The importance of nurse residency programs is addressed in the literature; however, a review of residency program outcomes and effectiveness is needed. Guided by Roy's adaptation model and Deming's plan-do-check-act model, the purpose of this quality improvement project was to assess the current state of a longstanding critical care nurse residency program in meeting organizational goals and objectives and to recommend modifications to the program related to external factors, internal challenges, and educational deficits of nurses entering the program. A review of the evidence-based literature and feedback from focus groups of leadership stakeholders were used to develop recommendations for residency program improvement. Using qualitative analysis of the focus group data, three common themes emerged related to external factors: financial resources, patient acuity, and generational differences that influence nurse satisfaction with the residency program. Three additional themes emerged related to organizational barriers to satisfaction with the program: preceptor availability and development, limited training hours due to productivity standards, and leader time to support novice nurses. Reality shock when starting to practice in the high acuity critical care area was the most frequently reported educational deficit among new nurses. Recommendations for program improvement included obtaining feedback from residency program participants and preceptors, initiating preceptor development pathways, reinstituting a dedicated cost center for nurse residents' training, and using competency assessment tools to customize training plans for residency program participants. This project has the potential for social change by increasing job satisfaction and retention of new nurses and improving health outcomes in critical care patients.

After nursing school, graduate nurses complete a licensure examination to demonstrate possession of the minimal knowledge necessary to practice nursing. Even with the successful completion of the examination, many new graduate nurses still lack the competencies required for safe practice. This discrepancy between demonstrated knowledge and competent practice, which is termed a transition-to-practice gap, is a safety issue especially for persons with chronic illnesses. The purpose of this study was to identify and clarify this transition gap to determine possible solutions in the local setting of a large health care system. The theoretical model framing this investigation was Benner's novice to expert theory. A descriptive case study was used to answer the research question regarding which competencies new graduate nurses should possess to facilitate their transition from an educational setting to a practice setting. Purposeful sampling yielded 4 nursing staff educators who had worked with graduate nurses in the past 12 months. Data from interviews with participants were coded using in vivo, initial, and axial coding. Participants reported that graduate nurses lacked adequate communication, socialization, and technical skills. Poor communication and socialization proficiencies compromised collaborative patient care, while the absence of technical skills such as physical assessment impaired direct patient care. Findings supported the development of a transition-to-practice course to prepare graduate nurses to provide quality health care. The implications of social change resulting from this transition-to-practice course may include the positive transformation of new graduate nurses, the improved professional nursing practice setting, and the positive health outcomes of community members.

<p><strong>AIM</strong>: To investigate  newly graduated nurses opinions on their introduction and preceptorship at Akademiska Sjukhuset in Uppsala. <strong>METHOD</strong>: A descriptive cross-sectional study using qualitative and quantitative evaluations. Data was collected by a questionnaire containing open and closed questions. Totally 42 participants took part in the study. Data analysis was obtained using descriptive statistics, thematic analysis and content analysis. <strong>RESULT</strong>: A majority considered the orientation of premises received as adequate and of significance for the adaption to their profession. A competent, dedicated, calm and pedagogical preceptor resulted in increased motivation, sense of security and learning as well as self-confidence. A stressed, unavailable, unconcerned or passive preceptor had the result that the introduction was unsatisfactory and that stress could intervene with the own way of working. Access to a mentor was considered to have a rather large significance for professional development. A majority considered that they were sufficiently or reasonably prepared for their profession after completion of their introduction. Good atmosphere, supportive co-workers, independency and clear ward-routines were considered as positive elements for professional development. Element as stress, lack of time and structure and were listed as negative. The participants requested clearer ward-routines, increased continuity and longer introduction.  <strong>CONCLUSION</strong>: Several elements and qualities in the preceptor was shown to be of positive or negative significance. Suggestions for improvement of preceptorship and introduction at Akademiska sjukhuset, is to make use of and to integrate with the work of the wards. Further  research in Sweden is necessary.</p>

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AIM: To investigate  newly graduated nurses opinions on their introduction and preceptorship at Akademiska Sjukhuset in Uppsala. METHOD: A descriptive cross-sectional study using qualitative and quantitative evaluations. Data was collected by a questionnaire containing open and closed questions. Totally 42 participants took part in the study. Data analysis was obtained using descriptive statistics, thematic analysis and content analysis. RESULT: A majority considered the orientation of premises received as adequate and of significance for the adaption to their profession. A competent, dedicated, calm and pedagogical preceptor resulted in increased motivation, sense of security and learning as well as self-confidence. A stressed, unavailable, unconcerned or passive preceptor had the result that the introduction was unsatisfactory and that stress could intervene with the own way of working. Access to a mentor was considered to have a rather large significance for professional development. A majority considered that they were sufficiently or reasonably prepared for their profession after completion of their introduction. Good atmosphere, supportive co-workers, independency and clear ward-routines were considered as positive elements for professional development. Element as stress, lack of time and structure and were listed as negative. The participants requested clearer ward-routines, increased continuity and longer introduction.  CONCLUSION: Several elements and qualities in the preceptor was shown to be of positive or negative significance. Suggestions for improvement of preceptorship and introduction at Akademiska sjukhuset, is to make use of and to integrate with the work of the wards. Further  research in Sweden is necessary.

Bakgrund: En sjuksköterska har stora och varierande arbetsuppgifter och en nyutexaminerad sjuksköterska förväntas göra arbetsuppgifter de inte känner sig kvalificerade för, men ansvariga för, i en miljö som andas stress. I övergången från student till arbetsliv är det många nyutexaminerade som väljer att lämna yrket när ansvaret blir alltför överväldigande. Syfte: Syftet med denna litteraturstudie var att undersöka nyutexaminerade sjuksköterskors erfarenheter av stöd på arbetsplatsen. Ett ytterligare syfte var att beskriva datainsamlingsmetoden i resultatets ingående artiklar. Metod: Litteraturstudien hade en deskriptiv design bestående av 13 systematiskt sökta artiklar. Databaserna Cinahl och Pubmed användes för artikelsökning. Huvudresultat: Resultatet visade att stöd i olika former kunde vara en ovärderlig hjälp för att klara av arbetet och för att hitta yrkesrollen. Stödet kunde komma från introduktion, att lära sig hur arbetsplatsen fungerar, möjlighet till utbildning, kollegor, handledare/mentorer och chefer. Slutsats: Nyutexaminerade sjuksköterskor upplevde stödet viktigt för att de skulle vilja stanna kvar och trivas på arbetsplatsen samt för möjligheten att växa in i sjuksköterskerollen och utvecklas till kompetenta sjuksköterskor. Författarna till föreliggande litteraturstudie tolkar resultatet som att arbetsplatser bör se över sina rutiner för introduktion, information och strategier för utslussning och mottagande av nyutexaminerade sjuksköterskor då dessa är sjukvårdens framtid vilka tryggt ska vårda patienter. / Background: A nurse has large and varied tasks where a newly graduated nurse is expected to do work they do not feel qualified, but responsible for in an environment that breathe stress. In the transition from student to working life, many graduate choose to leave the profession when the responsibility becomes too overwhelming. Purpose: The purpose of this study was to investigate newly graduated nurses experience of support in the workplace. A further aim was to describe data collection method in the result's depth articles. Method: The literature study had a descriptive design consisting of 13 systematically searched items. Databases Cinahl and Pubmed was used for article search. Main Results: The results showed that various forms of support could be an invaluable help to do the work and to find the professional role. The support could come from introduction, to learn how the workplace works, access to education, colleagues, tutors / mentors and managers. Conclusion: Newly graduated nurses felt that support was important to remain and thrive in the workplace as well as for the opportunity to grow into the nursing role and become qualified nurses. The authors of this literature interprets the result as workplaces should review their procedures for the introduction, information and strategies for channeling out and reception of newly graduated nurses since these are the future of health care which should be safely care for patients.

Nursing competence is a necessity as it affects public health, safety and welfare; however there are very few reliable and valid tools that measure nursing competence. The Nurse Competence Scale has been used in many different countries outside of the United States and is based on Benner’s Novice to Expert theory. The purpose of this study was to examine the content validity of the Nurse Competence Scale using a mixed methods approach. Descriptive statistics were used to report results of the frequency of use scale and the critical to practice scale. Nursing faculty indicate Prioritizing My Activities Flexibility According to Changing Situations in the Managing Situations category of the Nurse Competence Scale as most frequently used. Nursing faculty rated Acting Appropriate in Life Threatening Situations as most critical to practice. Based on the results from this study, there is evidence to support the content validity of the Nurse Competence Scale in the United States. Results may be used to assess students prior to National Council Licensure Examination and may further the discussion on how nursing competence is measured globally. Additional research is need on the use of the NCS in the United States.

Evidence-based practice (EBP) is a key driver of care and advancements within nursing. It is essential to emphasize EBP early in a nurse's career to promote inquisitive minds and enthusiasm for seeking evidence. The purpose of this project was to implement an EBP mobile app into a nurse residency program (NRP) to improve the process of providing EBP information and resources to new graduate nurses. The intent of the project was to leverage mobile technology to engage new graduate nurses in evidence-based practice. Roger's diffusion of innovation framework guided the project. The target audience for the project was 16 new graduate RNs participating in a health system's NRP who attend the EBP module and were required to complete an EBP project. The EBP module was provided during a classroom lecture and the mobile application was downloaded. After using the EBP module, all attendees were sent an electronic survey with open-ended questions related to the mobile application. Responses were reviewed to identify patterns. Survey responses reflected that a 50% did not utilize the mobile application. However, those that did use the mobile application (50%) found it useful and had a positive perception of the mobile application. Continued use of the mobile application and promotion of the mobile application for new graduate nurses may help with their own personal development of an EBP project. Ultimately, allowing nurses to effectively integrate nursing research into practice and impact patient care quality. This project impacted social change by empowering new nurses with knowledge and information related to evidence based practice and allowed for increased information to be accessible to a large audience of new graduate nurses.

Bakgrund: Behovet av legitimerade sjuksköterskor förväntas öka de kommande åren. Högskolor och hälso- och sjukvården har en utmaning i att locka till sig fler att utbilda sig och stanna kvar inom sjuksköterskeyrket då många blir sjukskrivna på grund av utmattning eller slutar redan det första året som yrkesverksam. Syfte: Att beskriva nyutexaminerade sjuksköterskors upplevelser av yrket. Metod: En beskrivande litteraturstudie med resultat från 13 stycken artiklar, som alla sökts fram i PubMed via biblioteket på Högskolan i Gävle. Huvudresultat: I studien framkom 3 huvudteman med tillhörande underteman: En överväldigande start på arbetslivet, Arbetsmiljö och Från Novis till erfaren. Nyutexaminerade sjuksköterskor upplevde övergången från utbildningen till arbetslivet som svår, med brist på klinisk erfarenhet under studietiden. Detta bidrog till stress och en känsla av otillräcklig kompetens samt till att en holistisk omvårdnad inte hanns med. Bra arbetsmiljö och handledning med återkoppling från handledare, kollegor och chef beskrevs ha stor inverkan på den nyutexaminerade sjuksköterskans upplevelse, självförtroende och kompetens. Slutsats: Många sjuksköterskor upplevde brister i kliniska färdigheter och kände sig osäkra i sin nya yrkesroll vilket antyder att sjuksköterskeutbildningen bör integrera mer praktik med teorin. I studiens resultat framgår det att tryggheten och självförtroendet kommer med tiden, det gäller att inte ge upp under den första tiden med osäkerhet i den nya yrkesrollen, vilket stämmer väl överens med Benners modell Från novis till expert. / Background: The need for licensed nurses is expected to increase in the coming years. Universities and health care face a challenge in attracting more people to study and stay in the nursing profession as many either take sick leave due to exhaustion or quit during their first year as a professional nurse. Aim: To describe newly graduated nurses' experiences of the profession. Method: A descriptive literature study with results from 13 articles, all of which were searched for in PubMed via the library at the University of Gävle. Main results: In the study, 3 main themes emerged with associated sub-themes: An overwhelming start to working life, Work environment, and From novice to experienced. Newly graduated nurses experienced the transition from education to working life as difficult, with a lack of clinical experience during their studies. This contributed to stress and a feeling of insufficient competence, as well as a lack of holistic nursing. Good work environment and supervision with feedback from supervisors, colleagues and the manager was described as having a great impact on the newly graduated nurse's experience, self-confidence and competence. Conclusion: Many nurses experienced shortcomings in clinical skills and felt insecure in their new professional role, which suggests that nursing education should better integrate more practice with theory. The results of the study show that security and self-confidence come with time; it is important not to give up during the first period of insecurity and uncertainty in the new professional role, which is in good agreement with Benner's model From novis to expert.