Klara, färdiga, gå : om sjuksköterskors kompetens i övergången mellan grundutbildning och yrkesverksamhet

Abstract

The transition from nursing student to Registered Nurse (RN) is known to be a stressful period in which the experiences of education encounter the expectancies of the labour market. Previous studies show that the way RNs handle this situation impacts on their continued socialisation process, but also on their decision to stay in the profession.

The overall aim of this thesis is to describe RN competence in the transition from basic training to performing the professional role to gain insight on how RNs perceive the knowledge they acquired during their education, how they manage the early stages of their careers and significant factors contributing to this process.

The two papers are based on a prospective longitudinal cohort study, the Longitudinal Analyses of Nursing Education (LANE-study). In the present papers, a national cohort of 1,110 nursing students registered in their last (sixth) semester of nursing education in 2002 at 24 educational establishments in Sweden were studied from the end of their nursing education (I) and one year after graduation (II). Data was collected by the use of questionnaires and analysed statistically (I and II) and with content analyses (II).

The first paper (I) show that the extent to which the students had acquired the requisite skills varied from 27 % to 91%. Nursing education had first and foremost contributed to the students ability to take responsibility for personal knowledge development. Even if 68% of students considered their education to have prepared them for professional practice, there was variation among students from different educational establishments of 45% - 86%. Results were also characterised by more female students considering their education to have contributed to a majority of the requisite abilities than male students.

From the results of the second paper it became apparent that the RNs professional self-efficacy, and thereby how they regarded themselves able to handle their role, varied across the professional competencies by 34-94%. The RNs especially regarded themselves highly capable of asking more experienced colleagues for advice and consulting physicians. From the results it became evident that the professional competencies for which the RNs displayed the highest professional self-efficacy were not entirely the same as those RNs regarded as the most critical competencies for mastery of their professional role. Instead, the most crucial was considered to be the ability to handle expectations and demands other professionals may have on them as RNs, while they attached least importance to investigating new findings and methods within their area of work and discussing them at their workplace.

The most significant factors for the RNs development of professional self-efficacy in the critical competencies were high professional preparedness at the end of their nursing education. Other factors that had a positive influence on professional self-efficacy was work experience within the health care sector prior to nursing education and the RN's induction at their first workplace after graduation.

The results from this thesis show that the socialisation process involved in the transition from basic training to performing the professional role is influenced by the students preparedness at the end of their nursing education, but also by individual and educationally related factors that are of significance for the acquisition of abilities during nursing education and for professional self-efficacy in relation to professional competencies. There are professional competencies that RNs describe as critical for mastery of their professional role during their first year of work. These results can contribute to the knowledge on how RNs perceive their competence and could thereby be valuable in education and to employers to facilitate entrance into the profession.