New Graduate Transition Today - Emerging Nurse Leader

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

It is the time of year when many units are preparing to transition new graduates into professional practice. This process has never really been easy. The book “Reality Shock ” was published a few years before I professionally transitioned into practice in the 1970s. It was evidence-based and did an excellent job of discussing the transition issues that new graduates experienced almost 50 years ago.

Some things have not changed. Transition into practice is complicated, as new graduates work on developing their clinical skills, adapting to work environments, and growing as professionals. The first year of practice has always been like drinking water from a fire hose – so much to learn in such a short time. But today, it is even more complicated for the following reasons:

The absence of a highly experienced core group of nurses to serve as preceptors.
The inability of nursing schools to truly prepare work-ready nurses.
Higher volumes, acuity, and expectations of nursing staff.
Patients and families who have higher expectations and less civility toward staff.
An ever-expanding documentation burden.
The expansion of the experience-complexity gap.

Many nurse managers now tell me that they are the most experienced nurses on their units and, therefore, far more involved with the professional transition of new nurses. Recently, in a session, a manager posed an interesting question:

I want to decrease the turnover of my new graduate staff, but I have very little time to coach and mentor them. What are three things I can do with new graduate staff that could move the needle on promoting better retention?

While it is hard to narrow things down to three things without fully understanding the complexity of her work environment, I attempted to identify three priority areas for a successful professional transition:

Spend time reviewing role expectations in the RN position description – many new graduates today face challenges with professional identity and understanding of their roles and potential liability. Be as clear as possible about this, along with a discussion of how you will provide feedback concerning these role expectations. The new graduate will be coached on what they need to start, stop, and continue doing. When discussing policies such as device use during work hours (Cell Phones, AirPods, Meta glasses), do so in a non-judgmental manner that focuses on the potential liability issues associated with using devices that can decrease situational awareness.
Ensure that the new graduate meets the rest of the team and becomes part of the unit community. One of the most important things you can do for nurses today is to help them feel valued and part of something bigger than themselves. Take the time to learn some personal information about each new graduate, including any career goals that they may have for themselves. Begin with the end in mind; new graduates are highly career-focused today, so take an interest in their plans and how working on the unit can help them move toward their goals, as well as identify team members who could support them. Follow up with preceptors on how each new graduate is doing, so you can be proactive with any transition issues. Work intentionally to help them make friends with others in the unit. We know that having a good friend at work is a strong motivator for retention.
Help new graduates with their communication skills – most new graduates today are members of Generation Z, born between 1997 and 2012. They have grown up in a text, social media, phone-based culture. They may have minimal experience with face-to-face or phone conversations. Coach them to learn how to connect with patients, families, physicians, and other staff through discussions and questions. Teach SBAR as a valuable method for ensuring that key information is communicated effectively. Explain the criticality of good communication regardless of what their career goals are. Nurses who establish strong connections with others are more likely to be satisfied with their professional work.

There are many other priorities I could add to this list, but even if you can only focus on these three, you will make great strides in helping your new graduates in their professional transition.

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