New registered nurse and registered psychiatric nurse graduates' transition-to-practice amid the pandemic: An art-based grounded theory study

According to the Transition Shock theory, new Registered Nurses face formidable obstacles within their first year of practice. However, little is known about the experience of new Registered Psychiatric Nurses entering the workforce. The aim was to explore how new graduates from nursing and psychiatric nursing experience their transition into the workplace that included identifying mediating factors that assist or challenge these entry-level professionals within their transition. Constructivist grounded theory methodology developed by Charmaz was utilized to explore the first-year transition period using art-based methods. A total of 13 new graduates practicing as Registered Nurses and Registered Psychiatric Nurse in a western Canadian province were recruited to participate in the study. Three art-based workshops occurred at four, eight, and 12-months starting in the fall of 2020 through the Spring of 2021 during the novel coronavirus pandemic with subsequent member checks in the Spring of 2022. A total of 38 interview and focus group data were collected. Art-based activities included sand tray and figurine object exercises, collaging, reflective and thematic writing, as well as group concept mapping. Through co-creation of knowledge using Charmaz's methodology, participants selected the major themes throughout their first year of transition with guided researcher facilitation. Data were analyzed using the constant comparative method of analysis for each workshop drawing on the art creations, discussion, and narrative reflective writing pieces generated by participants. Participants were in a basic psychosocial process of growing personal and professional self. Through co-construction of knowledge with the participants, three substantive interconnected categories were identified: (1) Being thrown into the fire; (2) Adjusting and adapting to the team environment; and (3) Nurturing self and others. The findings revealed many recommendations for employers hiring new graduates and nursing education programs preparing graduates for the practice arena.