The voice of nurses: Novice nurses' first experiences in a clinical setting. A longitudinal diary study

Abstract

Aims and objectives: To gain greater understanding of which personal and professional demands novice nurses are confronted with and what can be done to improve the transition from novice to professional staff nurse.

Background: Novice nurses are confronted with a lot of physical, emotional and intellectual changes in the role-transition process from student nurse to professional staff nurse, which are often related to feelings of confusion, uncertainty and stress. Few studies have investigated, on a longitudinal basis, the lived experiences of novice nurses in the clinical setting.

Design: The study adopted a qualitative longitudinal approach to investigate the described experiences of novice nurses during their first 2 years after graduation. Written diaries were selected for optimal data collection.

Methods: A sample of eighteen novice nurses was recruited from several wards at a University Medical Center in the Netherlands. The inclusion criteria were a Bachelor's degree in nursing, aged under 30, and no more than 1 year's work experience. Data were collected from weekly measurements from September 2013-September 2014.

Results: Eight major themes emerged from the diaries (n = 580): relatedness, competence, development, organisational context, existential events, goals, autonomy and fit. This study revealed that the need for relatedness was by far the most reported theme. Support and positive feedback from colleagues appeared to be crucial for novices starting work in a highly complex environment.

Conclusion: This study showed that one of the strategies novice nurses use to deal with challenging and existential situations is to share their experiences with colleagues. Therefore, novice nurses should always work in a safe environment which enables this.

Relevance to clinical practice: Identification of key issues around understanding novice nurses' first clinical experiences may help to improve their transition from novice to professional staff nurse. The presence and support from supervisors and mentors are inevitable to keep novice nurses motivated for the profession.

Keywords: competences; diaries; lived experiences; novice nurses; support.