Transition Shock and Self-Efficacy Amongst New Graduate Nurses Post Pandemic

Danica Nolette RN, MN

Historically, the first year of transitioning to practice is the most wearing of a nurse’s professional career. The transition shock period is described by Dr. Duchscher as the initial daunting and challenging process of learning to navigate moving from the student mindset into the role of professional practicing nurse. While working the frontlines of an intensive care unit and as an educator for a bachelor's of nursing program during the COVID-19 pandemic, I witnessed firsthand how this transitional period for new graduates was demanding emotionally, physically, and mentally. I found it pivotal to uncover and understand what new challenges were on the horizon for new graduates as they would transition to practice post pandemic in a significantly strained healthcare system. This curiosity led me to research how new graduates made sense of and perceived their transition shock experience, and identify if self-efficacy influenced their transition shock period. The goal was to identify new challenges from the perspectives of new graduates, and determine how nursing educators and leaders could better support them during their initial transition to practice period.

Summary of my research

This research was completed using a qualitative method called Interpretative Phenomenological Analysis (IPA). IPA methodology consists of conducting in-depth interviews with new graduate nurses exploring and analyzing their lived experiences and how they perceived those said experiences. This method allowed me to understand on a deeper level new graduates’ experiences and perceptions of their transition shock period post pandemic through empathetic and critical interpretations. Four main themes were identified from the data retrieved from the interview transcripts; 1) burden of self-doubt, 2) emotional whirlwind, 3) silver lining, and 4) pandemic effect.

The burden of self-doubt was the most prominent theme as all participants admitted doubting their abilities to tackle their new roles and responsibilities as new graduate nurses. Participants recalled having moments where they questioned their nursing knowledge and capabilities, which led to feelings of stress and anxiety during their transition shock period. They described having imposter syndrome while determining how to independently manage their patient care assignments. They also mentioned feeling that their workplace expected more from them as new graduates than they anticipated, causing them to recognize that nursing was more demanding than expected.

Participants described having overcome a whirlwind of emotions during their transition shock period, which they felt affected their transitional experience. They expressed how they felt at times overwhelmed, stressed, and anxious, which left them periodically dreading their next shifts. The unpredictable nature of their workplace was described as an added stressor, as well as striving to be liked by their peers. Adjusting to being in a professional role rather than a student role was felt to be a challenging process for participants, as they navigated achieving a healthy work-life balance.

Although the transition shock period brought on many challenging facets, each participant recognized that this period of time would be a stepping stone of their transitional journey. They all were able to relate with peers as they shared the hardships faced during this transitional experience, which gave them a sense of encouragement that these hardships were not unique to them alone. They voiced the importance of being surrounded by a strong support system to sustain this transitional period, whether it be composed of colleagues, friends or family. Participants also recognized the importance of utilizing and employing coping mechanisms that optimized motivation and perseverance to face the trials and tribulations of the transition shock period.

Finally, the participants found that the aftermath of the COVID-19 pandemic affected their transitional experiences in minimal ways. First, they felt that the challenges and shortcomings they faced due to the pandemic during their nursing education impacted the way their colleagues perceived their abilities, knowledge, and skill during their transition. Reduced hours in clinical settings as nursing students, and commencing their nursing careers with high nursing vacancy rates and poor staffing ratios was felt to create a more challenging initial transitional experience.  Participants also noted a degree of burnout amongst their colleagues, associating it with the impact of the healthcare demands during the COVID-19 pandemic.

Conclusion

New graduates are an integral part of the nursing workforce. Understanding their transition shock experiences is crucial to ensure adequate and efficient support while overcoming the current professional challenges embedded within the nursing profession. This study shed light on the lived experiences of new graduates during the transition shock period post-pandemic. In keeping with Duchscher’s work, this study suggests that imposter syndrome is an important element within the transition shock period. This research further demonstrated that imposter-like emotions weigh heavily on new graduates hindering their transitional period. Further investigation and strategizing ways to overcome this phenomenon is needed. Further investigation and strategizing ways to overcome this phenomenon is needed.

Although this study did not measure self-efficacy using a quantified approach, it was qualitatively assessed through the participants responses to formulated interview questions enabling the evaluation of self-efficacy skills. The findings also support that self-efficacy influences do exist in impacting the transition shock experience of new graduates, as participants touched on all four sources of efficacy derived from Bandura’s self-efficacy theory. Identifying ways to sensitize nurses within the clinical setting to encourage the development of self-efficacy amongst new graduates could greatly benefit their transition to practice. However, additional research on this concept is needed to further develop and support this notion.

Assuring the next generation of new graduates are supported, well informed, and efficiently prepared for their new roles and responsibilities is critical to optimize job satisfaction, retention, and mental well-being within the nursing profession. As the healthcare system landscape changes, nursing education and mentorship must adapt to these constant changes to provide relevant training and educational support to nursing students and new graduates. Ensuring a holistic approach in recovering the dampened nursing profession is key to upholding its’ foundation, especially during the transition to professional practice of new graduate nurses.

About the Author

Danica Nolette graduated with her Bachelor of Nursing degree in 2015. She started working as an emergency room nurse, and a few years later moved onto working on an intensive care unit. While working part-time in the intensive care unit, she pursued her passion for teaching and began working as a nursing educator and student advisor for a local Bachelor of Nursing program in 2018. She completed her thesis in March and graduated with a Masters of Nursing from Athabasca University in 2024. She loves traveling, a strong cup of coffee, and daily walks listening to her favorite podcasts. Her hope for the future of nursing is to continue to learn from other’s experiences to help shift our ways of thinking to provide meaningful guidance for the next generation of nurses transitioning to practice.