Transformative transitioning: Analysis of reflective journals from 28 new graduate FNPs who experienced a post-graduate, primary care residency program

Transitioning from new graduate to competent nurse practitioner (NP) is challenging and stressful.^{(e.g., 1,2)}  In their 2011 “Future of Nursing” Report, the Institute of Medicine³ recommended that residency programs be developed for all new nurses, as well as nurses who are experiencing a transition to a new practice area.  Although most new graduate NPs desire a formal post-graduate program to assist them as they transition into practice,^4,5few programs exist.  In addition, there are limited data regarding how residency programs assist new graduate NPs in their transition into practice.

As the NP profession begins to explore how to best assist new graduate NPs as they transition into practice, it is critical to understand the role of formal, post-graduate NP residency programs.  The purpose of this study was to further our understanding of how the NP residency program at the Community Health Center, Inc. (CHC) in Middletown, CT impacted its first residents’ transition into practice. The study employed a qualitative design informed by Content Analysis⁶and involved analyzing weekly reflective journals kept by 28 new graduate FNPs, who participated in the CHC’s one-year primary care residency program.  Results from this study indicate that the residents experienced a “transformative” experience that was facilitated by many factors, including but not limited to curriculum, program length, organizational culture, and engaged preceptors. 

References:

1. Barnes, H. (2014). Nurse practitioner role transition: A concept analysis. Nursing Forum, web before print. doi: 10.1111/nuf.12078.

2. Heitz, L., Steiner, S.H., & Burman, M.E. (2004). RN to FNP: a qualitative study of role transition. The Journal of Nursing Education, 43(9), 416-420. 

3. Institute of Medicine (2011). The Future of Nursing: Leading Change, Advancing Health. Washington, D.C. National Academy Press.

4. Hart, A.M. (2013). National NP preparedness survey, 2012. (Podium presentation). 39^th annual meeting of the National Organization for Nurse Practitioners, Pittsburgh, PA.

5. Hart, A.M. & Macnee, C.L. (2007). How well are nurse practitioners prepared for practice: Results of a 2004 questionnaire study. Journal of the American Academy of Nurse Practitioners, 19(1), 35-42.

6. Krippendorff, K. (2013). Content Analysis: An introduction to its Methodology (3^rd ed.). Thousand Oaks, CA: Sage Publications.