Exploring barriers and facilitators for successful transition in new graduate nurses: A mixed methods study

Background: The transition phase from student to nurse is an important time when new graduates grow and develop as professional nurses. Globally, the attrition rate of new graduate nurses is reported to range from 24.5 to 70%. Purpose: The study aimed to explore the barriers to, and facilitators of new graduate nurses' successful transition. Methods: A convergent mixed methods design was used. Newly graduated nurses (n = 212) were recruited from two K university medical centers. The quantitative research used a cross-sectional study, and the qualitative research used a focus group interview design. The survey and focus group interview were conducted from October to December 2017. The questionnaire comprised items on demographic characteristics (age, gender, employment duration, orientation duration, etc.) and items on transition experience, job satisfaction, self-efficacy, nursing work stress, and structural empowerment. Results: This qualitative study found that significant factors affecting transition (R-2 = 0.41, F = 35.29, p < .05) included self-efficacy (beta = 0.27, p < .01), job satisfaction (beta = 0.11, p < .01), nursing stress (beta = -0.04, p < .05), and structural empowerment (beta = 0.41, p < .01). The qualitative findings supported the quantitative results and also identified the barriers to and facilitators of a successful transition. The barriers were fears, workload, excessive role expectations, and emotional difficulties resulting from bullying. And, the facilitators are self-confidence, interaction with colleagues, positive and supportive work environments, and a phase transition program. Conclusion: This study showed that formal and informal strategies, to strengthen organizational factors (structural empowerment, phase transition program, etc.) and enhance individual factors (self-efficacy, self-confidence, interaction, etc.), are important for new graduate nurses' successful transition into their professional roles.