Managing the Current Workforce: Status of New Graduate Nurse Well-being and Clinical Development 2018-2021.

A structured transition to practice (TTP) program is beneficial to the professional success and retention of new graduate nurses (NGNs). The COVID-19 pandemic impacted clinical preparation and the TTP experience of NGNs. Data from the Versant National Database between 2018 and 2021 were analyzed to determine the current state of NGN well-being and clinical development. Key findings from the analysis indicate that NGNs that are a part of a comprehensive TTP program remain highly committed to their organization, have increased satisfaction working with their colleagues, and indicate low intent to leave their position. However, there are opportunities to address individual rewards and recognition, clinical assignments, morale, feelings of belongingness, and well-being. These findings further support the importance of a nurse residency program as part of an overall workforce strategy and that individual, programmatic, and practice environment outcomes must be longitudinally measured and analyzed to be able to make necessary evidence-based changes to meet the future needs of NGNs and the profession.

Comparing satisfaction and outcomes in on-campus versus virtual education for nurse practitioner students.

ABSTRACT: This article highlights the development and implementation of interactive training experiences for graduate nursing students as part of specialty training in endocrinology. Emphasis was placed on accomplishing the shift from on-campus to virtual training while maintaining fidelity and student satisfaction. A total of 106 graduate nursing students from five cohorts submitted evaluations. Student satisfaction remained high regardless of whether the content was delivered in person or virtually. Most students in the virtual cohorts evaluated the online training positively. Student presentation grades were highest with on-campus delivery. Transitioning in-person training to a virtual environment can be an effective method of delivering nurse practitioner education while promoting student satisfaction. Recommendations for optimizing hybrid learning experiences are offered based on adult learning principles.

Support for Doctoral Nursing Students in PhD Programs in the United States.

BACKGROUND: The number of PhD nursing programs in the U.S. has increased, but the number of nursing students entering and completing these programs remains stagnant. It is crucial to consider innovative approaches to recruit, nurture, and graduate more diverse nursing students. PURPOSE: This article presents the perceptions of PhD nursing students regarding their programs, experiences, and strategies to support their academic success. METHODS: This study used a cross-sectional, descriptive design. Data were obtained from an online 65-question student survey completed between December 2020 and April 2021. RESULTS: A total of 568 students from 53 nursing schools completed the survey. Five themes emerged regarding the barriers students experienced during their programs: Faculty issues, time management and balance, insufficient preparation for dissertation research, financial barriers, and COVID-19 impact. Student recommendations for improving PhD nursing programs were also captured in five themes: Program improvement, coursework improvement, research opportunities, faculty, and dissertation. The low numbers of male, non-binary, Hispanic/Latino, minority, and international survey respondents indicate a need for innovative recruitment and retention strategies to increase diversity of PhD students. CONCLUSION: PhD program leaders should complete a gap analysis based on the recommendations in the new AACN position statement and perceptions of PhD students reported from this survey. By doing so, PhD programs will be better positioned to implement a roadmap for improvement to better prepare the next generation of nurse scientists, leaders, and scholars.

Peer patient round table: An innovative approach for evaluating clinical performance for nurse practitioner students.

Clinical performance is a crucial part of evaluation in nurse practitioner education and has traditionally been accomplished through faculty site visits. The evolution of distance learning and on-line programs along with the recent COVID-19 pandemic has further complicated completing site visits, requiring innovative strategies. 'The Peer Patient Round Table (PPRT)' was developed as an innovative evaluation method of student performance. It utilizes the standardized patient simulation concept and shared role-play modality via a telehealth platform. During the PPRT evaluation session, students were involved in a shared role-play of three roles; as a patient, a nurse practitioner student, and a preceptor in individual scenarios. A family nurse practitioner program at Radford University, located in Southwest Virginia, incorporated the PPRT method as the alternative student evaluation method starting May 2020 during COVID-19 pandemic for the last two years. After the first year of implementation of the PPRT, students and faculty were surveyed about the effectiveness of PPRT as a clinical evaluation method as well as their satisfaction with the modality. This article discusses the details of the PPRT procedures, PPRT experiences from faculty and students along with lessons learned.

Webinar for New Graduate Nurse Recruitment: A Roadmap for Expansion, Diversity, and Innovation.

Recruitment of nurses is a key strategic initiative for nearly all health care organizations. The use of webinars for new graduate nurse recruitment is a proven innovation to increase volume and expand the diversity of nursing applicants. The webinar format will engage applicants and serve as a valuable marketing tool. [J Contin Educ Nurs. 2023;54(3):106-108.].

New Graduate Nurses Navigating Entry to Practice in the Covid-19 Pandemic.

BACKGROUND: The Covid-19 pandemic has significantly impacted organizational life for nurses, with known physical and psychological impacts. New graduate nurses are a subset of nurses with unique needs and challenges as they transition into their registered nurse roles. However, this subset of nurses has yet to be explored in the context of the Covid-19 pandemic. PURPOSE: To explore the experiences of new graduate nurses entering the profession in Ontario, Canada, during the Covid-19 pandemic approximately one year after entering the profession. METHODS: Thorne's interpretive description method was utilized. FINDINGS: All participants identified as completing second entry nursing programs, offering a unique perspective on new graduate nurse transition. Four themes emerged in the data: 'Virtual Didn't Cut It,' 'Go Where You Know,' 'Picking Up the Pieces,' and 'Learning When to Say No and Let Go.' Participants felt ill prepared to enter the profession and were cognizant of the various challenges facing the nursing profession, and how these pre-existing challenges were exacerbated by the pandemic. They acknowledged the need to protect themselves against burnout and poor mental health, and as such, made calculated early career decisions - demonstrating strong socio-political knowing. Half of the participants had already left their first nursing job; citing unmet orientation, mental health, and wellbeing needs. However, all participants were steadfast in remaining in the nursing profession. CONCLUSIONS: Second entry new graduate nurses remain a unique subset of nurses that require more scholarly attention as their transition experiences may differ from the traditional trajectory of new graduate nurses.

Resilience, Stress, Anxiety, and Depression: Exploring the Mental Health of New Graduate Nurses Transitioning to Practice During COVID-19.

Background Transitioning to practice during the COVID-19 pandemic multiplied the stressors and challenges typically encountered by new graduate nurses (NGNs), yet research exploring mental health variables of this subset of nurses remains sparse. Method This study used an observational design and convenience sampling. NGN alumni (n = 192) from a pre-licensure nursing program were surveyed during the summer of 2021 regarding their experiences with resilience, anxiety, depression, and stress while transitioning to practice during the COVID-19 pandemic. Results Participants reported moderate to severe levels of stress (76%), anxiety (27.6%), and depression (31.2%) while transitioning to practice. Most (79%) described themselves as resilient. The highest mean scores for stress, anxiety, and depression occurred during the fourth to eighth month of practice. Conclusion Nursing professional development specialists, managers, and other stakeholders need effective strategies to monitor and promote NGNs' well-being and mental health to prevent burnout and turnover throughout the first year of practice. [J Contin Educ Nurs. 2022;53(12):533-543.].

The impact of changes in nursing practicum caused by COVID-19 pandemic on new graduate nurses.

BACKGROUND: The impact of the COVID-19 pandemic has brought about major changes throughout nursing education. Most clinical practicum has been substituted by skills laboratories, simulation laboratories, virtual simulation or written assignments. Nursing students who have experienced this change in practicum have fears about their future role as new graduate nurses. However, to date, no studies have been conducted exploring how their fears work when they become new graduate nurses. OBJECTIVES: To investigate the status of nursing practicum at nursing universities before and during the COVID-19 pandemic, and to explore the relationship between difficulties in nursing tasks, work readiness, reality shock, and organizational socialization among new graduate nurses with nursing practicum experience during this pandemic. DESIGN: Descriptive comparative research design. PARTICIPANTS: 178 new graduate nurses with a clinical experience from 1 month to less than 12 months and graduating from nursing universities in 2021, the 3rd grade in 2020 and the 4th grade in 2021. METHODS: Cross-sectional study via a self-administered online questionnaire measuring difficulties in nursing tasks, work readiness, reality shock, and organizational socialization. Data were analyzed by descriptive statistics, independent t-tests, Pearson correlation. RESULTS: New graduate nurses were divided into 72 in the Clinical/Clinical group and 106 in the Clinical/Substitute group. There was a significant difference in the difficulties in nursing tasks (t = -2.342, p = .020), but there were no significant differences in work readiness, reality shock, and organizational socialization between the two groups. CONCLUSIONS: Efforts in the clinical field to increase the adaptation of new graduate nurses could prevent problems that may arise due to the restrictions and absence of clinical practicum. Discussions should be continued to develop and implement efficient nursing practicum education that not only can reduce the gap between nursing education and nursing practice, but also respond appropriately to any pandemic situation.

[Cultivating Human Resources in Nursing for Resilient Leadership in Times of Crisis: Focusing on Advanced Nursing Education].

The corona virus disease 2019 (COVID-19) pandemic has revealed an urgent need for a sustainable healthcare system, especially human resource development. Nurses play a front-line role in the prevention of infection and countermeasures for people with health problems in health, medical, and welfare systems, and society demands that their role be further expanded. The education and training programs for nursing professionals are diverse. This study focuses on under-graduate nursing education and post-graduate education, and outlines the development of human resources in nursing for resilient leadership in times of crisis. Under-graduate nursing education is developing and expanding based on the Model Core Curriculum for Nursing Education and the reference standards for quality assurance in nursing education, while assuring the quality. For the advancement of health care and society in times of crisis, it is essential to develop nursing human resources who can respond to crises of life, livelihood, and survival across multiple dimensions. To achieve this, it is necessary for educational institutions, medical institutions, and governmental agencies to strengthen cooperation and collaboration, and to promote the development of human resources who can build a sustainable, equitable, and resilient society.

Transition to Practice: The Use of Virtual Clinical Replacement During the COVID-19 Pandemic and Its Impact on New Graduate Nurse Readiness.

AIM: This study investigated graduate nurse readiness for practice after receiving virtual clinical replacement experiences during the COVID-19 pandemic. BACKGROUND: The pandemic led to the closure of clinical sites for many undergraduate nursing students. Nurse educators replaced the hospital setting with virtual clinical replacement experiences, potentially affecting readiness for practice in graduate nurses. METHOD: The Casey-Fink Graduate Nurse Experience Survey was used to collect data in the areas of demographics, comfort level with skills, work environment stress, job satisfaction, role transition, and the impact of the virtual clinical experience on transition to practice. Descriptive statistics and independent t -tests were used for analysis. RESULTS: The virtual clinical replacement experience was statistically significant with greater confidence in providing for patient safety, stronger professional communication/leadership skills, and recognized support in the workplace. CONCLUSION: The use of virtual clinical replacement experiences had a positive impact on new graduate nurses' transition to practice.

Telehealth across nursing education: Findings from a national study.

BACKGROUND: The onset of COVID-19 perpetuated the necessity for nursing students to be telehealth savvy upon graduation. There is minimal research regarding the integration of telehealth in nursing curricula across multiple levels. PURPOSE: The purpose of this survey study was to determine the current or future use of telehealth content and experiences in prelicensure and graduate nursing program curricula. METHODS: Following vetting, an adapted survey was sent to 386 nursing program or simulation directors in June 2020. FINDINGS: The survey had a 21 % (n = 82) response rate. Fifty-five percent of prelicensure and 40 % of graduate programs had no telehealth curricular content, while 22 % and 45 %, respectively, planned to integrate. The top barrier to integration was a lack of funds. DISCUSSION: Further research is needed to evaluate telehealth in nursing curricula. Due to many factors, the addition of telehealth curricula in nursing schools is inevitable.

A Virtual World: New Graduate Education in the Era of COVID-19.

In this article, the authors share strategies of adult learning principles for successful transition to virtual learning for new graduate clinical nurses. Knowles' theory was used to redesign a simulation-based education approach to fulfill the diverse learning needs during the COVID-19 pandemic. The delivery of efficient, effective, and meaningful education was achieved by leveraging technology. This evidence-based strategy was delivered via a cost-effective virtual platform that offered improved accessibility and convenience of education without compromising the quality of the educational outcomes, participant engagement, or learner satisfaction. This virtual platform incorporating a variety of active learning strategies exhibited effective practices, engaging the new graduate clinical nurses and enhancing their acquiring, retaining, and applying knowledge in providing high-quality and safe patient care. It demonstrated the promise that virtual education holds for future programs to enhance professional development and build the nursing workforce. Nurse educators can be instrumental in advancing this virtual agenda. [J Contin Educ Nurs. 2022;53(7):307-311.].

An Evaluation of Traditional Versus Virtual Nurse Residency Programs on New Graduate Nurses' Perceptions of Preparedness to Provide Safe Patient Care.

The impact of the COVID-19 pandemic on nurse residents' perceptions of preparedness while learning in a virtual environment remains unknown. This cohort study compared nurse residents' perceptions of preparedness in traditional in-person versus virtual learning environments. Results found no statistically significant differences between these two groups over 1 year. This demonstrates that a virtual learning format can achieve comparable outcomes to a traditional in-person learning format in successfully transitioning newly licensed nurses into the profession.

Innovative Team Approach for Achieving DNP Program Competencies for Distance Learners During the COVID-19 Pandemic.

ABSTRACT: Doctor of nursing practice (DNP)-prepared nurses must be competent in organizational and systems leadership, advanced clinical skills, and initiation of policy and programmatic changes. Students develop competencies in the DNP advanced practice and nurse administrator specialty tracks through online didactic and in-person practicum experiences within various settings. The COVID-19 pandemic created a barrier to in-person practicum experiences and an urgent need for flexible practicum opportunities. In response, faculty developed, implemented, and evaluated an innovative pedagogical strategy utilizing a team-based case study assignment to facilitate achievement of DNP program competencies for distance learners in these specialty tracks.

Trauma-Informed Pedagogy to Foster Resilience in Graduate Nursing Education.

ABSTRACT: The experiences of graduate nursing students during the COVID-19 pandemic necessitate a trauma-informed approach to education. Three hundred graduate nursing students responded to a discussion assignment in a doctoral-level health care policy course. Thematic analysis identified common themes of fear, anxiety, frustration, and exhaustion ( n = 93). Conflict and strain were identified in relation to all major roles (provider, student, and family member), ultimately creating physical and mental barriers to fulfilling each of the roles. Curricular standards must maintain rigor while incorporating flexibility into design standards to assist students when faced with trauma or crisis.

Integration of medication for opioid use disorder training into graduate nursing education.

The COVID-19 pandemic has further limited access to treatment for opioid use disorder (OUD). Advanced practice registered nurses can reduce opioid related complications and overdose by obtaining a Drug Enforcement Administration (DEA) regulated X-waiver that allows for prescription of medications for OUD (MOUD) in general medical settings. Graduate nursing education, where advanced practice nurse practitioner (NP) students are educated, has not incorporated this content into standard curricula. We describe an innovative approach to incorporate DEA X-waiver training in a required community health NP in partnership with addiction medicine clinicians. Advanced practice NP students (N = 114) either completed fully online or hybrid (virtual didactic and online) X-waiver training on MOUD. We describe how an interprofessional partnership to incorporate MOUD education into graduate nursing curricula is a feasible method for training students to treat OUD in the context of the pandemic. This approach is responsive to the crucial need for more health care providers to address the opioid overdose crisis.

Work readiness: Its determinants and association with work-related outcomes among new graduate nurses.

AIMS: This study aimed to identify determinants of work readiness and to assess the influences of work readiness on work-related outcomes in graduate nurses. BACKGROUND: Higher work readiness facilitates smoother role transitions of new graduate nurses. However, determinants of work readiness had not been fully examined. In addition, the relationships between work readiness and work-related outcomes, such as coping self-efficacy and occupational commitment, are also crucial but had not been assessed. METHODS: We recruited 794 graduate nurses and assessed their work readiness before working as nurses. After they commenced their work, we assessed their occupational commitment, coping self-efficacy and intention to remain. All assessments were conducted online. RESULTS: There were 728 (92%) female respondents. The mean scores and standard deviation (SD) of work readiness, coping self-efficacy, occupational commitment and intention to remain were 261.51 (SD: 45.40), 30.30 (SD: 6.13), 81.65 (SD: 11.56) and 11.01 (SD: 2.36), respectively. Based on a regression analysis, determinants of work readiness were positive school climate, student leadership experience, nursing as the primary choice of discipline and perceived influences of COVID-19 on the honorability of being a nurse and the willingness to be a nurse (p < .001). Moreover, after adjusted by all demographics and characteristics variables, higher work readiness would result in higher coping self-efficacy (estimated coefficient = 0.06, p < .001), occupational commitment (estimated coefficient = 0.06, p < .001) and intention to remain (estimated coefficient = 0.01, p = .002). CONCLUSION: Work readiness is a composite concept affected by psychosocial and environmental factors, which can predict new graduate nurses' future self-efficacy, occupational commitment and intention to remain. IMPLICATIONS FOR NURSING MANAGEMENT: The management of new graduate nurses when they begin to work could target their work readiness. Transition programmes that consider our identified determinants can be provided to those who show lower work readiness.

Commentary: Transition to Practice: Future Considerations for New Graduate Nurses.

There is a growing concern in education and healthcare that we are not adequately preparing or transitioning newly graduated nurses (NGNs) into the workplace. Several studies over the past decade have revealed relationships between the mental health of NGNs and their experience of the workplace environment. Even before the destabilizing impact of the global COVID-19 pandemic, overwhelming workload intensities were forcing nurses to become organizational task masters and crisis facilitators rather than clinical case managers and direct-care providers. This paper outlines numerous practical and evidence-based interventions for mitigating transition shock and assisting NGNs in successfully navigating the stages of transition.