Early-career nurses believed that nursing was a career which required lifelong learning. The opportunity for continuing professional development and growth was regarded as an attractive feature of the nursing profession. They were educated to recognize the importance of evidence-based practice and expressed a strong desire to constantly learn new things.
[Nursing] has lots of different opportunities, ways to learn, and I’ve already found in the couple of years that I’ve been working—I’ve been learning every day.
When starting their career, early-career nurses felt support, guidance and training were essential to transition them from students to nurses. They wanted to feel supported during this initial career phase and looked to other nurses, mentors and preceptors for this support.
I think that’s such a crucial period of time, right? You go from being a new student and learning all of this stuff in the classroom and out of a book, but going and actually practicing nursing and being out there...You just grow so much more, but to have that support during that period of time, it’s crucial. If you do have mentors and preceptors and co-workers who are supportive, it can be the most amazing experience, but if you don’t have that, it can be frightening.
Unfortunately, many early-career nurses described receiving inadequate orientation when starting their careers, which was often associated with a lack of staffing or time to train new hires. This left early-career nurses feeling unsupported, as if they had to “figure it out on [their] own”.
More often than not when I was orienting to the unit we’d be short-staffed so I’d have a patient with me.
Adding to an initial feeling of minimal support was the belief that their formal education did not always provide a realistic view of what their nursing career would look like.
You have this idea of what it means to be a nurse when you’re in school, and you do your practicum, and you think you’re going to start nursing and you’re going to work in this really supportive environment, and patient-centred care is your priority. Then you go into the workforce, and your colleagues want to be supportive but they’re busy with their own assignments. So I kind of felt like you just get thrown in there and you have to figure things out as best you can...you feel like you’re out there alone.
Participants who described feeling supported in their student-to-career nurse transition often associated it with a new graduate transition program that provided these nurses with a feeling of confidence and preparedness.
What helped me the most with my career was—I graduated about a year ago now—was the new grad initiative, and I found that to be something very valuable in terms of transitioning from being a student nurse into a working nurse.
Overall, many early-career nurses felt unprepared when starting their careers, and often they felt they were given too much responsibility too soon.
I had expected a lot more support as a new grad...I was trained for charge within two months of graduating, and I don’t feel that I was qualified to do that, but they said, ‘oh you can do it, you’ll be fine,’ and you’re a new grad so you say ‘okay,’ and thankfully nothing happened, but the expectation of new grads is very high.
Once through the initial career transition from student nurse to working nurse, early-career nurses had a strong desire to continue their training and education. They described how they wanted to take part in educational opportunities and training sessions but often felt unsupported in their efforts. A lack of time off and minimal funding support often left early-career nurses unable to continue with the education and training that they desired.
We have a great general education that gives us a great head start, but now I’m looking for education, I’m looking for more specialized training and I’m finding it’s really hard to find.
If you’re expected to come in on your only two days off to do education, it just gets to the point where you don’t even want to come in.
Significant importance was given to the training and support that early-career nurses received from more senior nurses they worked with. In the absence of formal, structured orientations, education and training opportunities, this informal mentorship and support from more experienced nurses was especially important. Intraprofessional support was acknowledged as a valuable resource, especially for new graduates.
I’m very pleased with the support that certain nurses have for other nurses...I find our support for each other is very strong.
It’s so important to just advocate for yourself if you can’t handle something. I’m very lucky at my hospital where our teamwork is so good, and I like the staff that I work with. I’m thankful for every day because when things like that happen, especially as a newer nurse, you need those seasoned nurses just to come and assess the patient and to sometimes even calm you down when you’re in a situation you’re not used to.
Positive co-worker relationships and teamwork were often able to fill the training void that many early-career nurses described. However, it was noted by some that when the unit was busy or understaffed, very little assistance was possible from other nurses.
I think there’s an expectation when you go into nursing that you’re going to have more support from your co-workers. You don’t realize that they’re going to have a huge assignment too so they don’t really have time to mentor you as much as you might have imagined when you first came on.
Early-career nurses described a commitment to continuing education and training in order to increase their preparedness and confidence in providing quality patient care. The provision of optimal care to patients was the primary impetus for their desire for ongoing learning and skills development. Although transition supports were identified as helpful for new graduates, early-career nurses recognized that educational opportunities were needed beyond their first few months as a novice. While other more experienced or ‘seasoned’ nurses were a resource for new nurses, in the absence of a formal support structure many participants described feeling as if they were “out there alone”.