Exploring Resilience Experiences Among Newly Graduated Nurses Transitioning to Professional Practice

Abstract

The global nursing shortage poses a significant threat to healthcare, exacerbated by high turnover rates among newly graduated nurses (NGNs). The COVID-19 pandemic has intensified this issue, leading to increased stress and burnout, causing many nurses to leave the workforce. Younger nurses and those with less experience report higher levels of emotional distress, which negatively impacts patient safety and professional satisfaction. Burnout and stress contribute to absenteeism, workforce turnover, and errors in clinical judgment, highlighting the urgent need for strategies to retain the nursing workforce and ensure patient safety.Despite the critical role of resilience in promoting workforce retention and supporting NGNs during their transition to professional practice, there are notable gaps in the existing literature. Most studies have focused on quantitative measures of resilience, with limited longitudinal and qualitative research exploring the nuanced experiences of NGNs. Additionally, the impact of socioeconomic status (SES) and cultural background on resilience is poorly understood, with most research conducted on white middle-class participants. As such, there is a need for research to better understand how SES and cultural factors influence NGN resilience. Addressing these gaps can provide valuable insights into resilience development, inform strategies to foster resilience, and potentially reduce workforce attrition in the nursing profession. To establish what is known about the resilience experiences among NGNs, a qualitative metasynthesis was conducted using a meta-ethnographic approach. The aim of this study was to provide an interpretive synthesis of existing qualitative literature on resilience in NGNs. The search included a systematic search of English and Korean literature. Seven articles published between 2008 and 2021 were reviewed, identifying three main themes: (1) internal experience of resilience, (2) external sources of resilience, and (3) building resilience over time. The study indicated that resilience can be developed during the transition from student nurse to professional nurse and is influenced by personal and organizational factors. This study also confirmed an evidence gap indicating the need for longitudinal qualitative methodologies to explore this phenomenon as well as exploration into how socioeconomic and cultural backgrounds impact NGN resilience. In response, an exploratory longitudinal qualitative study was conducted. This work explored the lived experiences of resilience among 10 associate degree nursing students transitioning to practice through use of online photovoice (OPV) surveys and virtual focus groups. Data were collected at three timepoints: baseline (final semester of nursing school), 3-4 months into practice, and 7-8 months into practice, and analyzed using interpretive phenomenological techniques. Six main themes emerged: (1) motivational aspirations, (2) supportive systems, (3) emerging stressors, (4) hidden obstacles in school and practice, (5) incivility from professionals, and (6) learning to endure. The findings also highlighted that burnout begins in nursing school and resilience can be developed and strengthened during the transition to practice. The feasibility of performing this study on a larger scale was also confirmed. Lastly, a nationwide study was conducted also using a multimethod, longitudinal, qualitative design. This study examined facilitators and barriers to NGN resilience, however it also aimed to describe the impact of cultural and socioeconomic factors on resilience. OPV and virtual focus groups were conducted with 62 nursing students across the U.S., with data collected at three timepoints: baseline (final semester), 4-5 months into practice, and 8-9 months into practice. Four themes emerged: (1) cultural duality, (2) discovery of nursing realities, (3) evolution of adaptation, and (4) financial implications. The study concluded that NGN resilience evolves over time and is shaped by various factors, including SES and culture, offering insights for nurse educators and leaders on promoting resilience and reducing attrition.