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Research question
How do new graduate registered nurses in acute care hospitals describe their experiences of the first year of practice, and what helps or hinders their transition?
Rationale for a qualitative design
Turnover in the first year of practice is a persistent problem for hospitals, and surveys have measured satisfaction and intent to leave. Less is known about how new nurses themselves make sense of the year. A qualitative descriptive design using interviews can capture their experiences in their own words and inform residency programs.
Sampling and setting
Purposive sampling will recruit 15 to 20 new graduate nurses with 9 to 15 months of experience from three hospitals of different sizes, aiming for variation in unit type, educational pathway and demographics. Recruitment will continue until the analysis is producing well-developed themes that answer the research question, recognizing that the final number depends on the richness of the data.
Data collection
Semistructured interviews of 45 to 60 minutes will be conducted by video or in person at a time and place chosen by each participant, outside work hours. The interview guide will begin with a broad question ("Tell me about your first year as a nurse") and include prompts about turning points, support, mistakes and thoughts of leaving. Interviews will be audio-recorded and transcribed verbatim, and the interviewer will write field notes after each one.
Analysis
Braun and Clarke (2006) describe thematic analysis as a method for identifying, analyzing and reporting patterns (themes) within data, and set out six phases:
- Familiarizing yourself with the data
- Generating initial codes
- Searching for themes
- Reviewing themes
- Defining and naming themes
- Producing the report
Analysis will be inductive, staying close to participants' accounts. Two researchers will code the first four transcripts independently and discuss differences to refine the coding approach, and a reflexive journal will record analytic decisions.
Rigor
Lincoln and Guba's (1985) criteria for trustworthiness guide the strategies:
| Criterion | Strategy |
|---|---|
| Credibility | Prolonged engagement with the data; peer debriefing; sharing a summary of themes with participants |
| Transferability | A thick description of settings and participants so readers can judge fit with their context |
| Dependability | An audit trail of coding and analytic decisions |
| Confirmability | A reflexive journal; examining how the researchers' own nursing backgrounds may shape interpretation |
Reporting
The study will be reported using the Consolidated Criteria for Reporting Qualitative Research (COREQ), a 32-item checklist covering three domains: the research team and reflexivity, study design, and analysis and findings (Tong et al., 2007).
Ethical considerations
Participants are employees, so recruitment will be through flyers and nurse residency coordinators rather than managers, to avoid any sense of pressure. Interviews will be confidential, names and hospitals removed from transcripts, and participants told they can skip questions or withdraw. Because talking about difficult experiences can be distressing, the interviewer will share employee assistance program information at the end of each interview.
Expected contribution
Findings will describe the first year from new nurses' perspectives and identify supports that hospitals and residency programs can strengthen.
References
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Sage.
Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349–357. https://doi.org/10.1093/intqhc/mzm042
