Background: The transition and retention of newly graduated nurses are worldwide problems. With the nursing shortage and 33-61% of newly graduated nurses leaving their job within the first year, newly graduated nurses need to be work ready. Work readiness of new nurses is a new concept developed in Australia. Significance: New nurses are a vulnerable population that is dependent upon experienced nurses for knowledge, skills, and socialization into the profession. However, new nurses often experience rudeness, humiliation and conflict influencing professional success, patient care, and retention. Purpose: To apply the Work Readiness Scale – Graduate Nurses (WRS-GN) to a population of Baccalaureate (BSN) and Master’s Entry into the Profession of Nursing (MEPN) graduates from a southwestern university and determine if there is a relationship between the variables of work readiness, individual experiences of graduates, and the two groups. Research questions included: 1) What is the relationship between work readiness (social intelligence, personal work characteristics, work competence, and organizational acumen) and individual experiences? 2) Do newly graduated BSN and MEPN degree nurses differ on the WRS-GN constructs of social intelligence, personal work characteristics, work competence, and organizational acumen? Method: Descriptive correlational study with a convenience sample of graduates from a southwestern university. Participants received a survey through their school email account and a message was placed on the Alumni Facebook page. Results: Thirty participants (9.2% response rate), 93.3% were female, and 76.7% work in Arizona. None of the participants were planning to leave the profession of nursing in the next year. A statistically significant relationship was detected between work competency and length of nurse residency (r=.44, p=0.02) and a negative relationship was detected between personal work characteristics and nurse residency (r=-.41, p=0.02). No relationship was detected between the two groups and constructs of work readiness. Implications/conclusions: Work readiness is complex. Longer nurse residency is associated with greater work competence. Academia and employers should collaborate and provide courses that enhance the work readiness of newly graduated nurses. The WRS-GN has been tested once in a population of Australian graduate nurses therefore further research is needed to validate the WRS-GN.

Background: Work-related stress among newly graduated nurses is a problem that results in ill health for the nurses and negatively impacts patient care, risking patient safety. For newly graduated nurses to provide quality and safe nursing care despite work-related stress, it is necessary to understand their experience regarding how work-related stress affects their nursingpractice. Purpose: The aim was to shed light on newly graduated nurses' experiences of work-related stress. Method: A general literature review, including ten original articles, was analysed using Graneheim & Lundmans method of qualitative content analysis. Results: The results of the literature study identified two categories and five subcategories: The transition from theory to practice with the subcategories of Managing unexpected workload, Being clinically ignorant, and Fear of making mistakes. New to the team with subcategories, Adapting to the healthcare team and Meeting expectations. Conclusions: The experience of work-related stress among newly graduated nurses affects their nursing practice and jeopardizes patient safety. With support from experienced nurses, colleagues, and adequate preparation, the transition process can be facilitated, enabling newly graduated nurses to provide quality and safe nursing care more easily. Further research: A longitudinal study would enable investigation of possible patterns and trends regarding stress levels, coping strategies and their impact on nurses' well-being, with a specific focus onnursing work and patient safety.

Syftet med studien var att beskriva nyutexaminerade sjuksköterskors upplevelser av arbetsrelaterad stress samt att beskriva deras upplevelser av vad stress kan leda till för konsekvenser. En deskriptiv intervjustudie med kvalitativ ansats genomfördes. Datainsamlingen utfördes genom åtta semistrukturerade intervjuer. Det insamlade materialet analyserades med kvalitativ manifest innehållsanalys. Huvudresultatet påvisade att nyutexaminerade sjuksköterskor har upplevt stress under sin första tid i yrket, bland annat till följd av att det är en tid av osäkerhet. Nyutexaminerade sjuksköterskor har beskrivit att upplevelsen av stress har minskat med tilltagna kunskaper och erfarenheter samt minskade krav på sig själv i yrkesrollen. Sjuksköterskeyrket har beskrivits vara stressigt på grund av en mängd olika orsaker men det finns åtgärder som kan vidtas för att minska stressen. Stressen har beskrivits kunna leda till konsekvenser både för sjuksköterskan som individ och för omvårdnaden av patienterna, vilket har beskrivits kunna resultera i känslor som frustration och otillräcklighet. I linje med Benners teori kan konstateras att nyutexaminerade sjuksköterskor genomgår en yrkesutveckling vilken leder till en upplevelse av minskad stress. Stress inom sjuksköterskeyrket är ett komplext problem som måste angripas från flera håll. För den nyutexaminerade sjuksköterskan är det av stor vikt att vara snäll mot sig själv i yrkesrollen genom att inte ha för höga krav på sig själv, detta för att kunna utöva sin yrkesroll som innebär att bedriva optimal patientfokuserad omvårdnad. / The aim of the study was to describe newly graduated nurses' experiences of work-related stress and to describe their experiences of what consequences stress can lead to. A descriptive interview study with qualitative approach was used. Data collection was performed by eight semi-structured interviews. The collected data was analyzed using qualitative manifest content analysis. The main result demonstrates that newly graduated nurses experienced stress in the beginning of their profession, partly because it is a time of uncertainty. Newly graduated nurses have described a decreased experience of stress with increased knowledge and experience, and reduced demands on herself in the professional role. Nursing is described to be stressful due to a variety of causes but there are measures that can be used to reduce stress. Stress has been described to cause consequences both for the nurse as an individual and for the care of patients, which has been described to result in feelings such as frustration and inadequacy. In line with Benner's theory it can be stated that newly graduated nurses undergo a professional development which lead to a experience of decreased stress. Stress in the nursing profession is a complex problem that must be dealt with on several fronts. For the newly graduated nurse it is very important that she is gentle with herself in the professional role by not having too high demands on herself to be able to practice her profession, that is carry out optimal patient-focused nursing.

Bakgrund: Det råder stor brist på sjuksköterskor. Nyutexaminerade sjuksköterskor är en grupp som löper hög risk att drabbas av utbrändhet och upp till var femte sjuksköterska överväger att lämna yrket inom sina första fem år. Många av de nyutexaminerade sjuksköterskorna känner sig oförberedda inför sjuksköterskeyrket och flera studier påvisar glappet mellan teori och praktik. Syfte: Att beskriva utmaningar den nyutexaminerade sjuksköterskan upplever under det första yrkesverksamma året. Metod: Studien har genomförts som en litteraturöversikt. Med hjälp av sökdatabaserna CINAHL och PubMed ligger totalt 20 artiklar till grund för resultatet. Resultat: Ett flertal faktorer beskrivs av nyutexaminerade sjuksköterskor som utmaningar. Däribland glappet mellan teori och praktik, bristen på stöd och handledarskap, kunskapsbrist, dålig arbetsmiljö, bemanningsbrist samt en allt mer komplex vård med multisjuka patienter som kräver en expertis som den nyutexaminerade sjuksköterskan omöjligt kan besitta. Slutsats: Utmaningarna som presenteras i litteraturöversiktens resultat är välkända och globala problem men också påverkbara. Fokus bör ligga i både att tillsätta nya sjuksköterskor men framförallt i att värdera och ta vara på de som redan finns. Nyutexaminerade sjuksköterskor behöver bättre stöd när de äntrar arbetslivet samt att utbildningen ses över för att motsvara verkligheten och förbereda inför arbetslivet så bra som möjligt. / Background: There is a great shortage of nurses. Newly graduated nurses are a group at high risk of being burned out and up to every fifth nurse is considering leaving the profession within its first five years. Many of the newly graduated nurses feel unprepared for the nursing profession and several studies show the gap between theory and practice. Aim: Describing challenges the newly graduated nurse experiences during the first year of working. Method: The study has been conducted as a literature review. With the help of the search databases CINAHL and PubMed, a total of 20 articles form the base for the result. Result: Several factors are described by newly graduated nurses as challenges. This includes a theory-practice gap, the lack of support and mentoring, a lack of knowledge, poor work environment, staff shortages and an increasingly complex care with patients have multiple ilnesses who require an expertise that the newly graduated nurse cannot possibly possess. Conclusion: The challenges presented in the literature review's results are well-known and global problems, but also influential. The focus should be on both appointing new nurses but more importantly valuing the ones already employed/working. Newly graduated nurses need better support when they enter the workplace, much also indicates that the education should be looked over in order to match the reality and prepare the students for work life as well as possible.

Syfte: Syftet med studien var att undersöka nyutexaminerade sjuksköterskors upplevelser av deras första yrkesverksamma år och om utbildningen ger en tillräcklig förberedelse inför yrket. Metod: Åtta nyutexaminerade sjuksköterskor intervjuades om deras upplevelser och innehållet analyserades med hjälp av en kvalitativ innehållsanalys. Sju kategorier och 19 subkategorier framkom. Resultat: Studien visar att de nyutexaminerade sjuksköterskorna var förväntansfulla inför sitt nya yrke men kände samtidigt rädsla och oro inför det stora ansvaret och kraven som ställs inom sjuksköterskans profession. Arbetet upplevdes som stressigt och svårt men med hjälp av stöd och gott bemötande från kollegor och arbetsledare kunde arbetet underlättas och sjuksköterskan kunde känna trygghet. Utbildningen gav grundläggande kunskaper men deltagarna ansåg att kraven och nivån var för låg i utbildningen. De upplevde att de saknade kunskap för det specifika kirurgiska verksamhetsområdet de arbetade inom samt för akutsjukvård. Vissa kurser ansågs som för omfattande medan andra kunde utökas. Slutsats: En bättre förberedelse under utbildningen samt ett bra stöd till nyutexaminerade sjuksköterskor kan underlätta övergången från student till yrkesverksam sjuksköterska och därmed bidra till en högre patientsäkerhet. / Aims: The aims of this study was to investigate newly graduated nurses' experiences of their first professional year and if the nursing education provides enough preparation for the profession. Method: Eight newly graduated, registered nurses were interviewed about their experiences and the content was analyzed using a qualitative content analysis. Seven categories and 19 subcategories revealed. Results: The newly graduated, registered nurses were excited about their new profession, but also felt fear and concern about the great responsibility and demands of the nursing profession. The work was perceived as stressful and difficult but with the support and good treatment from colleagues and supervisors could simplify the work and the nurse could feel more confident. The education provided basic knowledge but the participants felt that the demands and the standards were too low. They felt that they lacked specific knowledge of the ward and for emergency care. Some courses could be considered too wide while others could be expanded. Conclusion: A better preparation and a good support for the newly graduated, registered nurses can ease the transition from student to professional nurse and thereby contribute to greater patient safety.

Sigrid Wangensteen has the recent years been engaged in doctoral studies at Karlstad University in combination with teaching at the bachelor program in nursing at Gjøvik Universtity College. This doctoral thesis is focused on newly graduated nurses, their perception of competence, critical thinking dispositions, research use and their experiences of being a nurse during their first year as a nurse. Qualitative and quantitative methods were used. The very first period of time was experienced as tough but when looking back the newly graduated nurses appreciated the tough time. They described the need for a supportive environment, and gaining competence through managing challenging situations. The leadership role constituted the main difference between being a student and being a nurse. In the quantitative study the nurses perceived their competence as good, rating the Helping role competence category highest and the Ensuring quality competence category lowest. With respect to critical thinking the CCTDI total scores indicated a positive disposition. As regards the CCTDI subscale scores the nurses reported highest values for intellectual curiosity (Inquisitiveness) and lowest for intellectual honesty (Truth-seeking). The nurses reported a positive attitude towards research, but only 24% were classified as research users. Supportive environment was a significant predictor for research use. Critical thinking was a prominent predictor for attitude towards research, for research use and perception of competence. Nurse leaders in clinical practice and nurse educators in nursing education and clinical practice play an important role in nurturing student nurses and newly graduated nurses with respect to critical thinking. There is a need to assess whether teaching strategies meet the requirements of critical thinking and EBP in nursing education.

Bakgrund: Sjuksköterskeyrket anses vara viktigt, där erfarenhet utvecklas över tid. Det finns flera förväntningar på sjuksköterskan från patienter, kollegor, anhöriga och den framtida sjuksköterskan. Arbetssituationen kan vara utmanande, med förändrade och varierande arbetsuppgifter. Syfte: Syftet var att beskriva nyutexaminerade sjuksköterskors erfarenheter av att arbeta som sjuksköterska under sitt första verksamma år och anpassningen som sker under övergången mot självständighet. Metod: En beskrivande litteraturstudie med ett resultat som baserades på 12 vetenskapliga artiklar som erhållits genom databassökning via PubMed och Cinahl. Litteraturstudien analyserade och tematiserade resultatets vetenskapliga artiklar. Huvudresultat: Nyutexaminerade sjuksköterskor upplevde svårigheter att komma in i arbetsgruppen, samtidigt kämpade de för att hinna utföra tilldelade arbetsuppgifter. Svårigheter kunde uppstå gällande att leva upp till krav och förväntningar från kollegor respektive arbetsgivare. Relationen till de nya kollegorna kunde påverka övergångsprocessen för nyutexaminerade sjuksköterskor, där konflikter och ovänligt bemötande från kollegor påverkade övergångsprocessen negativt. Stöttande kollegor och god handledning kunde emellertid främja övergångsprocessen. Slutsats: Svårigheter i form av osäkerhet, krav och förväntningar framgick i litteraturstudiens resultat. Gemensamt för bearbetade studier i denna litteraturstudie är behovet av stöd och handledning hos de nyutexaminerade sjuksköterskorna, då detta kunde underlätta övergångsprocessen. Många nyutexaminerade sjuksköterskor upplevde svårigheter gällande anpassningen och övergångsprocessen till sin nya roll mot självständighet. Fungerande relationer på arbetsplatsen, tydliga arbetsuppgifter och riktlinjer samt en trygg handledning kunde underlätta övergångsprocessen. / Background: The nursing profession is considered important, where experience develops over time. There are several expectations of a nurse from patients, colleagues, relatives, and the nurses in training. The work situation can be challenging with changing and varying tasks. Aim: To describe the newly graduated nurses´ experiences of working as a nurse during their first year in clinical work and the adaptation that takes place during the transition to independence. Method: A descriptive literature study which include 12 scientific articles in the result. The articles were found through the databases PubMed and Cinahl. The literature study analyzed and thematized the articles of the result. Main result: Newly graduated nurses experienced difficulties in participating with the working group, at the same time they struggled keeping up with assigned tasks. Difficulties could arise in terms of living up to the demands and expectations of colleagues and employers, respectively. The relationship with the new colleagues could affect the transition process for newly graduated nurses, where conflicts and unfriendly treatment from colleagues had a negative effect on the transition process. However, supportive colleagues and good guidance could promote the transition process. Conclusion: Difficulties in form of insecurity, demands and expectations were evident in the results of this literature study. A common subject in the processed studies in this literature study was the need for support and guidance for the newly graduated nurses, as this could facilitate the transition process. Many newly graduated nurses experienced difficulties regarding the adaptation and transition process towards independence in their new role. Functioning relationships in the workplace, completing tasks and following guidelines but also safe supervision could facilitate the transition process.

Bakgrund: Under de senaste decennierna har sjuksköterskeutbildningen, sjuksköterskans yrkeskompetens och sjukvårdsverksamheten i Sverige genomgått omfattande förändringar. När nyexaminerade sjuksköterskor förväntas bekanta sig med arbetsmiljön och förväntningarna i yrket samtidigt som introduktionsperioden ska ske beskrivs situationen som komplex. Internationellt har introduktionsprogram visat sig främja nya sjuksköterskors arbetstillfredsställelse, kompetens, social tillhörighet samt antalet sjuksköterskor som valt att stanna i yrket. Det finns dock inga studier som undersökt vilka upplevelser nyexaminerade sjuksköterskor har av introduktionsprogram med avseende på övergång från studierna till yrkeslivet eller om det möjliggjort att förankra de kunskaper som uppnått under studierna. Syfte: Studiens syfte var att belysa nyexaminerade sjuksköterskors upplevelser av Region Skånes introduktionsprogram, med avseende på om det har underlättat övergången från utbildning till yrkeslivet, samt om det skapat ökade möjligheter för att förankra kunskaper i den nya professionen.Metod: En deskriptiv kvalitativ studie.Resultat: I resultatet framkom att introduktionsprogrammet hade underlättat övergången från studier till yrkeslivet, bidragit till att förankra kunskap och att kunskapen använts i arbetet som sjuksköterskor. Vidare framkom att upplevelser av programmet handlade om förväntningar, fördjupad kunskap, nätverk, profession och trygghet.Slutsats: Det finns vetenskapligt stöd för användning av introduktionsprogram för att säkerställa övergången mellan studier och yrkesliv. Samtidigt framkom information om vilka insatser som behöver göras för att förbättra introduktionsprogrammet och den första tiden i yrket för de nyexaminerade sjuksköterskorna. / Background: During recent decades, the nursing education, the nurse’s professional competence and the healthcare in Sweden have undergone extensive changes. The situation is described as complex when newly graduated nurses are expected to become acquainted with the work environment and expectations in the profession at the same time as the introduction period is to take place. Internationally, introductory programs have been shown to improve new nurses’ job satisfaction, skills, social affiliation and the number of nurses who have chosen to stay in the profession. However, there are no studies that have examined the experiences of newly graduated nurses of introductory programs regarding the transition from education to professional life, or whether they have made it possible to establish knowledge. Objective: The purpose of the study was to evaluate newly graduated nurses’ experiences of Region Skåne’s introductory program, concerning whether it has facilitated the transition from education to professional life, and whether it has created increased opportunities for anchoring knowledge in the new profession.Method: A descriptive qualitative study.Results: The results revealed that the introduction program had facilitated the transition from education to professional life, contributed to anchoring knowledge and that the knowledge was used in work as nurses. It was also found that experiences of the program were about expectations, in-depth knowledge, network, profession and security.Conclusion: There is scientific support for the use of introductory programs to ensure the transition between studies and professional life. At the same time, information emerged about what efforts need to be made to improve the introductory program and the first time in the profession for the newly graduated nurses.

Bakgrund: Årligen examineras ca 4400 nya sjuksköterskor trots det fortsätter behovet av dem att öka. Faktorer som en snabb vårdutveckling har förändrat villkoren för omvårdnaden vilket har satt högre krav på sjuksköterskornas kunskap. Det har visat sig att studenter i termin sex saknat kunskaper inför deras examen. Syfte: Var att beskriva nyutexaminerade sjuksköterskors upplevelser av den första tiden i yrket. Metod: En litteraturstudie av deskriptiv design vilken baserades på 13 vetenskapliga artiklar. Huvudresultat: Artiklarnas resultat gav fem teman vilka var; att vara förberedd inför sin nya yrkesroll, handledning/introduktion, relationer i yrkesrollen, arbetsmiljö samt att växa in i sin yrkesroll. Resultatet visade att övergången från skola till arbetsliv upplevdes svårt. De var oförberedda på allt ansvar och hade stort behov av stöd den första tiden. Bra relationer med kollegor gav trygghet och gynnade utvecklingen medan dåliga relationer upplevdes skrämmande. Arbetsbelastning och stress gav till en början osäkerhet, vilket de med tiden lärde sig att hantera. Slutsats: Resultatet visade att övergången från skolan till yrkeslivet var svårt. Faktorer som för lite stöd, hög arbetsbelastning samt dåliga relationer med kollegor var negativt för deras utveckling. Bra stöd och handledning, samt positiva relationer med kollegor gav dem bättre upplevelser vilket gynnade deras framtidsutveckling. Om upplevelserna i denna litteraturstudie uppmärksammas kan det både generera i mer och bättre forskning inom området men den kan även vara till nytta för chefer och övrig erfaren personal så att förbättringar på plats kan göras där det finns brister. / Background: Despite the fact that approximately 4,400 new nurses are examined annually, the need for them continues to increase. Factors that a rapid development of care has changed the conditions for nursing have placed higher demands on the nurses' knowledge. It has been shown that students in semester six have lacked knowledge prior to their academic degree. Aim: The aim of the present study was to describe newly graduated nurses’ experiences during their first time in practice. Method: A literature study of descriptive design which was based on 13 scientific articles. Main result: The results of the articles gave five themes which were; to be prepared for their new professional role, supervision / introduction, relationships in the professional role, work environment and to grow into their professional role. The results showed that the transition from school to working life was experienced as difficult. They were unprepared for all responsibility and had a great need for support at first. Good relationships with colleagues provided security and favored development, while bad relationships were perceived as frightening. Workload and stress initially gave insecurity, which they eventually learned to deal with. Conclusion: The results showed that the transition from school to working life was difficult. Factors such as too little support, high workload and poor relationships with colleagues were negative for their development. Good support and guidance, positive relationships with colleagues gave them better experiences, which benefited their future development. If the experiences in this literature study are noticed, it can both generate more and better research in the field, but it can also be useful for managers and other experienced staff so that improvements can be made on site where there are shortcomings.

Bakgrund: Nyutexaminerade sjuksköterskor [NS] kan uppleva att de inte känner sig tillräckligt förberedda inför deras nya yrkesroll. Tidigare forskning har påvisat att en bristande introduktion kan påverka nyutexaminerade sjuksköterskors upplevelse att vilja stanna kvar inom yrket. Det har även påvisats att brist på stöd i övergången ökar risken för vårdskador inom hälso-och sjukvården. Olika stödprogram och metoder [stödstrategier] har skapats vars syfte är att underlätta övergången för NS.Syfte: Att beskriva nyutexaminerade sjuksköterskors upplevelser av olika stödstrategier under den första tiden i yrket.Metod: Studien är utformad som en litteraturöversikt. Databassökning utfördes i CINAHL där 16 vetenskapliga artiklar utgör resultatet. Artiklarna är publicerade mellan 2011–2020 och innefattar olika designer såsom kvalitativ, mixad metod och kvasiexperimentell ansats.Resultat: Det framkomna resultatet har delats in i fyra kategorier vilket besvarar syftet med den här litteraturöversikten; (1) Främjar yrkesutövandet, (2) Möjliggör till ömsesidig relation, (3) Främjar personlig utveckling, (4) Upplevda svårigheter med stödstrategier. Resultatet visade att NS upplevde att stödstrategierna var främjande men med vissa förbehåll.Slutsats: Majoriteten av de NS som deltog i en stödstrategi upplevde det som fördelaktigt under den första tiden i yrket medan vissa NS kunde uppleva att det fanns utmaningar med erhållna stödstrategier. Stödstrategierna ansågs underlätta övergången och minska den övergångschock som vanligtvis kunde uppstå. Stödstrategierna upplevdes även stärka NS i deras nya yrkesroll vilket främjade deras förmåga till att ge god omvårdnad. / Background: Newly graduated nurses [NGN] may feel that they do not feel sufficiently prepared for their new professional role. Previous research has shown that a lack of introduction can affect the experience of NGN to remain in the profession. It has also been shown that a lack of support in the transition has a negative effect on patient care in healthcare. Various support programs and methods [support strategies] have been created whose purpose is to facilitate the transition for NGN.Aim: To describe newly graduated nurses’ experiences with various support strategies during their first time in the profession.Method: The study is designed as a literature review. Database search was made in CINAHL where 16 scientific articles formed the results. The articles are published between 2011–2020 and include different design types such as qualitative, mixed method and quasi-experimental approach.Results: The findings have been divided into four categories, which answered the purpose of this literature review; (1) Promotes professional practice, (2) Enables mutual relationship, (3) Promotes personal development, (4) Perceived difficulties with support strategies. The results showed that NGN felt that the support strategies were promoting, but with some reservation.Conclusion: The majority of those NGN who participated in a support strategy found it beneficial during their first time in the profession, while some NGN could find that there were challenges with the support strategies. The support strategies were considered to facilitate the transition and reduce the transitional shock that could usually occur. The support strategies were also seen to strengthen NGN in their new professional role, which promoted their ability to provide good care.