Dissertations / Theses on the topic 'Graduate School of Nursing'

The central objective of the study was to better understand 5th and 6th year school pupils’ perceptions of nursing as a career choice and to obtain current data regarding the recruitment situation pertaining to school leavers pursuing nursing as a career choice. This was achieved by utilising a multi-strategy approach which involved the use of a self-administered questionnaire (n = 1062) and the interviews of 20 paradigmatic cases. The school pupils came from 11 schools, with different socio-demographic profiles, from one educational area in Scotland. The study found that only 8.8% (n = 56) of school pupils who had made a career choice had chosen to pursue nursing as a career, despite the fact that 82.4% of the school pupils in the sample had the necessary academic qualifications to enter the student nurse education programme. Merely 21.2% of all the pupils had actually considered nursing as a career choice. The findings would appear to suggest that those pupils who had chosen to pursue nursing as a career choice are committed to this choice. As 93% of the pupils would still continue to pursue nursing as a career choice even if they obtained better grades in their examinations than they expected. Equally resolute in their choice were the pupils who had chosen not to pursue nursing. Of the school pupils in the sample who had not chosen to pursue nursing as a career choice 88.5% of the school pupils stated that even though they did not get the exam grades that they expected they still would not pursue nursing as a career. What was also significant was that of the school pupils who had not chosen nursing as a career choice 86.9% of the pupils stated that they would not consider nursing as a career option in the future. The gender breakdown of school pupils who had made a career choice showed that 2.5% of male pupils who had made a career choice had chosen to pursue nursing. 14% of female school pupils who had made a career choice had chosen to pursue nursing. Further examination in relation to the gender breakdown of those pupils who had chosen to follow nursing as a career revealed that males only accounted for 12.5% whereas females accounted for 87.5%. This would seem to propose that a gender bias still exists in relation to nursing as a career choice. Nursing was not ranked particularly highly by the pupils as a career choice. Male pupils ranked nursing 13th out of the 14 main career choice categories. While female pupils ranked nursing 8th out of the 14 main career choice categories, this being only slightly better than secretarial/administration. Parents appeared to have a major influence on the pupils’ career choice and there was evidence that parents as well as further significant others were influencing against a career in nursing. Nursing does not seem to be a popular career choice among school pupils. There is strong evidence from the questionnaire data to suggest that there are a number of problem indicators which could propose that recruitment of school pupils into nursing could prove extremely difficult even with the proposed increase in the number of school leavers entering higher education. This could have a serious impact on nursing care delivery within the United Kingdom as the nursing population continues to age. The paradigmatic cases interviewed were 20 high academic achieving school pupils who at one stage in their career choice process had considered nursing as a career choice. Despite considering nursing as a possible career choice none of the 20 pupils went on to pursue nursing as a career. The qualitative interview findings appeared to suggest that nursing was not a credible career choice consideration for high achieving pupils. There was a very strong feeling amongst the pupils that nursing would be a waste of their academic qualifications with a belief that nursing was not a career choice for intelligent pupils with good examination grades. Also that they could help people at a much higher level than nursing by becoming a doctor with a prevailing belief that knowledge and caring are polarised – doctors cure and nurses only care for patients. The status of nursing as a career choice was not high amongst the pupils and this was influenced by the type of person that they had observed who were nurses mostly, in their opinion, women who were weak and had no power within society. Also the perceived nature of the job that nurses do with the prominent belief that what nurses do is principally practical in nature having no intellectual aspects, for example making beds, washing and feeding patients. The influence of significant others, these being specifically parents, guardians, guidance teachers and careers advisors was very apparent in the data in that they had a very negative view regarding nursing as a career choice for high academic achieving school pupils. Participants reported that their parents were actively and vigorously discouraging them away from a career in nursing because of the pupils’ good examination grades and the belief that the pupils could do something better than nursing. Also the participants reported that their guidance teachers and careers advisors were assertively steering them away from nursing as a career choice because of their perception that nursing was a low status career choice requiring little intellectual ability and was on a par with hairdressing, office work and being a secretary. In addition the school pupils stated that guidance teachers and careers advisors were more interested in and attempted to have a greater influence on the career choice of the high academic achieving school pupils opposed to other less academic pupils. Only two of the pupils stated that they believed that their career choice was their own decision. With the majority of school pupils valuing the opinion of their parents regarding career choice and with parents along with associated significant others being a major influence on the school pupils’ career choice and advising against a career in nursing. There was strong evidence from the interview data to suggest that the chances of recruiting high academic achieving school pupils into nursing would appear to be negligible. There was also evidence that the image of nursing as an occupation was an important determining factor in the school pupils’ career choice. The pupils displayed a negative image of nursing and this was influenced by a number of factors. The negative image of nursing depicted in television programmes; the negative image of nursing portrayed by people who are nurses; the sexual stereotype image of female and male nurses; and the image that it is very easy to get into train to be a nurse. What was also concerning was that the pupils had few positive and contemporary images of nursing. Also with regard to the image of nursing the data showed that the pupils considered it important to join a profession. Nursing was deemed not to be a profession and did not merit being a profession because it was believed that the entry to student nurse education programmes is not strictly controlled therefore it is easy to get into nursing. There was a strong consensus among the high achieving school pupils regarding their image of the archetypical school pupil who would select nursing as a career choice – their view was of a predominantly unexceptional individual who was mostly female, no more than average intelligence, kind, caring, good listener, good practically and can follow task orders. This view of the typical school pupil who would enter nursing as a career, that of a person with a low academic achievement record, conflicts with their own personal typology and thus became a further important dissuading factor regarding nursing as a career choice for them.

Preloading student satisfaction and success factors into an online program orientation course can strengthen the potential for student retention and success. A 100% online graduate nursing orientation and guidance program was developed. Access to peer support, faculty advisor, and university resources were provided within the course using the same learning management system as the program. Students were taught the basic structure of courses (including discussions, quizzes, and dropbox) to ease the stress of the first few weeks of class. Graduate study requirements and expectations were explained along with the differences between online and face-to-face study. Guidance was provided to assist students in balancing work, life, and study. Students report decreased anxiety and increased comfort with graduate online education, increased self confidence, and feelings of support.

Thesis (Ph. D.)--Illinois State University, 1990.
Title from title page screen, viewed November 17, 2005. Dissertation Committee: John R. McCarthy (chair), Edward R. Hines, George Padavil, Kenneth H. Strand, David L. Tucker. Includes bibliographical references (leaves 146-158) and abstract. Also available in print.

This qualitative narrative descriptive study focused on nine successful Latino nursing school graduates. Five participants were interviewed twice and four participants were interviewed once for a total of fourteen interviews. Participants and their families immigrated from Brazil, Costa Rica, Cuba, and Mexico. Participants attended school in North Carolina, South Carolina, and Tennessee. Interviews revealed themes of Familism, Empowerment, and Perseverance. Familism was an overriding theme throughout each of the interviews. Participants described family as being their greatest support. They discussed sacrifices made by their families which assisted them in being successful. In addition, they also shared their willingness to make personal sacrifices in order to honor their family by being successful. Empowerment was also a theme which surfaced. Participants were empowered to attain their goal of attending college and then succeeding in nursing school. The theme of Empowerment was supported by descriptions of parental sacrifice, parental and family support, and support of faculty. The theme of perseverance was demonstrated through continued goal-attainment. Participants struggled through time-management issues such as balancing family, work, and school commitments. They also worked through the guilt of not providing 100% of their time and attention to any one area of their life, especially family. Perseverance was displayed in multiple ways by participants. One of the most compelling was their need to honor their family. Another area which fueled their perseverance was faith. Lastly, participants stated that their need to be self-sufficient added to their perseverance. Self-efficacy surfaced as an attribute they all attained. Familism, perseverance, and empowerment were themes which were consistent with other studies. However, this study is the first study to address the successfulness of Latino nursing school graduates in the Appalachian area of the United States. This study is also unique in that each of the participants attributed their success to family. In addition, seven of the nine families immigrated to the United States for sole purpose of educating their children. This act of sacrifice by families further strengthened the theme of familism.

The purpose of this study was to investigate whether certain student-entry characteristics collected from an admissions application from one nursing school’s graduate (master’s degree) programs had a statistically significant relationship with student persistence. Specifically, the study determined if the variables sex, age at matriculation, U.S. citizenship, state residency status, most recent schooling year, last statistics course taken and grade, graduate-level program of study, and credit hours identified on the graduate nursing admissions application and school transcripts, had a statistically significant relationship in predicting student persistence to graduation. If a relationship existed, it would contribute to graduate student persistence literature and influence how educators and student affairs professionals can identify and support students at risk. The population was the graduate nursing students who enrolled at a large public research university in the Pacific Northwest of the United States during Spring 2005 through the Fall 2009 terms. Graduate students meeting inclusion criteria had data extrapolated from the college’s database; including, the pre-entry characteristics, total credit hours completed, and if (and when) they graduated from their program of study. Astin’s (1985) Input-Environment-Outcomes (I-E-O) Model was the theoretical framework utilized in this study. Out of the 405 graduate nursing students, 257 students (63.5%) graduated within four years from time of matriculation, or 278 students (68.6%) graduated without any time restrictions. Certain pre-entry characteristic data were no longer accessible and not included in the data analysis (most recent schooling year, last statistics course taken and grade). The analysis showed that the age (p < 0.010) and type of graduate program of study one enrolls (p < 0.010) plays an influential role in student persistence to graduation at this nursing school during this time period. In summary, on average, those students who graduated within four years from the time of matriculation were 3.2 years younger than the average age of those who did not complete their graduate program, and the completion rates for practitioner-focused students were higher (66.5-70%) compared to their non-practitioner-focused (46.8-61.3%) counterparts. The results of this study will have an impact on graduate admissions and recruitment, student progression and advising services, and faculty development. Graduate nursing student persistence has multiple implications impacting institutions, communities, and the lives of students. Future opportunities to advancing knowledge on this subject include researching additional pre-entry variables across multi-campus populations with larger sample sizes, longitudinal studies, and interventions to promote persistence.

Background: Shortly after the graduate nurses’ orientation period, the expectation is to rapidly function as a competent nurse. With this expectation, the graduate nurse experiences stress when attempting to quickly make the transition from student to practicing professional nurse. New nurses report that the primary reason they are leaving their employment within the first year is related to stress and thus low job satisfaction.

Purpose: The overall turnover rate for a community Catholic Hospital’s Critical Care Department is 60% within the past year. Combating the turnover, increasing satisfaction, and ensuring patient safety is what is needed for this hospital.

Methodology: The design for this project is comparative and correlational utilizing the Casey Fink New Graduate Nurse Survey. Residents involved in the revised residency program were surveyed on their job satisfaction and comfort-confidence after six months of residency. The results from the new residents were compared to nurses who had completed the previous residency program who had at least six months of experience.

Results: The results demonstrated the new residency program had no statistical significance on comfort, however, presented a statistically significant association with how new nurses experience the work environment of the Critical Care department.

Conclusions: The results of the study revealed a need for on-going assessment of the residents past the six month integration period. Another identified need that was noted was for on-going preceptor education and consistency. The study also discovered the need to explore other methods of increasing comfort during and after their residency period.

The impact of technology in today's society affects every aspect of life. This study focused on exploring the extent of computer anxiety among graduate nursing students using the Oetting's computer anxiety scale. Computer and information seeking skills required for both education and advanced nursing practice were also assessed using a survey by Jacobs and dela Cruz. Special emphasis was placed on retrieval of information from large data-bases. The conceptual framework was based on Roy's Adaptation Model. The sample consisted of 28 students enrolled in a nursing informatics class in a south Florida university. Frequency distribution, and t-tests were used to analyze the data. The results indicate that graduate nursing students have a mild computer anxiety. Perceived informatics needs included Internet use, electronic mail, compiling research, and thesis construction. Results of the study may be used to identify future curriculum content for nursing informatics classes.

One of the core issues in distance education has been the adequacy of assessment of student experiences and the interaction between faculty and students. This challenge has become even greater with the increase in the numbers of online courses in nursing. Distance education programs that are delivered totally online have many advantages and some disadvantages. Masters level nursing students are choosing online programs for convenience, flexibility, and quality. The purpose of this study was two-fold: to describe Masters nursing students’ perceptions of online courses between 2005 and 2009, as expressed through word data in a web evaluation survey; and to analyze the student perceptions of the online learning environment for trends and themes. The questions of this investigation were the following: 1. What perceptions do Masters nursing students have of their online courses (2005-2009) as expressed through word data in a web evaluation survey? 2. What recommendations can be made for continuous improvement and best practices in programming and evaluation methods based on student perceptions. This research utilized Constructivist Theory as a theoretical model. There were 1625 student comments and 903 suggestions that were analyzed for themes and placed in categories. A qualitative analysis approach was utilized to create categories and look for trends in the data. There were six categories gleaned from the comments and six more that were found as a result of reviewing the suggestions that were made for future course offerings. The researcher found that there was some overlap between the categories of the comments and those of the suggestions. The perception of the students regarding their online course experience in the graduate nursing program was very positive. The flexibility and independence that the online environment offered was appreciated. Blackboard was viewed very positively and students felt that it was easy to use. Students enjoyed the interaction with peers and with faculty and felt it was a valuable learning experience. Recommendations were identified, based on the findings related to the use of technology, recruitment and retention of faculty, and teaching strategies and learning styles.
Access to thesis permanently restricted to Ball State community only
Department of Educational Studies

Research has found that the turnover rate of graduate nurses within their first year is significantly high. Specialties such as pediatric and emergency nursing have even a higher turnover rate. It has been suggested that significant amounts of stress and lack of skills are responsible for the turnovers. This quality improvement project, which is theoretically based on Benner's novice to expert theory, will examine if a lack of a specialized pediatric emergency graduate nurse orientation program is a contributing factor. The purpose of the project is to improve retention of graduate nurses by implementing a specialized orientation program that focuses on pediatric emergency nursing. The research question examined the effect of a specialized graduate nurse orientation program on increasing retention, nurses' competency, and job satisfaction. This project takes the hospital's original orientation program of 6 generalized classes and hands-on orientation and adds a more specialized approach. The Emergency Nurses Association (ENA) Core Curriculum of specialized skills and didactic classes for pediatric emergency nursing (developed by the ENA pediatric committee based on evidence and gold standard practice); evaluation tools (developed by researcher) for both the preceptor and orientee; and face-to-face meetings between the educator, preceptor and orientee were the tools used for specializing the orientation program. It is anticipated that the results will show that increase in retention. In terms of social change, it is anticipated increased nursing retention will increase nursing knowledge and job satisfaction, which will ultimately lead to improved patient outcomes and decreased mortality rates.

This study examined differences in cultural competency levels between undergraduate and graduate nursing students (age, ethnicity, gender, language at home, education level, program standing, program track, diversity encounters, and previous diversity training). Participants were 83% women, aged 20 to 62; 50% Hispanic/Latino; with a Bachelor of Science in Nursing (n = 82) and a Master of Science in Nursing (n = 62). Degrees included high school diplomas, associate/diplomas, bachelors’ degrees in or out of nursing, and medical doctorate degrees from outside the United States. Students spoke English (n = 82) or Spanish (n = 54). The study used a cross-sectional design guided by the three-dimensional cultural competency model. The Cultural Competency Assessment (CCA) tool is composed of two subscales: Cultural Awareness and Sensitivity (CAS) and Culturally Competent Behaviors (CCB). Multiple regressions, Pearson’s correlations, and ANOVAs determined relationships and differences among undergraduate and graduate students. Findings showed significant differences between undergraduate and graduate nursing students in CAS, p <.016. Students of Hispanic/White/European ethnicity scored higher on the CAS, while White/non-Hispanic students scored lower on the CAS, p < .05. One-way ANOVAs revealed cultural competency differences by program standing (grade-point averages), and by program tracks, between Master of Science in Nursing Advanced Registered Nurse Practitioners and both Traditional Bachelor of Science in Nursing and Registered Nurse-Bachelor of Science in Nursing. Univariate analysis revealed that higher cultural competency was associated with having previous diversity training and participation in diversity training as continuing education. After controlling for all predictors, multiple regression analysis found program level, program standing, and diversity training explained a significant amount of variance in overall cultural competency (p = .027; R2 = .18). Continuing education is crucial in achieving students’ cultural competency. Previous diversity training, graduate education, and higher grade-point average were correlated with higher cultural competency levels. However, increased diversity encounters were not associated with higher cultural competency levels.

The transition from student to new graduate nurse is a difficult conversion. The challenges of the new graduate are the demanding workload, lack of clinical skills, and incivility from staff nurses and unfamiliar institutional cultures. More than 40% of new graduate nurses report making medication errors and feel unprepared to recognize and intervene in life-threatening complications that keep the patient safe from harm. Preceptorship is a clinical instructive model in which a professional relationship provides new graduate nurses with access to a clinical expert and role model within a preset time frame. The goal of the program was to evaluate the outcomes of a preceptorship program that individualized a teaching-learning method in which a new graduate nurse was assigned a clinical expert in order to experience the day-to-day practice with a role model and a resource in the clinical setting. At the conclusion of the orientation process, the graduate nurse identified confidence in their ability to complete assigned skills, they were more motivated to remain on staff in the facility, and the retention of the new graduate nurses increased from 40% to 100% at the 1 year mark. The graduate nurses evaluated the program, the preceptor and the assigned competencies and the facility and the probability of continuing on staff. The surveys were collected by management, and evaluated for rigor, which revealed encouraging results of the program. The facilitation and integration of the preceptor program for new graduate nurses changed the perception of competency within the facility as it relates to the discipline of nursing and moves the graduate toward professional growth, establishing a changing environment in the facility's community of healthcare.

Graduate nurses' transition from school to the work place is challenging and often leads to burnout. There was no graduate nurse residency program in women's services at the practicum facility. As a result, this facility had been unable to recruit or hire graduate nurses in the women's services unit. The purpose of this project was to develop a nurse residency program in women's services to address the lack of formal orientation for new graduate nurses at this facility. A graduate nurse residency program will provide further training for nurses to care for a more complicated population of pregnant women. Theoretical support for this project was Duchscher's, theory of transition, which suggests that allowing graduates time to adjust within a context of support allows them to develop their thinking and practice and helps them move through the stages of professional role transition. The project included a review of literature, development of a nurse residency plan, all materials needed to operationalize the program in the institution, and plans for implementing and evaluating the program over time within the context of institutional challenges, goals, and strengths. Collaboration with institutional stakeholders helped to ensure the contextual relevance of the program and ongoing administrative ownership to provide momentum for the program to move forward following delivery of the products of the DNP project to the institution. In sum, the products of this project comprise a turn-key solution to the institutional need for a graduate nurse residency program in women's services. Social change implications include possible improvement in the recruitment and retention of graduate nurses as well as the consistent development of competent and safe practitioners who will improve maternal and newborn outcomes at the facility.

The Urban Graduate Center is an academic village for graduate studies in an urban setting. The project seeks to establish a campus setting for students and professors who will primarily attend the Graduate Center on evenings and weekends. The Graduate Center seeks to extend the fabric of the existing urban area into an abandoned railroad yard site. The project involves a building complex the approximate size of a small city block. The building complex includes places for learning, places for meeting, and places for contemplation. The project offers the opportunity to investigate the process of designing architecture. While the project relates to needs of particular users the discoveries and methods of meeting these needs can be applied to many different forms of architecture. The various functions that will occur in the urban graduate center provide the chance to investigate issues of organization, scale, transitions, and details.
Master of Architecture

Thesis (S.M.)--Massachusetts Institute of Technology, Computation for Design and Optimization Program, 2009.
Vita. Cataloged from PDF version of thesis.
Numerical methods and algorithms have developed and matured vastly over the past three decades now that computational analysis can be performed on almost any personal computer. There is a need to be able to teach and present this material in a manner that is easy for the reader to understand and be able to go forward and use. Three popular course at MIT were without lecture notes; in this thesis the lecture notes are presented. The first chapter covers material taught in Numerical Methods for Partial Differential Equations (2.097/6.339/16.920) specifically the Integral Equation Methods section of this course, chapter two shows the notes for the course Introduction to Numerical Simulation (2.096/6.336/16.910), and chapter three contains the notes for the class Foundations of Algorithms and Computational Techniques in Systems Biology (6.581/20.482). These course notes give a broad overview of many algorithms and numerical methods that one can use to solve many problems that span many fields - from biology to aerospace to electronics to mechanics.
by Laura L. Proctor.
S.M.

ABSTRACT Insufficient pain management continues to be problematic for hospitalized patients throughout the country. It significantly interferes with a person's quality of life making it an issue of great concern to nurses in any setting. However, nurses do not do a good job of managing pain. The purpose of this evaluation was to assess graduate nursing students' knowledge and attitudes toward pain management. Forty (n=40) graduate nursing students were asked to participate in the evaluation. All students agreed and completed the Demographic Data Form, Nurses Attitude Survey and the Pain Management and Principles Assessment. Thirty-eight females and two males participated in this study. The mean age was 35 years old (SD=9.77) with a range between 24 and 62. The majority of the participants were Non-Hispanic white (70%), followed by African American (10%), Hispanic (10%), Asian and others. The mean years of nursing experience was 10 years with a standard deviation 7.31. The data showed that nursing students demonstrated inadequate knowledge regarding pain management. The mean score on the PMPAT was 66% (SD= 3.61). The mean score on the Nurse Attitude Survey was 77 (SD=5.8) on a survey with scores that could range from 25 to 100. The higher the score the more favorable that nurse is towards pain management. The scores ranged from 69 to 91. Knowledge and attitude scores had room for improvement, suggesting that the curriculum of the college could be improved. In addition, continuing education courses could be developed to support nurses' knowledge of pain management.

Research has shown that job satisfaction influences retention of nurses, and policies focused on nursing satisfaction are more beneficial for retaining new nurses than adjusting work hours and wages. The prophecy job fit predictor is a quality improvement initiative designed to identify where a nurse should be assigned based on behavior, clinical capabilities, and personality assessment. The practice-focused question for this project focused on whether satisfaction rates of recently graduated registered nurses were influenced by their unit placement. The conceptual frameworks that guided this project were the plan, do, study, and act method and Herzberg's 2-factor theory. Data were obtained from surveying a cohort of 54 graduate nurses in 3 hospital locations in 6 specialty units. Results obtained using 1-way ANOVA and a Likert scale showed that graduate nurse satisfaction rates increased when assigned to their best fit unit: prophecy job fit 58.33% with a mean score of 3.34 (Hospital A), prophecy job fit 20% with a mean score of 3.1 (Hospital B), prophecy job fit 33.33% with a mean score of 3.1 (Hospital C). The results showed that the prophecy job fit predictor during nursing orientation can guide nurses into the appropriate specialty unit and increase nursing satisfaction. The implications of these findings for positive social change in nursing practice include the benefits of using the prophecy job fit predictor when assigning graduate nurses to their hospital setting to address the nursing shortage.

The Institute of Medicine (IOM) report To err is human: Building a safer health system raised the very important concern of patient safety. The ultimate goal of this report was to provide a call-for-action that promoted patient safety at the point-of-delivery (Kohn, Corrigan, & Donaldson, 2000). Registered Nurses (RNs) represent the largest discipline providing and coordinating patient care redesign. The aim of creating safe and quality care would not be possible without the presence of competent nurses. Conversely, new graduate nurses are prone to errors due to lack of transitional support from academics to practice. With the growing shortage of experienced RNs nationally, there is a need to evaluate and promote programs to assist in the transition, retention, and recruitment of competent new nurses. Structured residency programs offer a means to increase the competency of newly graduated RNs. This study performed secondary data analysis of the Versant 18-Week Residency Program to provide evidence of the success of this approach in assisting new nurses in their transition from academia to practice.

Worry and rumination are implicated in various disorders and are believed to contribute to the symptoms that create and maintain psychopathology. The current critical review will examine worry and rumination in the context of depression, Generalized Anxiety Disorder (GAD), Posttraumatic Stress Disorder (PTSD), Obsessive Compulsive Disorder (OCD), and Social Anxiety Disorder (SAD). The review will focus on these two types of repetitive negative thinking more specifically the (a) definition, (b) process, (c) theories, and (d) maintenance of psychopathology; as well as similarities and differences between these two processes. A second emphasis will be on the importance of cultural considerations when treating individuals with emotional disorders. A third focus of the analysis will be on the rationale, overview, and literature associated with a transdiagnostic treatment named the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) . Finally, this review will conclude by highlighting futures research studies that can be implemented to improve upon the existing UP research.

Keywords: Worry, Rumination, Anxiety, Depression, GAD, PTSD, OCD, SAD, Transdiagnostic, Culture, Unified protocol for transdiagnostic treatment of emotional disorders.

Nursing leaders continue to voice concerns over new nurse graduates’ performance problems. Gaps in new nurse graduate practice and performance problems have been identified primarily using nursing theoretical models. The key objective of this research was to examine new nurse performance through the lens of a human performance model. Using Gilbert’s (1978) updated Behavior Engineering Model (Chevalier, 2003), this study examined the performance of acute pediatric new nurse graduates with 3-15 months of experience in an urban Northeast United States hospital. The New Graduate Nurse Performance Survey (The Nurse Executive Center, 2007) and the updated PRObing BEhavior (Chevalier & Hersey, 2005) questionnaire were used to assess how new nurse graduates rated their performance, work environment, and individual behavior, as well as to identify the environmental and individual factors that support and inhibit their performance. Using a mixed method design, quantitative and qualitative data were collected by means of a web-based survey. Findings revealed new nurse graduates were satisfied with their clinical performance and clinical skills and rated their work environment and individual behavior as satisfactory. Communication, receiving adequate resources, a supportive work setting, and organizational incentives supported new nurse graduates’ work environment. Inadequate feedback, in addition to challenges with preceptors and patient care technicians, inhibited new nurse graduates’ performance. Clinical training programs were found to support new nurse graduates’ performance, whereas difficulties with managing job-related stress, lack of self-care, and strained working relationships with support staff, inhibited their performance. Implications from this study are that nursing leaders and nursing educators should assess the unique needs of their new nurse graduates. This would allow healthcare organizations to design and implement tailored strategies and programs to support their novice nurses’ specialized needs. In addition, nursing leaders can tackle barriers to their new nurse graduates’ nursing practice and role transition. Further studies could explore the hardships new nurse graduates experienced with support staff during their transition by looking at the dynamics, interactions, and working relationships between novice nurses and support staff. Future studies using Gilbert’s BEM (1978), Chevalier’s updated BEM (2003), Gilbert’s PROBE model (1982, as cited in Hersey and Chevalier, 2005), and Hersey and Chevalier’s updated PROBE Model (2005), or other human performance models could be used in the nursing field to investigate different aspects of new nurse graduates’ performance, role, and workflow. Another area for future consideration is examining pediatric nurses at other stand-alone pediatric acute care hospitals and non-specialty acute care hospitals among general clinical nurses to determine what work factors present challenges for them within the work environment.

The assessment of new graduate nurses’ competency is an important outcome of orientation. Nurse managers and nurse preceptors are important stakeholders in the transition of new graduate nurses and are often responsible for assessing the competency of new graduate nurses. This study used the New Graduate Nurse Performance Survey to assess the perceptions of nurse managers and nurse preceptors related to new graduate nurse competency post orientation.

The traditional new graduate nurse (NGN) orientation process places NGN with an experienced preceptor for 24 weeks and requires clinical skills checklists to be completed by the preceptor, a practice which is not an evidence-based practice for orienting NGNs. The purpose of this quality improvement project was to develop an evidence-based orientation to decrease time requirements and standardize the processes and evaluation of the NGN in the emergency department. The project was informed by Benner's novice to expert theory and focused on acquisition of clinical skills. The project team included 6 stakeholders: the Doctor of Nursing Practice student-leader, the unit manager, and several preceptors and novice nurses. The current evidence was identified utilizing various search terms via OVID, CINAHL, and MEDLINE. Five emergency department nurse residency programs and 7 rubric-based criterion articles were identified and evaluated. The team synthesized the available evidence to create the program. Resulting products included guidelines, evaluation rubrics, and projected pathways for ongoing development. Content validation was undertaken using peer review by 2 nurse scholars with area expertise, after which the project team revised all products based on feedback. Together, these products comprise an evidence-based solution to the problematic orientation of NGNs in the institution's emergency department. Adoption of methods that have proven valuable in undergraduate education, such as incorporation of syllabi and rubrics, may increase retention and improve clinical judgment in the NGN. These improved educational outcomes will, in turn, promote improved health outcomes for patients. Outcomes for the project will be monitored using retention rates and the results of the Casey-Fink Graduate Nurse Experience Survey.

East Tennessee State University has taken several approaches to offering professional development for graduate students over the past several years. This includes graduate student research grants, thesis and dissertation awards, teaching awards, awards for service for the public good, Graduate Student Success Specialist service, Thesis/Dissertation/Capstone Boot Camp, Add-on Fellowships, GA Fee Scholarship, Thesis/Dissertation Scholarships, formal courses (GRAD), graduate student research magazine, and workshops. These will be briefly described, including funding sources supporting the initiatives. A mention of professional development for faculty will also be presented. There will be ample time for discussion of strategies and sharing of ideas by participants.

The traditional new graduate nurse (NGN) orientation process places NGN with an experienced preceptor for 24 weeks and requires clinical skills checklists to be completed by the preceptor, a practice which is not an evidence-based practice for orienting NGNs. The purpose of this quality improvement project was to develop an evidence-based orientation to decrease time requirements and standardize the processes and evaluation of the NGN in the emergency department. The project was informed by Benner’s novice to expert theory and focused on acquisition of clinical skills. The project team included 6 stakeholders: the Doctor of Nursing Practice student-leader, the unit manager, and several preceptors and novice nurses. The current evidence was identified utilizing various search terms via OVID, CINAHL, and MEDLINE. Five emergency department nurse residency programs and 7 rubric-based criterion articles were identified and evaluated. The team synthesized the available evidence to create the program. Resulting products included guidelines, evaluation rubrics, and projected pathways for ongoing development. Content validation was undertaken using peer review by 2 nurse scholars with area expertise, after which the project team revised all products based on feedback. Together, these products comprise an evidence-based solution to the problematic orientation of NGNs in the institution’s emergency department. Adoption of methods that have proven valuable in undergraduate education, such as incorporation of syllabi and rubrics, may increase retention and improve clinical judgment in the NGN. These improved educational outcomes will, in turn, promote improved health outcomes for patients. Outcomes for the project will be monitored using retention rates and the results of the Casey-Fink Graduate Nurse Experience Survey.

The transition experience of new graduate Registered Nurses (RNs) is described as complex, negative, and leading to dissatisfaction, and increased turnover. The first year of nursing practice is critical as new graduate RNs are seeking a supportive work environment to assist in the transition from the academic to clinical setting. During this time, many new graduate RNs leave the profession because of job stress, lack of organizational support, unreasonable workloads, uncivil work environments, and difficulty transitioning into the practice setting. This small exploratory master’s thesis study explored the experiences of new graduate RNs throughout their onboarding and orientation process at a small rural community hospital in North Carolina. The purpose of this basic qualitative study, which employed Husserl and Heidegger’s approach of phenomenology, was to explore the experiences of new graduate RNs during their onboarding and orientation process. Semi-structured interviews using open-ended questions were utilized to collect rich, contextual data until data saturation occurred. Open and axial coding of the data documented in a code/theme frequency table, facilitated the discovery of central themes within the data including: The need for a structured preceptorship; need for support and a mentoring program for up to a year; and need for additional classroom training on delegation, communication, and dealing with unprofessional behavior. Other themes were expectations placed on new RNs, patient load, and patient ratios. These findings will assist the small community hospital, and other organizations to identify factors that impact transition into the workplace and utilize these findings to improve the new graduate RN orientation experience and improve retention through a proposed New RN Residency Program that will meet the Commission on Collegiate Nursing Education (CCNE) accreditation standards.

Factor H is a newly identified phenomenon which describes a constellation of attributes of the new graduate nurse reflecting personality traits, intellectual abilities, and clinical judgment. In a previous pilot study conducted by this researcher nurse managers and experienced Registered Nurse (RN) preceptors described characteristics demonstrated by new graduate nurses demonstrating Factor H and the new graduate nurse's ability to transition quickly and successfully into the RN role in the acute care environment. There is currently no instrument available to measure this phenomenon. The specific aim of this research was to develop and psychometrically test a scale designed to identify the presence of attributes of Factor H in the new graduate nurse. The Sims Factor H Assessment Scale (SFHAS) was developed and piloted with a sample of one hundred one new graduate nurses within three months of completing the their nursing program at one of three nursing schools in central and south central Indiana. Evidence of content validity was demonstrated through the use of the Content Validity Index conducted with a panel of four experts. Evidence of face validity was demonstrated through interviews with a group of new graduate nurses, nurse managers, and experienced RN preceptors. Principle Axis Factoring with Varimax rotation was used to demonstrate evidence of construct validity and the scale was found to have a single component which was identified as nursing personality. Evidence of criterion-related validity was demonstrated utilizing analysis of the SFHAS and the criterion scale for personality traits (NEO-FFI). Evidence of internal consistency reliability was demonstrated through analysis of inter-item correlations, Cronbach's coefficient correlations, and item-total correlations. Test re-test reliability using interclass correlation was also conducted to demonstrate stability of the scale. The SFHAS was found to be reflective of nursing personality and not general mental ability or clinical judgment. Use of the SFHAS will allow organizations to evaluate the nursing personality of the new graduate nurse for fit into the work environment. Further study is recommended to gain clarity around the attributes which support successful transition of the new graduate nurse into practice in the acute care environment, also known as Factor H.