Experiences of Newly Graduated Nurses on Strategies of Gaining Self-Confidence During Their Initial Work: A Qualitative Study

10.1097/jnr.0000000000000050

Vahid Zamanzadeh；Fariborz Roshangar；Eskandar Fathi-Azar；Leila Valizadeh；Jodyanne Kirkwood

newly graduated nurse ； self-confidence ； strategy ； qualitative content analysis

The Journal of Nursing Research

22卷4期（2014 / 12 / 01）

283 - 291

英文

Background: The presence of newly graduated nurses (NGNs) in clinical settings increases the rates of clinical errors and patient injury. In addition, the turnover rate for NGN staffs is significantly higher than the average turnover rate. Therefore, familiarizing NGNs with their workplace and increasing their professional selfconfidence increase their empowerment and efficiency. Purpose: This article elicits the strategies used by NGNs to gain self-confidence during their early career. Methods: This qualitative study was conducted using the purposive sampling method and was based on the data saturation principle. Data were collected using in-depth, semistructured interviews from 30 NGNs working at teaching hospitals in four northwest provinces of Iran during 2012 and 2013. Data were collected by means of in-depth semistructured interviews. Qualitative content analysis was used to analyze the data. Results: The interviews elicited eight coping strategies that participants used to form self-confidence during the first 6 months of their career. These strategies included familiarity, knowledge enhancement, clinical skills learning, self-exploration, validation, responsibility, mutual interaction, and personal creativity. In addition, participants used these strategies to reinforce their self-confidence during their first 2 years at work. Conclusions/Implications for Practice: The results of this research increase the understanding of NGNs, managers, and healthcare professionals regarding the strategies used by NGNs to gain self-confidence. This knowledge may be applied in programs designed to increase the empowerment and efficacy of nurses to improve the quality of patient care and reduce nurse turnover.

1. Chen, Y. H.,Duh, Y. J.,Feng, Y. F.,Huang, Y. P.(2011).Preceptors' experiences training new graduate nurses: A hermeneutic phenomenological approach.The Journal of Nursing Research,19(2),132-140.
   連結：
2. Lee, Y. Y.,Chen, C. H.,Wang, C. J.(2002).Entry-level skill competency: Acomparison of head nurses' expectations and new graduates' perceptions.The Journal of Nursing Research,10(3),217-226.
   連結：
3. Yeh, S. H.,Hsiao, C. Y.,Ho, T. H.,Chiang, M. C.,Lin, L. W.,Hsu, C. Y.,Lin, S. Y.(2004).The effects of continuing education in restraint reduction on novice nurses in intensive care units.The Journal of Nursing Research,12(3),246-256.
   連結：
4. Bagay, J.M.(2012).Self-reflection in nursing.Journal of Professional Nursing,28(2),130-131.
5. Berkow, S.,Virkstis, K.,Stewart, J.,Conway, L.(2009).Assessing new graduate nurse performance.Nurse Educator,34(1),17-22.
6. Boswell, S.,Lowry, L. W.,Wilhoit, K.(2004).New nurses' perceptions of nursing practice and quality patient care.Journal of Nursing Care Quality,19(1),76-81.
7. Casey, K.,Fink, R.,Krugman, M.,Propst, J.(2004).The graduate nurse experience.The Journal of Nursing Administration,34(6),303-311.
8. Chan, Z. C. Y.(2013).Critical thinking and creativity in nursing: Learners' perspectives.Nurse Education Today,33(5),558-563.
9. Chandler, G. E.(2012).Succeeding in the first year of practice: Heed the wisdom of novice nurses.Journal for Nurses in Staff Development,28(3),103-107.
10. Chesser-Smyth, P. A.,Long, T.(2013).Understanding the influences on self-confidence among first-year undergraduate nursing students in Ireland.Journal of Advanced Nursing,69(1),145-157.
11. Clancy, A.,Svensson, T.(2007)."Faced" with responsibility: Levinasian ethics and the challenges of responsibility in Norwegian public health nursing.Nursing Philosophy,8(3),158-166.
12. Crooks, D.,Carpio, B.,Brown, B.,Black, M.,O'Mara, L.,Noesgaard, C.(2005).Development of professional confidence by post diploma baccalaureate nursing students.Nurse Education in Practice,5(6),360-367.
13. Dee, C.,Stanley, E. E.(2005).Information-seeking behavior of nursing students and clinical nurses: Implications for health sciences librarians.Journal of the Medical Library Association,93(2),213-222.
14. Delaney, C.(2003).Walking a fine line: Graduate nurses' transition experiences during orientation.The Journal of Nursing Education,42(10),437-443.
15. Dempsey, S. E.,Burr, M.(2009).The level of confidence and responsibility accepted by Australian radiation therapists in developing plans and implementing treatment.Radiography,15(2),139-145.
16. Dyess, S. M.,Sherman, R. O.(2009).The first year of practice: New graduate nurses' transition and learning needs.The Journal of Continuing Education in Nursing,40(9),403-410.
17. Godden, B.(2011).Orientation, competencies, skills fairs: Sorting it all out.Journal of PeriAnesthesia Nursing,26(2),107-109.
18. Graneheim, U. H.,Lundman, B.(2004).Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness.Nurse Education Today,24(2),105-112.
19. Halter, C.,Stoffers, P.,Kelly, L.,Redding, K.,Carr, L. L.(2011).Work unit transformation to welcome new graduate nurses: Using nurses' wisdom.Nursing Economic$,29(2),88-93.
20. Hedberg, B.,Sätterlund Larsson, U.(2003).Observations, confirmations and strategies-Useful tools in decision-making process for nurses in practice?.Journal of Clinical Nursing,12(2),215-222.
21. Higgins, G.,Spencer, R. L.,Kane, R.(2010).A systematic review of the experiences and perceptions of the newly qualified nurse in the United Kingdom.Nurse Education Today,30(6),499-508.
22. Kaufman, J. C.(2002).Creativity and confidence: Price of achievement?.The American Psychologist,57(5),375-376.
23. Labaf Ghasemi, F.,Marbaghi, A.,Joz Kabiri, F.,Hosseini, F.(2005).Assessment of work experiences of the temporary employed nurses within the program of human research project.Iran Journal of Nursing,18(43),7-19.
24. Lew, M. D. N.,Schmidt, H. G.(2011).Self-reflection and academic performance: Is there a relationship?.Advances in Health Sciences Education,16(4),529-545.
25. Major, G.,Holmes, J.,Hons, B.(2008).How do nurses describe health care procedures? Analysing nurse-patient interaction in a hospital ward.Australian Journal of Advanced Nursing,25(4),58-70.
26. McElhinney, E.(2010).Factors which influence nurse practitioners ability to carry out physical examination skills in the clinical area after a degree level module: An electronic delphi study.Journal of Clinical Nursing,19(21-22),3177-3187.
27. Nemadi Vosughi, M.,Tazakkori, Z.(2008).The views of newly graduated nurses toward their supporting status during transition stage in Tabriz University of Medical Sciences.Iranian Journal of Medical Education,7(2),389-395.
28. Nicholl, H. M.,Tracey, C. A. B.(2007).Questioning: A tool in the nurse educator's kit.Nurse Education in Practice,7(5),285-292.
29. Olson, M. E.(2009).The "millennials": First year in practice.Nursing Outlook,57(1),10-17.
30. Reid, D. H.(2010).North Carolina, USA,Gardner-Webb University.
31. Smith, A.,Lollar, J.,Mendenhall, J.,Brown, H.,Johnson, P.,Roberts, S.(2013).Use of multiple pedagogies to promote confidence in triage decision making: A pilot study.Journal of Emergency Nursing,39(6),660-666.
32. Thrysoe, L.,Hounsgaard, L.,Dohn, N. B.,Wagner, L.(2012).Newly qualified nurses experiences of interaction with members of a community of practice.Nurse Education Today,32(5),551-555.