There are challenging times ahead for the nursing workforce due to the increasing global nursing shortage and the continued marked attrition rate of newly graduated registered nurses.
A recent study on the lived experience of nine male West Australian GRNs in their first year has revealed that two of them, James and Oliver (not their real names), had trouble securing GRN positions post-graduation.
Their experiences concur with the findings of a 2014 graduate nurse and midwife questionnaire. Respondents who were unable to obtain employment, even after applying for multiple positions, cited issues such as lack of nursing experience, lack of nursing positions for new graduates, and lack of jobs without the completion of a nursing graduate program.
It had been over six months since James had completed his undergraduate nursing degree before he started in the mid-year GRN program, although he would have preferred to start straight after his registered nurse (RN) registration.
James continued to work in patient care assistance while waiting for his program, as he knew many other new GRNs who had been unsuccessful in obtaining nursing positions despite copious applications to various health services. The reasons for this, according to James, included their lack of RN experience and novice status.
He also revealed that as the months went on after graduating, he became more nervous about commencing as a new GRN and was not sure how it would go for him. He further recapped on his lack of confidence: “The responsibility of having a patient load on my own was definitely a big factor, coupled with the medications – ensuring not to make an error, etc.”
This lack of confidence intensified as he neared his entry into the graduate program. He doubted his ability to perform as an RN and meet the team’s expectations of him in his new role, stating: “I fear not holding up my end when it comes to being in a team environment.”
Although his previous career was in a team environment – his background in the army and the associate life experiences he saw as a big advantage – James still felt he required a transition platform such as the GRN program due to the nuances of the nursing profession and the socialisation required when entering a dynamic and ever-changing health environment.
For Oliver, he did not apply for a GRN program as he could not find one that was specific to aged care, the area he believed was his best fit. The months after his graduation proved very challenging as he received rejection after rejection on his nursing job applications.
His frustration is illustrated in one of his responses: “They keep saying I need more experience – this coming from both the acute and aged care jobs I applied for – but how can I get the experience if I can’t get jobs in the first place?”
Finally, four months post RN registration, Oliver started working in a small private aged care facility as the casual RN. On the first day, he felt overwhelmed and overloaded with his duties. As the shift progressed, he found himself getting faster and becoming more confident: “I just needed to find my way around the ward and get my head around what I was expected to do. It was because of my limited experience but mainly due to the lack of support – no one there to ask how things worked, etc. It was really hard when I was the only RN on duty.”
The next shifts, which were a few days apart, proved to be no better. Two residents needed hospitalisation and took up a substantial amount of his time, resulting in some uncompleted duties being handed over to the following shifts.
As a result of the uncompleted work, and with no consideration for Oliver’s overall workload and his novice status, he was not given any further shifts. He said: “I was not alone in this situation, as other graduates had faced the same fate.”
He went on to comment: “I felt really let down and really disappointed, and felt very disillusioned. I am rethinking my career and if I should look for something else.”
Oliver said finding a nursing position, as a new GRN, was very difficult. “Employers seem to seek out more-experienced nurses for permanent roles and use the inexperienced nurses as casual relief as a last resort.
“I personally feel that in order to support myself and a family in the future, if this is the problem you face when entering the field of nursing, then it is quite discouraging. It has made me feel that nursing isn’t a stable career option and that I may need to consider other opportunities.”
At the six-month post-RN-registration contact, Oliver acknowledged that he had persevered in his quest to gain a GRN program, remarking: “I felt that after my aged care RN experience, the only way I would find the support needed to transition into a competent RN, and then be able to obtain a permanent position within nursing, was through doing a GRN program.”
On his first attempt, he was given an interview but was not successful, due to very limited graduate positions, but he was offered a place on his second attempt.
Oliver said: “I am excited and happy about this opportunity but a bit disappointed it will be nearly a full year before I gain entry into a GRN program.”
He discussed his experience and voiced his disappointment at the lack of opportunities for new graduates who are unable to obtain entry into GRN programs in order to find a job for which they have been trained. He further reiterated that there is a very unrealistic view of what new GRNs should be able to do as they enter their new career environment.
The challenging situation faced by Oliver and James in finding employment due to their novice RN status and lack of clinical nursing experience is a phenomenon common across the Australian nursing workforce.
The concerns about decreased employment opportunities for Australian graduate nurses and health employers’ tendency to employ 457 visa RNs are outlined in the March 2016 Senate report, A National Disgrace: The Exploitation of Temporary Work Visa Holders. The report highlights the lack of transition support as a major issue, which is consistent with the experiences of James and Oliver.
New GRNs require access to the professional practice environment to gain RN experience with given time to synthesise their nursing theory to practice. Therefore, the challenge to reduce graduate nurses’ frustration in gaining registered nurse experience requires health industry financial investment for GRN professional support and the opportunity for successful transition into the professional-practice environment with gainful nursing employment are paramount.
Moreover, it can be argued that there is a need to establish quarantined graduate registered nurse positions within the health environment and to invest in nurse leadership in the form of mentor support and role modelling supportive transition for novice nurses in professional practice.
Dianne Juliff is a nursing PhD candidate at the University of Notre Dame Australia, Fremantle.Want to share your thoughts on this topic? Do you have an idea for a story?
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