University of Central Florida

College of Nursing

The Relational GenerationExpectations of Millennial Student Nurses

Preparing to Transition into Practice

Diane R. Andrews, PhD, RNAssistant Professor

UCF College of Nursing

The 2012 National State of the Science Congress on Nursing ResearchSeptember 14, 2012

Washington, DC

University of Central Florida College of Nursing

This study was supported through intramural funding provided by

UCF College of Nursing

University of Central Florida College of Nursing

Why Study New Grads?

Shortages and Retention

New Generation/New Values

Turnover

Expectations Unknown

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Purpose: Identify Expectations

What do new graduate nurses expect as they transition into the workforce and what

might be the impact?

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Method

Qualitative descriptive design

BSN students

Semi-structured, open-ended questions

Interviews, recorded, transcribed

Data analyzed and coded

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Findings

Expect transition will be stressful

Expect a safety-net of support

Expect respect and acknowledgement

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Stressful

Self-doubt regarding knowledge and competency

Worried about independent decision-making Worried about “Being Judged”

• Patients and Families• Physicians

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“I’m so used to having a preceptor or having an instructor there that the thought of me doing it on my own kind of scares me a bit.”

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Safety-net

Expect safety-net of support …

Orientation and preceptor support

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“I expect to be in the role of graduate nurse. And I expect to have a preceptor. And I expect not to be put in positions that I am not supposed to be put into.”

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Safety-net

Expect safety-net of support …

Orientation and preceptor supportColleague support

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“I would just hope they would view me as a peer from the beginning.”

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Safety-net

Expect safety-net of support …

Orientation and preceptor supportColleague supportSupervisor supportFamily support

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Respect & Acknowledgement

Collegiality

Teamwork

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“I would hope they would view me as a peer from the beginning. I mean even though I’m just beginning it’s “I’m doing the same work you know. Just learning as I go.” So I’d hope to be viewed maybe as a peer, or like a younger peer, from the beginning.”

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Expectation vs. Reality

Anticipatory stress related to confidence and competence …

Anticipatory stress well documented Residency programs lead to improved skill

with delegation, prioritization, managing patient care delivery, autonomous decision-making, collaboration, conflict resolution and constructive use of feedback.

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Expectation vs. Reality

Supportive relationships ….

Multiple reports of incivility in the workplace Age/generational differences precipitate.

misunderstanding and affect unit culture. Inappropriate use of power in assessment of

new graduates is a source of conflict.

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Expectation vs. Reality

Collaborative teamwork …

The expectations of Millennials for collaboration and teamwork is inconsistent with the work values of previous generations.

Nurse/Physician collaboration remains a challenge.

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Implications

There is evidence that residency and preceptor programs address the known stressors. associated with competence and confidence.

Participation in such programs has been demonstrated to improve short-term retention.

Programmatic intervention.

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Implications

The expectations of transitioning nurses related to supportive relationships and collaborative teamwork are associated with unit culture.

Unit culture is associated with job satisfaction and stated intent to leave.

Organizational interventions to meet the expectations of new graduates need to be addressed.

Healthy work environment critical.

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References

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References

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References

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References

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References

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References

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References

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References

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Thank-you

Questions ….