The experiences of newly graduated nurses in Saudi Arabia : a qualitative case study examining social, cultural, and contextual challenges

Background: The literature indicates that newly graduated nurses (NGNs) tend to feel inadequate during their first year of employment, due to a series of challenges they encounter with whilst transitioning into the role of qualified nurse. Although there is much research on the experiences of NGNs in a western context, far less attention has been paid to the experiences of NGNs in the eastern context, where the social, cultural and contextual climate is largely different. Aim: To explore, describe and interpret the experiences of NGNs at a hospital in Saudi Arabia during their first year of employment, emphasising how culture and social attitudes affect the NGNs’ transition process, and how NGNs rationalise such experiences.Method: Qualitative case study informed by an ethnographic approach, to provide rich data into the context and meaning-making. Data collection: Data was collected via fieldwork observations and semi-structured interviews with nine NGNs and four Head nurses. Data Analysis: Data was analysed using thematic analysis, as described by Braun and Clarke (2006), to enable the synthesis of different data elements to produce a cohesive account of the case. Findings: The Saudi NGN transition process shares multiple features with the transition process described in international literature. However, the Saudi transition process is also shaped by unique cultural and social challenges not present in other countries that influence experiences in a culturally distinct manner. These factors include nursing’s lesser status in Saudi society, cultural views on women’s labour force participation, the presence of foreign nurses, Saudi culture's lack of familiarity with nursing, sex-segregation, night shifts, and transportation challenges. Due to these challenges, NGNs struggle with self- confidence, emotional distress, low job-satisfaction, asymmetric relationships with senior nurses and doctors, and an intention to leave. These findings inform a set of recommendations for government, policy-makers, and educators that help to improve Saudi NGNs’ transition process