Exploring the Experience of New Graduate Nurses in Saudi Arabia During Orientation Program

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1.7. Research questions

The study will be guided by the following research questions.

1. What are the experiences of graduate nurses in northern region of Saudi Arabia?

2. What is the role of orientation programs in the transition from a graduate nurse to a registered nurse in the northern region of Saudi Arabia?

3. How can orientation programs for graduate nurses in the northern region of Saudi Arabia be improved to meet the graduates’ needs?

1.8. Limitations of the study

Although the use of Casey-Fink Graduate Nurse Experience Survey will offer various benefits to the study, the tool can be associated with a few limitations. Since questions in this survey will depend on the nurses’ memory, cases where some nurses will forget vital information will limit the study validity. Standardization of the survey may also give room for misinterpretation of some questions, especially in sections containing close-ended questions as these questions do will not give the nurses a chance to explain their points. Open-ended questions included in the survey may generate huge amounts of data, forcing the researcher to spend a great deal of time in data processing and analysis. The use of primary data as the only source of data can be termed as another source of limitation in the proposed study. Use of secondary sources of data such as books, reports and journals can improve the study validity as these sources act as a good source of information about what is already known about the topic in question.

2.0. Literature review

A number of research studies have been carried out and results published about the experiences of graduate nurses as they transition from student to acting as professional nurses. Throughout the available literature on this topic, it is clear that these nurses experience several difficulties in the course of the transition. For example, Marshburn et al. (2009) explain that lack of confidence is one of the major challenges faced by the graduate nurses. Since confidence is vital in the creation of interpersonal collaboration, its absence in graduate nurses or fresh professional nurses may hamper their interpersonal interaction. This is in turn makes it difficult for these nurses to provide effective and safe healthcare.

Casey et al. (2004) assert that graduate nurses exhibit feelings of lack of enough clinical knowledge that makes them to assume that they are incompetent to provide effective healthcare. This is majorly experienced in first year of professional nursing practice. They are not sure whether they can learn new skills and are therefore anxious as well as scared when required to make decisions affecting patients’ care. Additionally, the lack of confidence makes it a challenge for the graduate nurses to provide answers to most of the patients’ questions. However, Casey et al. (2008) avow that the specific challenge starts to fade towards the end of the first year of the transition program. This period is characterized by increase in the graduates’ confidence in and readiness to think critically. This is when they begin getting comfortable with their new set of clinical roles. This experience is confirms the explanations of Duchscher (2008), who argued that the nurse stops acting like a nurse and becomes a nurse.

Transiting from graduate nurses to professional nurses subject nurses to mentor-mentee relationships. At the same time, these nurses work in the same environment with nurses who have already worked as professional nurses for several years. Therefore, the relationship between the graduate nurses and their peers of mentors is another aspect of their experience. Although there are many cases where graduate nurses are treated positively by their peers and preceptors, some exceptions exist. As explained by Dyess & Sherman (2009) there are cases where graduate nurses feel demoralized by the lack of respect and acceptance from the professional/experienced nurses. As a matter of fact, many of them dislike being referred to as “new graduates”.

Research shows that a good number of graduate nurses feel that most of the experienced nurses they work with do not understand how it feels to be a new graduate. This is given as the reason why such professional nurses are insensitive to the need to maintain continued development of graduate nurses, especially in time management skills. More importantly, lack of consistency in provision of preceptor assistance in the course of transition has been recognized as a great challenge as it contributes to lack of proficiency on the side of graduates. Lack of positive and timely feedback from the peers and preceptors makes the graduates develop fear and find it difficult to speak out any idea. This is made more complicated by the fact that the graduates fear to report the negative treatment they receive from their peers and preceptors. Therefore, there is a great need for healthcare institutions to develop interventions that will help them provide interprofessional collaboration support at both organizational and team levels.

Goode et al. (2013) identified the struggle between dependence and independence as an aspect of graduate nurses’ experience. The nurses are found to struggle because they need to be independent and continue to rely on the input of experienced nurses. Some of them feel lonely and overwhelmed by huge amount of work. Others are made comfortable by the feeling that there is no one telling them what to do. However, research reveals that the graduate nurses are able to work independently after working as professional nurses for about one year.

The environment in which graduate nurses work in influences their experience as they transition into working as professional nurses. Nurses working in understaffed environments complain of being required to execute overwhelming tasks as such environments are characterized by high nurse-to-patient ratios. Lack of proper nurse retention has been found to be the major cause if the high ratios. A small percentage of graduate nurses find it difficult to work during the day and sometimes during the night. They are made unhappy by lack of school vacations and other forms of time off. As they gain experience, some graduate nurses are required to work as preceptors while executing other tasks. This is normally a challenging experience to them since multitasking is new to them at such a stage.

Graduate nurses with less than 6 months experience have no organization skills in most cases. This presents as a major barrier to effective performance in their newly acquired role. They normally have a hard time when