The lived experience of new graduate baccalaureate-prepared Registered Nurses working in an acute care hospital setting

The purpose of this study was to explore the lived experience of new graduate baccalaureate prepared Registered Nurses (RNs) who work in an acute care hospital setting. The study was a phenomenological qualitative research design, with researcher-developed guiding questions to help direct the interviews. Participants had passed the National Council for Licensure Examination for Registered Nurses (NCLEX-RN), and had been practicing from three months to one year. Eight RNs participated in the study, with seven usable interviews. Results found that new graduate RNs experience multiple stressors as they acclimate to their new roles. The primary stressors that were identified by the participants included high nurse-to-patient ratios, short orientation periods, time management and prioritizing, and lack of time with their preceptors. In addition, the RNs expressed frustration with the inability to spend quality time with their patients. They felt that although the patient’s needs were met, they were rushed in providing care and were unable to serve as a patient advocate. Other stressors identified by the RNs were concerns about interacting with physicians, and constant apprehension that a patient’s condition would deteriorate and they would not recognize the change in a timely manner. In addition, concerns about lack of staff support were mentioned by a majority of the participants, and they were very particular who they approached for assistance. The results of this study also indicated that the new RNs were very committed to patient care and overall enjoyed nursing. While they acknowledged the stressors, many were very surprised by the mental and physical demands of working in an acute care hospital setting. Preceptors were of great value in the transition, and served as a role model, educator, and support system. The researcher identified the following themes that emerged: 1) The Honeymoon Phase, where the new RNs were excited, nervous, and anxious about beginning their job; 2) The Transition Phase, where reality of their roles began to set in, and multiple stressors were identified; and 3) The Divorce or Reconciliation Phase, where the new RN made the decision to stay or leave their job in the acute care hospital setting