Bakgrund: I det nya yrket som barnmorska i en ny arbetsmiljö med nya kollegor och arbetsuppgifter är behovet av stöd från kollegor en betydande del i upplevelsen av övergången från barnmorskestudent till legitimerad barnmorska. Forskning visar att de nyutexaminerade barnmorskorna är i behov av ett strukturerat stöd men ett utarbetat mentorsprogram finns inte. Syfte: Syftet med studien var att belysa nyutexaminerade barnmorskors upplevelser av stöd från barnmorskekollegor på olika förlossningskliniker i södra Sverige. Metod: Enskilda intervjuer utfördes med åtta nyutexaminerade barnmorskor som arbetade på olika förlossningskliniker. Analysmetoden som användes var en kvalitativ innehållsanalys med induktiv ansats enligt Creswell och Creswell (2018), vilket resulterade i fyra teman. Resultat: Nyutexaminerade barnmorskorna är i behov av stöd och feedback för att känna sig trygga i den nya yrkesrollen, vilket de inte alltid får i den utsträckning de önskar. Tillgången till en mentor under det första året var en positiv aspekt för att kunna reflektera och få feedback. Ett öppet arbetsklimat och att få bekräftelse var viktigt, där mer organisation och feedback behövs. Ett strukturerat mentorskap var önskvärt. Slutsats: Stöd finns men kan förbättras genom mer bekräftelse och feedback, där ett organiserat mentorsprogram skulle kunna vara till hjälp. Det sociala stödet är en del av arbetsmiljön men då det finns brister i stödet finns risk att den nyutexaminerade barnmorskan inte känner trygghet i sitt nya yrke. / Background: In the new profession as a midwife in a new work environment with new colleagues and work tasks, the need of support from colleagues is an important aspect in the transition from a midwife student to a licensed midwife. Research shows that newly graduated midwives need a structured support but there is no such thing as a mentor program. Aim: The aim of the study was to illustrate the newly graduated midwives experience of support from midwives in different delivery wards in south Sweden. Method: Individual interviews were conducted with eight newly graduated midwives working in different delivery wards. The method of choice was a qualitative analysis with an inductive approach (Creswell & Creswell, 2018), which resulted in four themes. Results: The newly graduated midwives are in the need of support and feedback to feel comfortable in the new role as a midwife, which they do not get in the extent they wish for. The access to a mentor during the first year was a positive aspect to reflect and to get feedback from. An open work environment and to be acknowledged was important, were more organization and feedback was needed. A structured mentorship was wished for. Conclusion: Support do exist but can be improved with more acknowledgement and feedback, where a structured mentor program could be an asset. The social support is a part of the work environment but since there are deficiencies in the support there is a risk that the newly graduated midwife does not feel confident in his or her new profession.

New graduate nurses (NGNs) at bedside are faced with numerous challenges, which prompt them to leave jobs in their first year. The transition from being a student to competent nurse requires a NGN to have the necessary skills and experience. Subsequently, hospitals continue to face shortages of staff because of high turnover and low retention levels. Nonetheless, evidence from reviewed literature has indicated that the use of residency programs can increase NGNs' stay at bedside, improve retention, reduce costs of operations, and return employees' turnover. The purpose of this quality improvement project was to identify the likelihood of NGNs remaining at bedside after participating in a 52 week NGN residency program in the critical care units at Palmetto Health hospital. When a hospital recruits and retains NGNs at the bedside, the quality of life among patients is improved. Benner's theory of novice to expert was utilized to understand professional growth of nurses. Data were collected from the human resource department of the 18 nurses who initially participated in the residency program to compare retention rates before and after its implementation. The project initiative was based on a quantitative non-experimental comparison design. Based on the evidence from the human resource department, there was a 14% improvement in nurse retention 3 months after the implementation of the NGN residency program. A statewide adoption of NGN residency programs was recommended to help improve retention and enhance NGNs' professional improvement and quality of care. The implementation of NGN residency program also demonstrated implications for social change through increasing retention, building nurse competency, and enhancing quality of care delivered.

This project study addressed the problem of knowledge and skills lost by new graduate RNs while delayed in transitioning to professional nursing practice. There is a paucity of knowledge about how new RNs experience their delay and how a delay may affect their future clinical performance. Mezirow's transformation learning theory was the conceptual framework for this qualitative case study. Research questions addressed new RNs' understanding of their experiences during a delay to professional practice. A purposeful sample included 8 new RNs who had completed a New Graduate Residency Transition Program (NGRTP) after a delay to practice of 6 months to 3 years. Four managers of the RN participants were also included in the sample. Data were collected through audio-recorded semistructured interviews and manager questionnaires. Qualitative data were coded and analyzed to identify themes. Findings indicated that while waiting for a RN position, the delay to practice new RN (DTP-RN) passed through stages that reflected clinical and professional needs. The consequences of the new RNs' delay to practice may impact the required NGRTP process. Findings influenced the development of a white paper to educate hospital nurse educators and managers about the DTP-RNs' unique needs. Recommendations include a NGRTP designed to meet the transition needs of the DTP-RN. Implementation of recommendations for a NGRTP may enhance the DTP-RNs' successful transition into professional practice with a result of greater job satisfaction and decreased RN turnover.

Background: Studies have demonstrated that new graduate nurses' (NGNs) transition experience is complex and often negative leading to dissatisfaction with nursing and increased attrition. Many existing studies of NGNs' transition experience are small, qualitative, concerned with NGNs experiences in the West. No study has been conducted to date examining NGNs' transition experience in any of the developing countries where the cultural context and nursing education and practice are different to those in the West. Aim: To explore the experience of NGNs during their transition period in one of the developing countries, the Sultanate of Oman. Method: Qualitative case study utilising an embedded-single case design was conducted to investigate the transition experience of baccalaureate NGNs graduating from Sultan Qaboos University (SQU) and working at Sultan Qaboos University Hospital (SQUH). Data were collected from the perspective of NGNs and also from the perspective of other key informants using triangulated methods. This includes individual and focus group interviews, observation and documentary analysis. Results: Four over-arching themes are identified from NGNs' transition experience in the Sultanate of Oman. These are 'Studying Experience'; 'Role Transition'; 'Working Conditions' and 'Status of the Nursing Profession'. This study showed that nursing is not an attractive choice for Omani students to study and pursue as a future career because of its low status. During the transition period, NGNs experienced reality shock which mainly resulted from a theory-practice gap. NGNs had limited practical experience but a high level of theoretical knowledge, which they were unable to utilise in practice. They found the working environment to involve many competing priorities resulting in task-orientation and compromised patient care. This study showed that many NGNs resented their involvement in basic nursing care, which they believed should not be part of their role as degree nurses. Despite the challenges of the transition period, many NGNs remarked that nurses play the most important role at the hospital and they are proud being nurses. Conclusion: Omani NGNs' transition experience is complex and similar in many respects to NGNs experience in the West. However, there are distinctive challenges Omani NGNs faced due to the Omani culture, working environment and the status of nursing in Oman.

Background: Nurses’ responsibility is complex and primarily aimed at promoting health, prevent disease and patient’s suffering as well as restore health. In addition, nurses are in contact with the patient’s relatives as well as they are team leaders. Stress is a clear element in today's society and common in the caring professions and it can have a negative effect on the care. Psychological illness is common among nursing students and it might be due to concerns about their future profession. Aim: The aim was to describe the newly graduated nurses' experience of work-related stress. Method: A literature review has been conducted in which 14 scientific articles have been analyzed by similarities and differences. The key findings were identified, put under main headings and subheadings and is presented in the result. Results: Newly graduated nurses experienced a lack of clinical and academic knowledge during the first three years of their professional career. These were the most common work related stress factors. Nurses were also stressed about the responsibilities and requirements that follows the professional role. Time management and work overload were two other factors that contributed to work related stress.  Discussion: Nurses felt they have difficulties coping with the demands that followed their professional role. Heavy workload, time constraints and lack of knowledge were factors that contributed to nurse´s experience of not being able to exert control of their work. When the demands are high and there is little ability to exert control, the risk of unhealthy stress will increase. Support from employees and managers can reduce stress in working life.

Forty years after Kramer's (1974) seminal work, Reality Shock, new graduate nurses continue to have difficulty transitioning to the registered nurse (RN) role. The purpose of this phenomenological study explores the lived experience of new graduate nurses who completed a Veterans Affairs externship program in their senior year of nursing coursework and its perceived impact on their successful transition into the practice role 3-24 months following graduation. Benner's (1984) Novice-to-Expert Model, Karmer's (1974) Reality Shock Theory, and Selder's (1989) Life Transition Theory support a framework for this study. Twelve telephone interviews were conducted using van Manen's (1990) method for researching the lived experience. One overarching theme "feeling confident" and three main categories, "transitioning to the RN role," "making decisions," and "interacting with professionals," were identified from the data. Externship programs assist the student to comfortably and smoothly transition as a new graduate nurse by offering additional clinical and practice experiences. Given the complexity of today's health care environment, there is a growing need to better prepare the graduate nurse for their transition into nursing practice. Externship programs can serve this purpose.

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Background: Newly graduate nurses experience the transition into working as a nurse as overwhelming due to a lack of work experience. Working with acutely ill patients requires readiness to act where not only adequate treatment and interventions are important but also where every second matters. Aim: The aim was to describe newly graduated nurses’ experiences of caring for acutely ill patients. Method: A literature review was carried out using Friberg’s four-step model where data from a total of nine studies with quantitative and qualitative research studies were analyzed. Results: The result emerged in two categories and five sub-categories that indicated that newly graduated nurses feel unprepared and insecure in handling and treating acutely ill patients. They question their ability to care for their patients and are afraid of making mistakes which may cause harm to the patient. Newly graduated nurses also felt an urge to take control of the acute situation. The five sub-categories are as followed: fear of making mistakes, feeling unprepared, take control, feelings of inadequacy and lastly questioning one’s ability. Conclusion: Collegial support and having a preceptor were crucial factors that facilitated newly graduated nurses to adequately care for acutely ill patients. By giving the right support to newly graduate nurses they feel less afraid, stressed and less overwhelmed. Readiness to act was found to be something that a nurse developed over time and by experiencing acute situations. / Populärvetenskaplig sammanfattning Att börja arbeta som nyexaminerad sjuksköterska kan vara utmanande, särskilt vid vård av akut sjuka patienter som kan bli försämrade väldigt hastigt. Akuta situationer kräver snabba åtgärder vilket kan upplevas extra påfrestande för den nya sjuksköterskan. Akut sjuka patienter kan påträffas oavsett vilken typ av arbetsplats som sjuksköterskan är verksam inom, och snabbt insättande åtgärder och en tillgänglig vård kan minska miljontals dödsfall och funktionsnedsättningar världen över. Den här litteraturöversikten utgick från ett sjuksköterskeperspektiv och hade som syfte att beskriva hur nyexaminerade sjuksköterskor upplevde att vårda akut sjuka patienter. Studiens resultat bestod av nio vetenskapliga artiklar och påvisade chockartade upplevelser där de nyexaminerade sjuksköterskorna var oförberedda och var rädda för att göra misstag. De strävade också efter att skapa kontroll i den akuta situationen, vilket kunde uppnås genom stöd från kollegor och erfarenhet av akuta situationer. Resultatet beskrev också upplevelser av att inte kunna möta kraven i det nya yrket med känslor där den nyexaminerade sjuksköterskan ifrågasatte sin egen förmåga och kände sig otillräcklig. I bakgrunden beskrevs sjuksköterskeprofessionen och dess kärnkompetenser, vidare beskrevs akutsjukvård och de vårdvetenskapliga begreppen “vårdande” och “handlingsberedskap” som kan relateras till akutsjukvård. I metoden användes totalt nio vetenskapliga artiklar, varav sex kvalitativa, två kvantitativa och en med både kvalitativ och kvantitativ metod. I diskussionen diskuterades nyexaminerade sjuksköterskors reaktioner på akuta situationer och olika typer av påverkan som kollegor kan ha. Stöd från kollegor och en tilldelad handledare var faktorer som möjliggjorde för den nyexaminerade sjuksköterskan att vårda akut sjuka patienter. Rätt stöd minskade rädsla, stress och gjorde sjuksköterskan mindre överväldigad.

Sjuksköterskor väljer att lämna yrket på grund av rådande arbetsvillkor. I den kliniska verkligheten är det högt arbetstempo samtidigt som krav och ansvar över patienten måste uppfyllas. Nyutexaminerade sjuksköterskor upplever en hög stressbelastning vilket ger konsekvenser på hälsan och ökar benägenhet att vilja lämna professionen. Sjuksköterskans kärnkompetens handlar om att främja patientens hälsa och lindra lidande samtidigt som den egna hälsan ska skötas så förmågan att ge en god vård inte äventyras. En komplex problematik för den enskilde individen och samhället. Syftet med studien var att undersöka upplevelser av orsaker till stress i arbetet bland nyutexaminerade sjuksköterskor. Metoden som använts är en litteraturöversikt över befintligt forskningsläge där både kvalitativa och kvantitativa studier har sammanställts. I databearbetningen framkom tre teman, Känsla av otillräcklighet, Känsla av utsatthet och utanförskap samt Individen i professionen. Resultatet visar att nyutexaminerade sjuksköterskor upplever ett flertalstressfaktorer och att det verkar vara en allmängiltig upplevelse runt om i världen i denna yrkesgrupp. Upplevelser av orsaker till stress visades i samband med rollanpassning, klinisk kompetens, hantering av palliativ vård, konflikter, brist på stöd, mobbning, arbetsbelastning samt schema. Ålder, yrkeserfarenhet och karaktärsdrag påverkade upplevelsen av arbetsrelaterad stress och det framgick att vissa grupper av nyutexaminerade sjuksköterskor har en ökad sårbarhet. Dessa kunskaper är viktiga för att utveckla strategier som kan minska stressrelaterad ohälsa i denna yrkesgrupp och föra yrket mot en mer hållbar utveckling. / Nurses choose to leave the profession because of prevailing working conditions. In the clinical reality, it is a high workload, while demands and responsibilities over the patient must be fulfilled. Newly graduated nurses experience high rate of stress load, which have consequences on their health and increases the tendency for wanting to leave the profession. The core competence of the nurse’s is about promoting the patient’s health and alleviating suffering while at the same time managing their own health so that the ability to provide good care is not compromised. A complex problem for the individual and society. The purpose of the study was to investigate experiences of causes of stress in the work of newly graduated nurses. The method used is a literature review of the existing research situation where both qualitative and quantitative studies have been compiled. In the data processing, three themes could be revealed, Feeling of inadequacy, Feeling of vulnerability and exclusion and The person in the profession. The result shows that newly graduated nurses experience a number of stress factors and that it seems to be a universal experience around the world in this professional group. Experiences of causes of stress were shown in connection with role adaptation, clinical competence, management of palliative care, conflicts, lack of support, bullying, workload and schedule. Such as age, professional experience and character traits affected the experience of work-related stress and it emerged that certain groups of newly graduated nurses have an increased vulnerability. These insights are important for developing strategies that can reduce stress-related ill-health in this professional group and lead the profession towards a more sustainable development.

Every year, millions of medical errors are committed, costing not only patient health and satisfaction, but thousands of lives and billions of dollars. Errors occur in many areas of the healthcare environment, including the profession of nursing. Nurses provide and delegate patient care and consequently, standard nursing responsibilities such as medication administration, charting, patient education, and basic life support protocol may be incorrect, inadequate, or omitted. Although there is much literature about errors among the general nurse population and there is indication that new nurses commit more errors than experienced nurses, not much literature asks the following question: What are the factors contributing to the commission of errors, including the omission of standard nursing care, among new nurses? Ten studies (quantitative, qualitative, and mixed-mode) were examined to identify these factors. From the 10 studies, the researcher identified the three themes of lack of experience, stressful working conditions, and interpersonal and intrapersonal factors. New nurses may not have had enough clinical time, may develop poor habits, may not turn to more experienced nurses and other professionals, may be fatigued from working too many hours with not enough staffing, may not be able to concentrate at work, and may not give or receive adequate communication. Based on these findings and discussion, suggested implications for nursing practice include extended clinical experience, skills practice, adherence to the nursing process, adherence to medications standards such as the five rights and independent double verification, shorter working hours, adequate staffing, no-interruption and no-phone zones, creating a culture of support, electronically entered orders, translation phones, read-backs, and standardized handoff reports.