The survival process of newly graduated Japanese nurses in their first year of clinical practice: A qualitative study using modified grounded theory approach

Abstract

Turnover of newly graduated nurses is an international problem. Although there are many studies on the learning process of newly graduated nurses, there is little research on why they were able to stay and survive. Therefore, this study aimed to clarify the survival processes of newly graduated nurses in clinical practice. Interviews were held with 12 nurses who had graduated from a 4-year nursing college, had 3-4 years of clinical experience in a general hospital ward, and were currently in a preceptor or similar educational role. Modified grounded theory was used for data collection and analysis. Consequently, we identified 1 core category, 1 category, 7 subcategories, and 31 concepts. The category "It's Sink or Swim" was a major turning point in the survival process of newly graduated nurses in the clinical field, after which the daily intention of the core category "Keeping my Commitment" continued with new realizations and repetitions of actions. The repetition of this routine also meant that the breadth of the newly graduated nurse's experience was broadened, and the burden of the core category "Keeping my Commitment" gradually reduced. In this way, new nurses survived in clinical settings. These findings showed that for newly graduated nurses to survive in a clinical setting, the core category of "Keeping my Commitment" while building relationships with their seniors was important. Therefore, it may be important for nursing education to strengthen not only supportive interpersonal relationships with patients but also foundational skills for interpersonal relationships with senior nurses.