Blog spotlight: Helping new graduate nurses over transition shock: Part 2: The "being" stage

Nurse Leader Insider, July 4, 2011

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Kendra Varner, MSN, RN, nurse residency program coordinator for the Kettering Health Network in Dayton, OH, wrote in the book Nurse Residency Program Builder, that new nurses go through many experiences as they transition to become competent nurses. In the second part of a three part series, Varner describes the second stage.

Judy Duchscher elaborated on the concept of new graduate nurse shock by describing the transition process as a nonlinear "Process of Becoming" a nurse (Duchscher, 2008). This process has three stages: doing, being, and knowing.

During the "being" or transition crisis phase, the real work of role transition occurs, beginning around the fourth month. During this stage, new nurses have consistent and rapid knowledge, skill, and critical thinking acquisition, but at the same time begin to experience a paradoxical loss of confidence resulting in uncertainty, confusion, and even depression. Consciously aware of competency level and significantly doubting their own abilities, new nurses seek validation of decisions from more experienced coworkers, which may be met with mixed reactions. While examining inconsistencies and inadequacies within the healthcare setting, graduate nurses struggle to reconcile their previously held view of self and the world with current reality, or they cognitively adapt to the change. Described by Bridges (2009) as a psychological wilderness state between identities and realities, this stage is profoundly frustrating, as well as irritating for nurses, impacting both personal and professional lives.

Duchscher (2008) indicated that new graduates, attempting to cope with internal conflict and ambiguity, expend significant energy and can deplete emotional, physical, and spiritual reserves. Searching to escape the stress, nurses will be tempted to "put things back" by returning to a familiar routine or comfort zone, such as leaving the post or returning to school. Choosing to remain at the current position, but feeling perpetually incompetent, inadequate, exhausted, devalued, disappointed, and powerless, nurses will likely withdraw, desperate to find balance and restore energy.

Read the rest of this blog post at The Leaders' Lounge.

Click here to read part 1 in the series.

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