Factors influencing the practice of new graduate nurses : a focused ethnography of acute care settings
Factors influencing new graduate nurses
Article [Accepted Manuscript]
Abstract(s)
Aim: To explore the influence of an acute care setting on competency deployment of new graduate
nurses (NGNs) from a competency
-based undergraduate programme
.
Background: In the last 15 years, nursing education has shifted to competency
-based education
(CBE). Few studies have focused on how NGNs from these reformed programmes use the
competencies they have developed. To be paradigmatically coherent with the nature of a
competence, studies should also examine how context influences nursing practice and competency
deployment.
Design: A focused ethnography of three acute care units from one academic hospital in Canada.
Methods: Purposive and snowball sampling strategies were used to recruit 19 participants: NGNs (n
= 4), nurse preceptors (n = 2), clinical nurse specialists (n = 9)
, and nurse managers (n = 4). Data were
collected through individual interviews, focus groups
, observation and documentation. Data were
analysed according to Roper and Shapira’s (2000) ethnographic nursing analysis framework.
Results: Organizational and individual factors were identified as influencing NGNs
’ competenc
y
deployment. Organizational factors are orientation, stability, workload, and the scientific culture of
the unit. Personal factors have been linked to groups of professionals: for NGNs, personality and
clinical placements during their initial education; for nurses working with NGNs, to be role models,
to promote integration and to denounce bullying; and for other health professionals, to recognize
nursing expertise.
Conclusion: One way to s
mooth the transition from academic to clinical settings for NGNs is by
offering transition or orientation programmes that will provide them with stability and a reduced
workload, allowing them to progressively deploy their competencies.
Relevance to clinical practice: Organizational and individual factors influence how new graduate
nurses deploy their competencies. Clinical educators and nurse managers can help new nurses by
acting on these factors.
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