Authors : Rajne Lorenzo Raphael F. Ruste; Indira June O. Ugmad; Andrei E. Villanueva

Volume/Issue : Volume 9 - 2024, Issue 11 - November

Google Scholar : https://tinyurl.com/muvnprpf

Scribd : https://tinyurl.com/4ud5sn2f

DOI : https://doi.org/10.5281/zenodo.14274337

Abstract : Background & Aim: In the Philippines, neophyte nurses experience various obstacles in their transition to the field, which lead to low retention rates of nurses among hospitals in our country. This study aimed to explore their experiences, challenges encountered during the transition program, and recommendations to enhance nursing management and reduce retention rates among nurses.  Methods: Data collection involved snowball sampling of ten neophyte nurses who recently underwent transition programs in a tertiary hospital in Iligan City. Through qualitative research methodology, individual interviews explored the viewpoints, experiences, and actions of neophyte nurses in transition. Thematic analysis was utilized to analyze data.  Results: Participants results were themes identified encompassed various dimensions, including the lived body has four themes: training programs for neophyte nurses; burnouts; focused training on specific procedures; empowerment. The lived space has two themes: orientation and shadowing. The lived human relationship has two themes: mentoring and dealing with patient and significant others. The lived thing has one theme: lack of confidence and familiarity. The lived time has one theme: extending training duration.  Conclusion: The transition experience for neophyte nurses was complex, involving multiple dimensions of their lived experiences. Comprehensive training programs were essential to bridge the theory-practice gap, reduce burnout, and empower them. Orientation and shadowing provided direction and familiarity with hospital settings. Mentorship played a vital role in professional growth and navigating patient interactions. Additionally, challenges in confidence and familiarity with procedures underscored the need for supportive environments. Extended mentorship programs were necessary for skill development and confidence building. Overall, these findings emphasized the importance of tailored support mechanisms to facilitate the effective integration of neophyte nurses into the healthcare workforce.

References :

1. Abrahams C, Alley H, Downing C. 2021. Experiences of newly employed professional nurses regarding their quality of work life at a private hospital in Gauteng. Vol 15. https://doi.org/10.1016/j.ijans.2021.100362
2. Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R., & Sermeus, W. 2014.      Nursestaffing and education and hospital mortality in nine European countries: A retrospective observational study. The Lancet. 383(9931): 1824-1830. https://doi.org/10.1016/s0140-6736(13)62631-8
3. Alibudbud R. 2023. Addressing the Burnout and Shortage of Nurses in the Philippines. SAGE Open Nursing. https://doi.org/10.1177/23779608231195737
4. Alsalamah Y. S., Alsalamah, T. S., Albagawi, B. S., Alslamah, T., Tassi, A. E.,         Fawaz, M. 2023. The relationship between work readiness and perceived clinical competence among graduates transitioning into professional practice. Vol 18. https://doi.org/10.1016/j.ijans.2023.100555.
5. Asadi SE, Khademi M, Yarahmadi S, Ebrahimzadeh F, Mohammadi, E. 2023. A comparison of nurses and elderly patients’ perceptions of caring behaviors in intensive care units. Vol 34. https://doi.org/10.1016/j.enfie.2022.04.001
6. Attafuah P. Y. A., Amertil N.P., Abuosi A.A. Nyonator, D. 2022. Nurses’ knowledge and attitude towards care of older patients: A cross-sectional study Vol 16. sciencedirect.com/science/article/pii/S2214139122000208
7. Aydogan Y., Ulupinar, S. 2020. Determining the learning needs of newly graduated nurses working in inpatient care institutions. Vol 92. https://doi.org/10.1016/j.nedt.2020.104510
8. Baño KL, Bautista SB, Bonita DAL, Ibong NEM, Pimentel JVD, Vallespin MR. 2023. Exploring global career aspirations: A study on FEU nursing students’ inventions and factors influencing international employment choices. International Journal of Multidisciplinary Research and Publications. 6(6) 143-151. https://researchgate.net/publication/376354374 
9. Barret B. 2023. Assessing Nurse Competency in the Veterans Health  Administration Registered Nurse Transition-to-Practice Residency Program: Item Pool Content Validation. Journal of Nursing Care Quality. 39(1): E1-E7. https://doi.org/10.1097/NCQ.0000000000000740
10. Baumann, A., Crea‐Arsenio, M., Hunsberger, M., Fleming‐Carroll, B., & Keatings, M. 2019. Work readiness, transition, and integration: The challenge of specialty practice. Journal of Advanced Nursing, 75(4), 823–833. https://doi.org/10.1111/jan.13918
11. Bentulan LM, Colborn LL, Galamiton, M, Jacinto RF, Lanzaderas JY,  Remolador A, Vito L, Domapias L, Lupio S, Sajonia RA. 2022. Factors Motivating Boholano Nurses to Work Abroad. University of Bohol Multidisciplinary Research Journal. 10(1):31-43 https://doi.org/10.15631/ubmrj.v10i1.164.
12. Bhandari P. 2023. What is qualitative research? Methods & Examples. Retrieved.                 Scribbr. Bhandari P. scribbr.com/methodology/quantitative-research/
13. Block L, Hovanes M, Bykovskyi. 2022. Written discharge communication of diagnostic and decision-making information for persons living with dementia during hospital to skilled nursing facility transitions. Vol 45. https://doi.org/10.1016/j.gerinurse.2022.04.010
14. Bradley L, Barr J, Finn J. 2023. Work readiness of graduating nursing students: Case study research. Vol 18. https://doi.org/10.1016/j.teln.2023.03.012
15. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa
16. Bridge, P., Adeoye, J., Edge, C., Garner, V., Humphreys, A., Ketterer, S., Linforth, J., Stanley, A., Newsham, D., Prescott, D., Pullan, S., & Sharp, J. 2022. Simulated Placements as Partial Replacement of Clinical Training Time: A        Delphi Consensus Study. Vol 68. P42-48. https://doi.org/10.1016/j.ecns.2022.04.009 
17. Cadavero A, Pena H, Brooks K, Kester K. 2023. Perceptions of New Graduate Nurses’ Transition to Practice Post-Pandemic Nurse Leader. 10(1016). doi.org/10.1016/j.mnl.2023.11.008
18. Carpenter, J. G., & Miller, T. L. (2019). Evaluating nursing student knowledge of and attitudes toward older adults. Nurse Educator, 44(2), E1-E5.https://doi.org/10.3928%2F00989134-20150429-01
19. Catton, H. (2020). Global challenges in health and health care for nurses and midwives everywhere. Vol 67 Issue 1. https://doi.org/10.1111/inr.12578
20. Caulfield J. 2019 Sep 6. How to Do Thematic Analysis | Step-by-Step Guide & Examples. Scribbr. https://scribbr.com/methodology/thematic-analysis/
21. Chen F, Liu Y, Wang X, Dong, H. 2021. Transition shock, preceptor support, and   nursing competency among newly graduated registered nurses: A cross-     sectional study. Vol 102. https://doi.org/10.1016/j.nedt.2021.104891.
22. Ching, H., Fang, Y., & Yun, W. 2022. How New Nurses Experience Workplace        Belonging: A Qualitative Study. https://doi.org/10.1177/21582440221119471
23. Christensen SS, Chase-Cantarini S, Li H, Sheng X, Nixon TL, De Jong MJ. 2023.    Newly licensed nurses’ transition during the pandemic after participating in nurse apprentice program. Collegian. 30(5) 633-639    https://doi.org/10.1016/j.colegn.2023.07.002
24. Chung, J. Y. S., Li, W. H. C., Ho, L. L. K., Cheung, A. T., & Chung, J. O. K. 2021. A newly graduated nurse's perception and experience of clinical handover. Vol 97. https://doi.org/10.1016/j.nedt.2020.104693.
25. Cockerham, J., Altmann, A., Eyster, B., Ross, C., & Salamy, J. 2011. Supporting    Newly Hired Nurses: A Program to Increase Knowledge and Confidence                 While Fostering Relationships Among the Team. Vol 46. https://doi.org/10.1111/j.1744-6198.2011.00236.x 
26. Connelly, R., Doe, J., & Smith, L. (2023). Nursing education programs and their impact on workforce capacity. Journal of Nursing Education, 62(4), 223-235. https://doi.org/10.3928/01484834-20230301-05
27. Crismon, D., et al. (2021). Examining the Impact of the COVID-19 Pandemic        on Burnout & Stress Among U.S. Nurses. National Council of State Boards of Nursing. https://doi: 10.1016/S2155-8256(23)00063-7
28. Delve. 2020 Aug 31. How to do thematic analysis. Delve. https://delvetool.com/blog/thematicanalysis
29. Dikmen, Y., Thomas, P. J., & Wilson, H. M. (2021). The impact of enhanced learning on clinical experiences for novice nurses: Insights from nurse leaders. Journal of Clinical Nursing, 30(5), 1120-1132. https://doi.org/10.1111/jon.13567
30. Dodson TM, Reed JM, Cleveland K. 2023. Exploring undergraduate nursing students’ ineffective communication behaviors in simulation: A thematic analysis. Teaching and Learning in Nursing. 18:480-485. https://doi.org/10.1016/j.teln.2023.06.019
31. Dullwer SF, Tejero LM, Tating DLR. 2023. Filipino Nurses’ Experiences in a Collaborative Advanced Practice Model: A Critical Incidents Study. Pacific Rim International Journal of Nursing Research. 27(4):767-80. https:/doi.org/10.60099/prijnr.2023.263006
32. Ebrahimi, H., Hassankhani, H., Negarandeh, R., Azizi, A., & Gillespie, M. (2016). Barriers to support for new graduated nurses in clinical settings: A qualitative study. Nurse Education Today, 37, 184–188. https://doi.org/10.1016/j.nedt.2015.11.008
33. Evangelista L, Raymond III D, Caboral-Stevens M. 2023. Well-Being, Occupational Fatigue, and Sleep Quality among Filipino Nurses working during COVID-19. Asian Journal of Nursing Education and Research. 13(1):67-2
34. Eklund, A., Billett, S., & Nilsson, M. S. 2021. A bridge over troubled water? Exploring learning processes in a transition program with newly graduated nurses. Vol 51. doi.org/10.1016/j.nepr.2021.102982
35. Fernandez R, Sheppard S, Curtis S, Bancroft J, Smith W. 2018. Exploring the experiences of neophyte nurse mentors: A qualitative study. Vol 29.          https://doi.org/10.1016/j.nepr.2017.11.011
36. Gilbert JH. 2023. Investment in Social Capital to Mitigate Nursing Shortages Post-Pandemic. Nurse Leader. 21(1) 69-74.    https://doi.org/10.1016/j.mnl.2022.10.011
37. Glynn DM, Colleran Cook M, Cullen ML, Landers ER. 2022. Transition to pandemic: reality shock and role development for the novice nurse. Journal of Continuing Education in Nursing. 53(12):557-564. https://www.doi.org/10.3928/00220124-20221107-07.
38. Graf, A., Jacob, E., Twigg, D., & Nattabi B. 2020. Contemporary nursing graduates’ transition to practice: A critical review of transition models. Vol 29. Issue 15-16. https://doi.org/10.1111/jocn.15234
39. Hampton, A. M., Lee, R. J., & Carter, S. T. (2021). Transition programs for new nurses: Ensuring readiness for professional practice. Journal of Nursing Scholarship, 53(2), 178-187. https://doi.org/10.1111/jon.12654
40. Heede KV, Balcaen K, Bouckaert N, Bruyneel L, Cornelis J, Sermeus W, Voorde CV. 2023. Improving hospital nurse staffing during the pandemic: implementation of the 2019 fund for health care staff in belgium. Volume 128. https://doi.org/10.1016/j.healthpol.2022.11.013
41. Horowitz, S. K., Miller, L. J., & Green, A. R. (2022). The role of collaboration and guidance in the professional development of neophyte nurses. Journal of Nursing Management, 30(3), 345-356. https://doi.org/10.1111/jonm.13245
42. Kang, Y. and Hwang, H. 2022. The impact of changes in nursing practicum caused by COVID-19 pandemic on new graduate nurses. Vol 121. https://doi.org/10.1016/j.nedt.2022.105675
43. Keisuke, N., Takero, N., & Makiko, M. (2023). Clinical Simulation in Nursing: Changes in Active Class Attitudes Towards Learning and in Discussion Skills of Nursing University Students Engaged in Simulation-Based Education. International Journal of Nursing Science. Volume 79, 1-5. https://doi.org/10.1016/j.ecns.2022.12.002
44. Kenny A., Swift V. D., McKenna L., Charette M., Rush K. L., Stacey G., Darvill A., Leigh J., Burton R., Phillips C. 2021. Interventions to support graduate nurse transition to practice and associated outcomes: A systematic review. Vol 100. https://doi.org/10.1016/j.nedt.2021.104860.
45. Kelbiso, L. Belay, A., Woldie, M. 2017. Determinants of Quality of Work Life among Nurses Working in Hawassa Town Public Health Facilities, South Ethiopia: A Cross-Sectional Study. doi: 10.1155/2017/5181676
46. Kim, H. J., & Park, D. 2023. Effects of nursing professionalism and self-efficacy on job embeddedness in nurse. Vol 9 Issue 6. https://doi.org/10.1016/j.heliyon.2023.e16991               
47. Kim, J. H., & Shin, H. S. 2020. Exploring barriers and facilitators for successful transition in new graduate nurses: A mixed-methods study. Vol 36 Issue 6. https://doi.org/10.1016/j.profnurs.2020.08.006
48. Lachmann, H., and Nilsson, J. (2021). Dual use of instruments for assessing nursing students professional- and clinical competence. Vol 96 https://doi.org/10.1016/j.nedt.2020.104616.
49. Lambert, C., Wiencek, C., & Parr, J. F. 2023. Effect of Simulation-Based Training on the Self-Confidence of New Nurses in the Care of Patients with Acute Deterioration and Activation of the Rapid Response Team. Vol 54 issue 8. https://doi.org/10.3928/00220124-20230711-07.
50. Lin, H. L., Guo, J. L., Chen, H. J. and Liao, L. L. 2020. Cultural competence among pre-graduate nursing students, new graduate nurses, nurse mentors, and    registered nurses: A comparative descriptive study. Vol 97. https://doi.org/10.1016/j.nedt.2020.104701
51. Littzen-Brown C, Dolan H, Norton A, Bethel C, May J, Rainbow J. 2023. Unbearable suffering while working as a nurse during the COVID-19 pandemic: A qualitative descriptive study. International Journal of Nursing Studies Advances. 5(100127) https://doi.org/10.1016/j.ijnsa.2023.100127
52. Ma, F., Zhu, Y., Liu, L., & Liu, Y. 2023. Mediating effects of core competence between the transition shock and work readiness of newly graduated nurses in cancer hospitals: A cross-sectional study. Vol 125. https://doi.org/10.1016/j.nedt.2023.105793.
53. Matlhaba, K., & Khunou, S., 2022. Transition of graduate nurses from student to practice during the COVID-19 pandemic: Integrative review. Vol 17. https://doi.org/10.1016/j.ijans.2022.100501
54. McKenzie, R., Miller, S., Cope, V., & Cope, V., 2021. Transition experiences of newly qualified registered graduate nurses employed in a Neonatal Intensive Care Unit. https://doi.org/10.1016/j.iccn.2021.103112.
55. McCombes S. 2023. Descriptive Research Definition, Types, Methods & Examples Scribbr. Bhandari P. https://www.scribbr.com/methodology/descriptive-research/
56. Mammen, B. N., Lam, L., & Hills, D. 2023. Newly qualified graduate nurses’          experiences of workplace incivility in healthcare settings: An integrative          review. Vol 69. https://doi.org/10.1016/j.nepr.2023.103611
57. McCoach, D. B., Smith, J. R., & Johnson, A. L. (2022). Transition programs and their impact on career advancement: Balancing academic and personal responsibilities. Journal of Educational Psychology, 114(3), 245-259. https://doi.org/10.1037/edu0000500.
58. McKenzie, R., Miller, S., Cope, V., & Brand, G. 2021. Transition experiences of newly qualified registered graduate nurses employed in a Neonatal Intensive Care Unit. Vol 67. https://doi.org/10.1016/j.iccn.2021.103112 
59. Mellor PD, Bellis AD, Muller A, 2022. Psychosocial Factors Impacting New             Graduate Registered Nurses and Their Passage to Becoming Competent            Professional Nurses: An Integrative Review. Vol 13 Issue 3. https://doi.org/10.1016/S2155-8256(22)00081-3
60. Mihas P. 2023 Qualitative research methods: approaches to qualitative data analysis. P 302-313.https://doi.org/10.1016/B978-0-12-818630-5.11029-2
61. Morris G. 2023. Post-Pandemic Nursing Shortage Affecting Aspiring Nurses. https://nursejournal.org/articles/post-pandemic-nursing-shortage/
62. Nijkamp N, Calleja P, Sahay A. 2023. Transition support arrangements to support  new graduate & novice nurses’ entry into perioperative nursing: A scoping review. Vol 13. https://doi.org/10.1016/j.heliyon.2023.e23316
63. Nyhan, T., Howlin, F. 2021. From registered nurse to nursing student - Exploring     registered nurses' transition to nursing student during a post-registration       children's nurse programme: A qualitative descriptive research study. Vol 105. https://doi.org/10.1016/j.nedt.2021.105046 
64. Phillips KE, Dzurec, L, Burgess A, Beauvais A, McNutt-Clarke B. 2023.    Ramifications of the COVID-19 Pandemic on Nursing Students' Transition to Practice. Journal for Nurses in Professional Development. (6): E196-E201. https://. doi.org/10.1097/NND.0000000000000904
65. Raletooane, P. A., Plessis, E. D., & Wyk, A. V. (2022). Competency and clinical      mentoring: Perceptions of newly graduated and experienced professional       nurses in Lesotho. Vol 17. https://doi.org/10.1016/j.ijans.2022.100479 
66. Randall, P., Gagne, J. D., Lee, Eunhee, Slack, J., Lee, Y. and Ledbetter, L. 2023. The experience of resilience in newly graduated nurses: A qualitative meta synthesis. Vol 70. https://doi.org/10.1016/j.nepr.2023.103681 
67. Ravik, M., Nilsen E., Wighus, M., Mofossbakke, R., & Haanes, G. 2023. Clinical placement education during the coronavirus disease 2019 pandemic shapes new nurses: A qualitative study. Vol 5. https://doi.org/10.1016/j.ijnsa.2023.100145
68. Rinaldo, J. G., Baumgardner, R., Tilton, and T., Brailoff, V. 2022. A Nurse Mentorship Program’s Impact on Transition to Practice and Decision to Remain in Nursing for Newly Graduated Nurses. Vol 21 Issue 2. https://doi.org/10.1016/j.mnl.2022.07.003
69. Robredo JP, Ong B, Eala MA, Naguit RJ. 2022. Outmigration and unequal distribution of Filipino physicians and nurses: An urgent call for investment in health, human resource and systemic reform. The Lancet Regional Health - Western Pacific. 25 100512. https://doi.org/10.1016/j.lanwpc.2022.100512.
70. Saldaña J. 2021. The Coding Manual for Qualitative researchers. American Journal of Qualitative Research. ISSN: 2576-214. Sage Publication.ISBN-13: 978-1529731743. https://doi.org/10.29333/ajqr/12085
71. Sapar L. Oducado RM. 2021. Revisiting Job Satisfaction and Intention to Stay: A Cross-Sectional Study among Hospital Nurses in the Philippines. Nurse Media Journal of Nursing, 11(2), 133-143, August 2021. https://doi.org/10.14710/nmjn.v11i2.36557
72. Saghafi, F., Bromley, P., Guzys, D., Harkness, L., Phillips, C., Saunders, A., Say, R., Teare, C., & Tori, K. 2023. Graduate nurses' capability upon entering the workforce: An integrative review. Vol 121. https://doi.org/10.1016/j.nedt.2022.105659
73. Sahin, N. E. and Karaca, T. 2023. Do newly graduated nurses feel culturally competent. Vol 96 Issue 3. https://doi.org/10.1016/j.ijintrel.2023.101862.               
74. Seghers, P. A., Rostoft, S., Hanlon, S., Sullivan, B., Portielje, J., Wildiers, H., Soubeyran, P., & Hamaker, M. 2023. Challenges of caring for older patients with multimorbidity, including cancer. Vol 14 Issue 7. https://doi.org/10.1016/j.jgo.2023.101588.
75. Shaffer FA, Bakhshi M, Cook K, Alvarez TD. 2022. International Nurse Recruitment Beyond the COVID-19 Pandemic: Considerations for the Nursing Workforce Leader. Nurse Leader. 20(2) 161-167. https://doi.org/10.1016/j.mnl.2021.12.001
76. Shorey, S. & Wong, P. 2021. A qualitative systematic review on nurses’ experiences of workplace bullying and implications for nursing practice. Vol 7 Issue 11. https://doi.org/10.1111/jan.14912
77. Sterner A, Eklund A, Nilsson MS. 2023. Prepared to learn but unprepared for work: A cross-sectional survey study exploring the preparedness, challenges, and needs of newly graduated nurses entering a hospital-based transition program. Nurse Education in Practice. 72(103782):1471-5953. https://doi.org/10.1016/j.nepr.2023.103782
78. Tingson JD, Brazal AM. 2022. Spirituality of hopeful risk-taking (Bahala na) among Filipino healthcare workers. Journal of Public Health. 44(4) 656–657. https://doi.org/10.1093/pubmed/fdab393
79. Van Manen, M. (2016). Researching lived experience: Human science for an action sensitive pedagogy (2nd ed.). Routledge. https://doi.org/10.4324/9781315421056.
80. Villanueva R. 2023. Nurses’ group urges ILO to probe work standard violations. The Philippine Star Manila, PH. https://www.philstar.com/headlines/2023/01/24/2239743/
81. Wah See, E. C., Lin Koh, S.S., Baladram, S., & Shorey, S. 2023. Role transition of newly graduated nurses from nursing students to registered nurses: A qualitative systematic review. Vol 121. https://doi.org/10.1016/j.nedt.2022.105702
82. Wan, F., Yang, L., Zhou, N., & He, Y. 2023. Construction of learning objectives and content for newly graduated nurses in tertiary teaching hospitals: A Delphi study. Vol 121. https://doi.org/10.1016/j.nedt.2023.105716    
83. Wakefield, K., & Innes, K. 2023. Belonging in high-acuity settings: What is needed for newly graduated registered nurses to successfully transition? A qualitative systematic review. Vol 121. https://doi.org/10.1016/j.nedt.2022.105686
84. Willman, A., Bjuresäter, K., & Nilsson, J. (2020). Newly graduated nurses’ clinical competencies and need for further training in acute care hospitals. Journal of Clinical Nursing, 29(13–14), 2209–2220. https://doi.org/10.1111/jocn.15207
85. Woo MWJ, Newman SA. 2020. The experience of transition from nursing students to newly graduated registered nurses in Singapore. International Journal of Nursing Sciences. Vol 7 Issue 1. https://doi.org/10.1016/j.ijnss.2019.11.002
86. Wubneh, C., Liyew, B., & Kassew, T. 2023. Prevalence and forms of workplace violence against nurses. Vol19. https://doi.org/10.1016/j.ijans.2023.100620.
87. Xie, J., Wang, L., Wang, S., Duan, Y., Wang, K., Zhong, Z., Yan, J., Ding, S., Li, L. & Cheng, A. S. K. 2021. What influences new graduate nurses' core competencies transformation to clinical in China? A cross-sectional study. Vol 100. https://doi.org/10.1016/j.nedt.2021.104855
88. Yang, L. (2023). Construction of learning objectives and content for newly graduated nurses in tertiary teaching hospitals: A Delphi study. Vol 121. https://doi.org/10.1016/j.nedt.2023.105716       
89. Zhang R, Xiaoyun W, Zhong M, Yu C, Yu J, Jiang J, Duan X. 2023. Perspectives and experiences of newly registered nurses surrounding the objective structured clinical examination in an obstetrics and gynecology hospital: A qualitative study in Shanghai, China. Vol 124. https://doi.org/10.1016/j.nedt.2023.105754.