Dr David Barrett & Dr Jane Wray, Faculty of Health Sciences, University of Hull
The transition from student nurse to registered practitioner can be a challenging and turbulent time. Newly-qualified nurses (NQNs) often feel pressure as a result of taking on accountability for their own practice and having to move from supervised student to independent practitioner. The impact of this change in role and function can be exacerbated when NQNs are working in an unfamiliar environment with a new team of colleagues.
These factors all lead to some NQNs experiencing what is sometimes labelled ‘transition shock’ (Duchscher, 2009) or the ‘flaky bridge’ (Health Education England, 2018). In turn, this can impact on the wellbeing of NQNs and their ability to practice effectively. As a result, the risk of nurses leaving employment (or even the profession) is particularly high in the first year following qualification (Brook et al, 2019).
To address transition shock, healthcare employer and Higher Education Institutions (HEIs) implement a range of interventions that support NQNs during transition. Examples in the literature include use of preceptorship and structured induction/orientation programmes (Brook et al, 2019). Though there is evidence that these interventions can be effective in easing transition, the development of additional support mechanisms can expand the ‘toolkit’ of interventions available to employers and HEIs.
As part of the University of Hull’s ‘Supporting Transition and Retention’ (STaR) project – a mixed methods study that supports the development of a ‘transition toolkit’ – a single cohort of pre-registration student nurses were given the opportunity to spend a proportion of their final clinical placement working in the setting where they had secured post-qualification employment that was due to commence upon completion of their course.
This initiative was developed as a result of feedback from students and clinical leaders from interviews carried out earlier in the study. This included suggestions that spending time with a future employer might “…give them the opportunity to meet people…you know the code for the door…silly little things, it will make them less anxious on the day they start” or might help with “…simple things, like you know where the coffee room is…you know how things work …they know your work ethic…they know what you are like”
Students were given the option to spend up to 75 hours of their final placement working within their place of first employment (PFE). This could either be through ‘day release’ from their core placement area each week, or in longer blocks of placement time. Students were able to maintain supernumerary status during their time with their PFE, but their performance was not formally assessed. Permission to spend time with their PFE was conditional on them making good progress with their final placement and receiving approval from their practice supervisor and personal tutor.
To evaluate the success (or otherwise) of the initiative, the student cohort was asked to answer a series of questions during a face-to-face classroom session. Data were collected using ‘Mentimeter’, an online system that allowed the students to answer questions via digital devices and for real-time data to be collected.
Of the 228 respondents, 64% reported having spent some time working with their first employer.