How graduate nurses adapt to individual ward culture: A grounded theory study

AIM: To increase understanding of strategies graduate nurses use on a day-to-day basis to integrate themselves into pre-existing social frameworks. BACKGROUND: Being a graduate nurse and transitioning from a novice to beginner in the first year of clinical practice is stressful, challenging and overwhelming due to steep learning curves and adjusting to working in professional environments. How graduate nurses socially adapt and fit into ward cultures is a hurdle to successful transition and can be difficult. DESIGN: A qualitative constructivist grounded theory methodology was used. METHODS: Seven adult, Registered Nurses were recruited using a purposive sampling technique. Participants were undertaking a graduate nurse transition programme, in one of two acute care, adult public hospitals in South Australia. Data collection conducted in 2016 used individual interviews consisting of open-ended questions in an unstructured format. Transcripts were transcribed verbatim. Data analysis processes included initial and focused coding, theory building, memo-writing and theoretical sampling. RESULTS: Three main categories: self-embodiment and self-consciousness, navigating the social constructs and raising consciousness, supported by subcategories describe the main strategies graduate nurses use to facilitate adaptation into complex clinical environments and ward cultures. Subsequent concept and theory development explains how graduate nurses find the social and professional balance to fit in. CONCLUSIONS: Understanding the graduates' adaptation strategies can inform improvements in graduate nurse transition programmes. Facilitating and enhancing graduate nurse adaptation is the precursor in creating more resilient nurses ready to face the challenges that exist in today's work environments.