Transition to professional practice in baccalaureate nursing: A multiple case study approach using the middle range theory of transition

Abstract

Scope and Method of Study: Concern is growing about the readiness of graduates of nursing education to assume the responsibility for safe effective patient care. The purpose of this qualitative, multiple case study research is to explore and document the transition of baccalaureate nursing graduates into professional nursing practice. The middle range theory of transition was used as a framework to view the experiences of 7 graduates in their first year of practice. Academic and hospital nursing educators were interviewed to find an alternate viewpoint of the experience. The analysis documented the experience of each nurse and then determined common experiences. The data was then examined for fit with the middle range theory of transition.

Findings and Conclusions: The results of these case studies show that these seven nurses experienced several common experiences. These included, extreme fatigue for several months, sleep disturbances, preoccupation with their jobs to the exclusion of personal lives and families. Common critical time points were also identified. Four to five months after beginning employment is a low point while 9 to 10 months after beginning work is when satisfaction may begin to improve. The middle range theory of transition proved to be a useful tool in describing this transition and the nursing profession's role in facilitating this transition in newly graduated nurses. Future studies are suggested to focus on better defining the transition properties and conditions. Nursing therapeutics that facilitate healthy transition outcomes are suggested.