Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

New Graduate Nurse Transition Programs: Relationships with Bullying and Access to Support

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

New Graduate Nurse Transition Programs: Relationships with Bullying and Access to Support

Article excerpt

New nurse graduates' transition to practice is considered to be as challenging today as almost 40 years ago when Kramer (1974) termed the transition a reality shock. New graduate nurses are expected to assume an expanded role that often involves new and unfamiliar expectations for clinical and interpersonal competence. This transition is especially overwhelming when the workplace environment is not supportive but rather is characterized by horizontal violence and bullying (Kramer, Brewer, & Maguire, 2011). Transition programs have emerged to facilitate transition by providing new graduate nurses with a supportive and nurturing learning environment and with improved access to support people and resources. Whether new graduate programs enhance new nurses' perceptions of support and mitigate negative work environments (e.g., bullying and harassment) is currently unknown. The purpose of this study was to examine the relationships between access to support, workplace bullying and new graduate nurse transition within the context of new graduate transition programs.


Support has been identified as key to successful transition of new graduates (Levett-Jones & FitzGerald, 2005). Clarke and Springer (2012) described new graduates who felt valued and supported as having greater professional satisfaction and overall commitment to the organization. Transition programs designed specifically for new graduates have been described in terms of support because of the additional educational and people resources they make available to facilitate integration. In their qualitative study, Johnstone, Kanitsaki, and Currie (2008) found that appropriate support tailored to new graduates in a transition program allowed them to progress from novice to advanced beginner level practitioner within 3-4 months. The value of people supports/resources, such as preceptors, mentors, and peers, has been highlighted in a number of qualitative studies related to new graduate transition (Kaihlanen, Lakanmaa, & Salminen, 2013; Kary, 2012). In her integrative review of the literature, Kary (2012) found that preceptor support that was constant and consistent was key for new graduates during orientation. New graduates who did not have consistent preceptors felt less supported (Johnstone et al., 2008). Kaihlanen et al. (2013) found that mentors served as role change supports by identifying with the role of being a new graduate and sharing personal experiences about adjusting to work life.

Staff and peer-support have been shown to be important to new graduate transition. New graduates who remained in their acute care practice after 2 years of employment indicated that the sense of community and support they felt on their hospital units was the biggest contributor to their retention (Zeller, Doutrich, Guido, & Hoeksel, 2011). Yet new graduates have described a lack of acceptance and respect, and an insensitivity of experienced nurses to their needs for continued development in time management skills (Casey, Fink, Krugman, & Propst, 2004). Transition programs that have provided peer-support opportunities for new graduates to meet and discuss their transition experiences have assisted new graduates in coping with the stress and emotions experienced during transition and to offer moral support (Fink, Krugman, Casey, & Goode, 2008; Keller, Meekins, & Summers, 2006). Few studies have addressed the relationship between access to support and new graduate transition experiences and whether it differs between new graduates participating in a new graduate program and those not participating in a program.

Bullying and horizontal violence

Although new graduates expect support they may not always receive it. They often experience horizontal violence and bullying, a trend reported in the nursing literature for more than two decades (Woelfle & McCaffrey, 2007). Prevalence rates ranging from 33% to over 50% have been reported among new graduate nurses (Clare & Loon, 2003; Laschinger, Grau, Finegan, & Wilk, 2010; McKenna, Smith, Poole, & Coverdale, 2003). …

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