Nurses' perceptions and experiences of work role transitions: a mixed methods systematic review of the literature

Aim To understand nurses' perceptions and experiences of work role transitions. Background Globally an uncertain healthcare landscape exists and when changing work roles nurses experience periods of transition when they may not cope well. A greater understanding of work role transitions may help facilitate workforce retention and successful careers. Design Mixed methods systematic review. Data sources Six data bases were searched for peer reviewed primary empirical research, published in English language between January 1990 and December 2014, supplemented by hand and citation searching. Review methods Evidence for Policy and Practice Information and Co-ordinating Centre methods for systematic reviews principles were followed. Analysis and synthesis of the qualitative and quantitative papers was conducted separately using thematic analysis. A third synthesis combined the narrative findings and a narrative synthesis of results is presented. Results Twenty-six papers were included. Across nurses' work role transitions two pathways were found: Novice and Experienced. ‘Novice’ comprises pre-registration and newly qualified nurses. ‘Experienced’ comprises, Enrolled/Licensed Practical Nurse to Registered Nurse, experienced to specialist nurse and clinical role changes. Each pathway results in different emphasizes of two themes; ‘Striving for a new professional self’ includes emotional upheaval and identity while ‘Know how’ includes competence and boundaries. Novice nurses are more susceptible to the extremes of emotional upheaval while experienced nurses' competence eases aspects of transitions while boundary issues pervade. Conclusion Informed work and educational environments are required for all groups of nurses. Using existing models of transition can facilitate successful individual transitions and develop the workplace