Rural transition to practice: A phenomenological analysis of the new graduate nurses’ experience

Abstract

Objective/Background: The nursing shortage uniquely impacts rural communities as staffing issues often result in emergency department closures and leave communities without adequate healthcare. One contributing factor in this crisis is difficulty recruiting and retaining new graduate nurses (NGN) rurally. Improving transition to practice for NGNs is a potential solution to this problem. This study explores the new graduate nurses’ lived experience when transitioning to rural nursing practice.

Methods: A descriptive phenomenological approach was used. Seven participants completed virtual surveys and virtual, semi-structured focus groups exploring the new graduate nurses transition to practice experience, underpinned by Patricia Benner’s From Novice to Expert model. Transcripts were analysed using thematic concept mapping.

Results: Three themes were derived across the stages of transition to practice: education, mentorship and both intrinsic and extrinsic expectations on NGNs. Each phase in the first two years of practice had unique characteristics, most significantly, a six-month delay occurs to accommodate acquisition of non-nursing skills, which deviates from Benner’s model.

Conclusions: This research emphasizes the importance of supporting NGNs during the first two years of transition to rural practice. The complex role of the rurally practicing registered nurse requires approximately six months more time than what is described in Benner’s model to develop competence. A focus on nursing education that begins at the undergraduate level and continues into practice is required. A shift to focus on supporting the wellbeing of the NGN is a key intervention; as well as improving mentorship and management support through education and policy change.