Being in Transition: Accessing the Transition Experience of Bachelor of Science in Nursing Graduates Using a Heideggerian Hermeneutic Approach

This study used Heideggerian hermeneutic phenomenology to access the transition experience of baccalaureate prepared nurses with 12-18 months of practice experience. The transition theory of Chick and Meleis (2010) was used to frame existing knowledge relative to the transition experience. The philosophy of Martin Heidegger (1927/1962) provided a philosophical framework for this study and was used to guide study methodology. The following overarching research question guided this study: Q1 What is the experience of moving/transitioning from being a student in a Bachelor of Science in Nursing program to being a practicing professional registered nurse? The Diekelmann, Allen, and Tanner (1989) seven-step process was used to interpret and analyze data. Units of meaning from each story of new nurse transition were identified. Significant statements were offered to substantiate the identification of each unit of meaning. Five relational themes were identified by considering the data within and across all stories of transition and included: My work provides me with meaning; You Must Look Outside Yourself to Make an Impact; I Need a Supportive Environment to Thrive; Trust Is a Two-Way Street; and If You Teach Me, I Will Grow. Through this process, three constitutive patterns describing the transition experience of new nurses in transition emerged: Being a Nurse is Impactful; When Nurses Support Nurses, the Patient is at the Center of Care; and Nurse-Doctor Interaction: Do No Harm. Within the constitutive pattern of Being a Nurse is Impactful, the nurses in this study found deep meaning in the act of providing nursing care. After they became familiar with the routines and practices of their job, they found an outward awareness and focus not described in previous research investigating new nurses in transition. The profound meaning these nurses ascribed to their nursing practice helped them ameliorate the intensity inherent to the act of providing nursing care. The constitutive pattern--When Nurses Support Nurses, the Patient is at the Center of Care--revealed that nurses in transition depend not only on the support of their preceptor but also on the support of other nurses on their unit of practice. The findings of this study highlighted the importance of a supportive environment beyond the initial orientation period as well as throughout the first year of practice to ensure the nurses continue to grow and develop in their role. The constitutive pattern--Nurse-Doctor Interaction: Do No Harm--provided a deeper understanding of the new nurse-physician relationship than what had been previously described. The new nurses in this study gained an understanding of how ineffective patterns of interaction with physicians on their units not only impacted patient safety and quality of care, these ineffective patterns also created more stress for them in their daily work as a nurse. The phenomenon of “double-standards” and a perception of “the doctor knows more than the nurse” attitude spoke to the new nurses’ beliefs about interactions between physicians and nurses. The findings of this study could be of use to nurse educators, leaders in nursing practice, bedside nurses, physicians, and advanced practice nurses. These findings could assist healthcare professionals to understand and assist new nurses transitioning to practice