Tough love or bullying? New nurse transitional experiences.

AIMS AND OBJECTIVES: This qualitative paper reports on the transition experiences of new nurses and preceptors in Singapore, focussing on the construction of a supervisor strategy termed 'tough love'. The authors discuss the concept of tough love, as a metaphorical euphemism for workplace bullying and interrogate rationales from the data that behaviours associated with tough love, prepare nurses for independence and competence in their new responsibilities. BACKGROUND: Successful transition of new nurses to professional practice is dependent on the transition challenges they face at work. When new nurses are well supported in the clinical environment, retention occurs. However, when workplace adversity intensifies, nurse turnover rates increase. DESIGN: This qualitative study was conducted using a constructivist grounded theory approach. METHODS: New nurses (n = 26) and preceptors (n = 5) from five different hospitals participated in the study. Data were collected from semi-structured interviews and reflective journal entries and analysed using the constant comparative method. FINDINGS: Data analysis gave rise to the generation of a definition of tough love, not otherwise identified in the literature, as the negative behaviours of senior nurses towards new nurses, that is rationalised as a well-intentioned but nevertheless abusive strategy, used to condition targets into conforming to expected professional or organisational behaviour. CONCLUSIONS: The authors conclude that tough love behaviour damages the transition experience of new nurses and has the potential to influence decisions on whether to remain in a health organisation and indeed the profession. RELEVANCE TO CLINICAL PRACTICE: Given nursing shortages in Singapore and internationally and that the retention of new nurses appears to be part of the problem, tough love behaviours and cultures clearly need to be addressed if investment into training and recruitment are to be realised.

New nurse transition: success through aligning multiple identities.

PURPOSE: The purpose of this paper is to explore the perceptions of new nurses in Singapore of their experiences of role transition and to examine the implications for managers in terms of employee training, development and retention. DESIGN/METHODOLOGY/APPROACH: This qualitative study was conducted using a constructivist grounded theory approach. In total 26 novice nurses and five preceptors (n=31) from five different hospitals participated in the study. Data were collected from semi-structured interviews and reflective journal entries and analysed using the constant comparative method. FINDINGS: The findings revealed that novice nurses remained emotionally and physically challenged when experiencing role transition. Two major constructs appear to play an important part in the transition process; learning how to Fit in and aligning personal with professional and organisational identities. The findings highlight factors that facilitate or impede Fitting in and aligning these identities. ORIGINALITY/VALUE: Although the concept of Fitting in and its relation to the attrition of novice nurses has been explored in global studies, that relationship has not yet been theorised as the dynamic alignment of multiple identities. Also, whilst most research around Fitting in, identity and retention has been conducted in western countries, little is known about these issues and their interrelationship in the context of Singapore. The study should inform decision making by healthcare organisations, nurse managers and nursing training institutions with respect to improving the transition experience of novice nurses.