“I had fear when I was coming in; I am confident now”: Transition experiences of newly qualified nurses and midwives in Uganda

Abstract

Introduction: Transitioning from university-based education to clinical practice may be quite challenging for newly qualified nurses and midwives. The study explored clinical transition experiences of newly qualified nursing and midwifery graduates in Uganda. Methods: The qualitative descriptive design was used based on the Duchscher’s transition shock theory. We conducted 15 in-depth interviews among new graduates who were working in various private and public health facilities in Uganda. The data were analysed using a deductive thematic approach. Results: We identified three themes: (1) transition experience, (2) recovery and adaptation to new roles (3) confidence and challenges during transition. New graduates’ excitement of joining clinical practice was replaced with a transition shock experience. The shock experience involved emotional and socio-cultural responses to the realities of clinical practice. Transition shock was related to unfamiliar clinical settings, fears of fitting in, fears of making mistakes, difficulty translating theory to practice and unpreparedness for clinical practice. Transition programs, including internship, orientation, training opportunities, preceptorship, and mentorship helped new graduates to adapt to new clinical settings. While new graduates were initially bereft of confidence, they eventually gained confidence and competence. During the transition phase, new graduates faced several challenges in clinical practice. These included employment challenges, poor work conditions, mistreatment, inadequate supervision and mentorship, and unrealistic expectations. Conclusion: Newly qualified nurses and midwives experience transition shock and several challenges during the transition to clinical practice. Improving new graduates’ work conditions, support systems, supervision, and mentorship is critical in promoting positive transition experiences. Ultimately, this may help improve new graduates’ experiences during the critical transition period. Clinical trial registration: Not applicable.