Supporting new graduates successful transition into practice through orientation in the emergency department: an integrative literature review




Kary, Amy

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The phenomenon of newly graduated nurses (NGs) beginning their professional careers in emergency departments is relatively new in the nursing world. Considering the complex and dynamic nature of the emergency environment, clinical nurse educators are challenged to plan and implement orientation programs that meet the unique transition needs of NGs in their departments. Using Whittemore and Knafl’s empirical integrative literature review as the methodological basis for this project, an examination of existing literature exploring the efficacy of orientation in supporting NG transition from the student to RN role was conducted. Duchscher’s Stages of Transition Theory provided the theoretical foundation for this review as it offered a clear conceptualization of the anticipated three-stage, 12 month long transition journey that NGs new to acute care clinical practice experience. The key finding of this review is that various aspects of orientation had a positive or negative effect on the successful transition of NGs into clinical practice and were dependent on their position on the transition continuum. During the first stage of transition, NGs are best supported through practical aspects of orientation that met their immediate clinical practice and social needs. The aspects of orientation that supported NGs through the second and third stage of transition were more broadly focused on pushing their knowledge and practice at a time when they were ready, fostering and supporting more independent clinical practice, and helping them to learn about and become a part of the larger community of nursing. Based on these findings, recommendations for orientation that support NG transition are offered for those advanced education practice nurses involved in the development, implementation, or evaluation of such programs.



new graduates, nursing, emergency department, practice