professional respect that I feel I deserve? 

· Claiming their ‘rightful place’ on the healthcare professional continuum is an ongoing process. This struggle may be particularly evident: 

a. within institutions or unit cultures that are more hierarchical; 

b. where nurses of varying levels of responsibility do not act collegially or collaboratively; 

c. when nurses and physicians do not work together as a collaborative professional team; 

d. if nurses are not valued for their knowledge, practice skill, clinical judgment and decision making. 

· Everyone deserves to be respected by others for the unique knowledge, skill and character that they bring to the care of their patients/clients but oftentimes the respect we REALLY want and need is from ourselves—this is where the NG should focus their attention. 

4. Will my life ever be well balanced? 

· NGs may well be exceptionally tired at this stage and this exhaustion can feed doubt. Be sure to ‘ground’ their questions and doubts in the knowledge that ‘things always look different when you have a good sleep’; 

5. Who am I as a nurse? 

· It is normal for the NG to compare themselves to other nurses within and outside of their own scope of practice—we often ‘measure’ ourselves against others ‘like’ us, particularly when we are new; 

· At this point in their transition, they have seen enough to come to some conclusions about what they DO and DO NOT want to see in their practice; they are starting to crystallize their own professional identity; 

· It is in this 2^nd stage that NGs make decisions about ‘what does it mean to be an Licensed/Registered Practical Nurse, Registered Nurse, or Registered Psychiatric Nurse’ and how they will honor those credentials?

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. 

Bridges’ Model of Transitions 

Dr. William Bridges is an internationally recognized transitions author, speaker and organizational consultant. His personal experiences of the transition process birthed his life’s work on how to deal with transition changes effectively. Bridges earned his Bachelor of Arts at Harvard University, went on to complete a Master’s degree in American history at Columbia University in New York, and earned his PhD in American civilisation from Brown University, Rhode Island. Dr. Bridges taught American literature at Mills College at Northeastern University in Oakland, California until 1974, when he left his lecturer job to explore writing, leading to the publication of his first book: Transitions: Making Sense of Life’s Changes (1979). Bridges' personal experience navigating change influenced his approach to writing and made his book relatable to many individuals. After his initial success, Bridges ventured into consultation and established William Bridges & Associates, a firm that focuses on supporting organizations and guiding individuals to manage transitions. He has authored and published books that address many dimensions of transitions and is a former President of the Society for Humanistic Psychology. In 2013, Williams passed away from complications of Atypical Parkinson’s disease, however, his tremendous contributions to coping with transitions remain highly applicable today. 

Theoretical concepts 

Bridges started teaching an independent “Being In Transition” seminar shortly after he left his lecturing career. These seminars introduced him to 25 students who were negotiating transition curves like himself. While each transition was different from the other, the students were remarkably alike in how they responded. It became evident to Bridges that these collective transitions were occurring in three phases: an ending, a period of confusion and distress and a new beginning. Anthropologist Arnold van Gennep studied rituals performed across diverse cultures and recognized a similar pattern in these ceremonies. Persons being initiated were often separated, allowed to undergo a period of finding themselves and then incorporated back into the community. These findings, alongside his own experiences with transition formed the basis for Bridges’ Model of Transitions. According to Bridges, ‘change’ and ‘transition’ are two distinctly separate concepts in that while change refers to the external occurrence, transition is the internal process an individual undergoes to make meaning of the change. Responses to events unfolding around an individual are the products of their inner psychological processes. The internal responses are influenced by the memories of experiences in the past which were shaped over time through interactions with others. The transition process is unique for each individual and can result in profound personal development if the individual remains positive about the experience. 

Tenets of the Theory 

Bridges' Model of Transitions identifies three stages that individuals must progress through for a successful transition. These are endings, the neutral zone and the new beginning. 

Endings: Endings are the beginning of every transition process. Often characterized by loss and disruptions in the status quo, this stage sets the pace for the transition process. Endings are experienced in four ways: Disengagement (a separation from usual and ways); Disidentification (a loss of sense of who one is especially when titles or labels attached to occupied positions are lost); Disenchantment (a sudden realization that what one held as true is unreal);and Disorientation (uncertainty about what next steps to take). Though unpleasant and difficult, this process forces the individual to let go of old yet familiar structures, accepting the current circumstances and exploring alternatives. Bridges suggested that individuals must be allowed to grieve their loss in their unique way because not fully dealing with the loss can affect subsequent phases. 

Neutral Zone: The neutral zone is the period of profound emptiness between the old and the new reality. An individual may feel stagnant because even though an old chapter has been closed, the new chapter is yet to begin. The stage is considered a time for reorientation and rediscovery where new perspectives are developed through an evaluation of the past occurrence. 

New Beginnings: This is the period where things begin to realign inwardly, and an inner resolve is reached to pursue future endeavours. With this intrinsic motivation spurring, the individual can surmount obstacles that threaten the achievement of new goals. Bridges concluded that to successfully reach the new beginnings phase, the first two phases of transitions must be fully embraced. 

Application of the Theory to New Nurses 

Student nurses recognize that to progress to the next stage of their careers, professional roles must be assumed once their basic nursing training and education is complete.  The change in roles can be daunting due to the sudden realization that they must let go of the student status, the safety and privileges attached to that role, and take on the new graduate nurse role with its associated responsibilities and accountabilities. This marked end and the awareness of their limitations in skills and knowledge can cause an inner apprehension. Bridge’s model suggests that anyone experiencing a major transition must be supported and encouraged to embrace and embody the transition process as an opportunity for exploration and discovery and an avenue for reinvention as they pursue their professional goals. 

References 

Association for Talent Development. (n.d.). Obituary Transition Pioneer William Bridges. https://www.td.org/newsletters/atd-links/obituary-transition-pioneer-william-bridges 

Bridges, W. (1980). Transition: Making sense of life’s changes. Addison -Wesley 

William Bridges Associates. (n.d.). The Bridges transition model [PDF]. Available at: https://wmbridges.com/about/what-is-transition/ (Accessed: 27 June 2024). 

Coming Soon!

Are you thinking about pursuing a nurse specialty? Watch our social media for an upcoming NTFLive session in February focused on specialties adeepnd certification with the early-career nurse in mind!