Abstract: Aims to understand influences on new graduate nurses' confidence in their nursing practice. Confirms the value of self-confidence in newly-qualified nurses commencing practice. Utilises Appreciative Inquiry methodology to analyse the dialogue of nine new graduate nurses who share their stories of practice. Highlights five themes from their accounts. Identifies influences on the nurses' confidence, and the reflective practice pervading their nursing practice.

Abstract: The Plunket orientation programme, first implemented in 1994, aims to prepare new Plunket Nurses for autonomous practice within the complexity of community based nursing. This study seeks to identify what new Plunket Nurses feel are their orientation needs. An evaluation research approach was used. An examination of the literature explored how orientation is conducted and the needs of nurses in orientation. Key aspects in relation to orientation were identified as including socialisation, job change, new graduates, preceptorship, orientation frameworks and retention. A focus group followed by a postal survey were utilised to collect data from new Plunket Nurses nationwide to ascertain what they thought their orientation needs were. Data analysis was completed using descriptive statistics and thematic analysis. The results of the study identified key orientation needs for new Plunket Nurses. These were an orientation programme, preceptorship, clinical skills teaching, time in own area and beginning autonomous practice, administration needs and support needs. The participants recommended quality preceptorship and early clinical teaching from the Clinical Educator. There was a general dissatisfaction with orientation as it stands in preparing them for their role as a Plunket Nurse. Recommendations to the Plunket Management Team were made based on the results of this study.

Abstract: This report is an evaluation of the academic journey undertaken by a group of newly graduated nurses who were sponsored by a New Zealand district health board to work in a variety of primary health care nursing settings. The impetus for this pilot employment option was the Ministry of Health's focus on primary health care nursing and workforce development for this sector and the Expert Advisory Committee for primary health care nursing's recommendations to district health boards regarding employment of graduate nurses and support for them to engage in post graduate study. Evaluation participants were primarily the graduate nurses who were interviewed at the end of their first year of practice which was following programme completion then again nine to ten months later. Findings include the nurses reflections on what supported them and what acted to impede as barriers to their learning success and practice development. The report concludes with five recommendations that can be used to ensure that the travels of future newly graduated nurses taking this pathway are supported, safe and successful.

Abstract: This pilot descriptive study examines and measures the characteristics of preceptors of new graduate registered nurses undertaking the Nurse Entry to Practice Programme in an acute hospital in New Zealand. Thirty-three new graduate registered nurses at the five month stage of the programme completed a questionnaire pertaining to the characteristics of their preceptors. The questionnaires were adapted from the Ferrans and Powers (1998) Quality of Life Questionnaire. The adapted questionnaires were designed to measure the importance, satisfaction and overall quality of the preceptor's characteristics as perceived by the new graduate registered nurse, using a Likert Scale. Literature both international and national was examined to gain an understanding of the importance of the characteristics in question, in relation to the new graduate registered nurse preceptee experience. Descriptive data revealed the importance of characteristics as perceived by the new graduate nurse preceptee, and how satisfied the new graduate nurse was with their particular preceptor's characteristics. The results identified that the majority of new graduates were satisfied with the characteristics of their preceptor but there was evidence of negative discrepancies between the mean importance and satisfaction scores. The range of data between the scores of the overall quality of the preceptor uncovered areas where the quality of preceptorship was unsatisfactory as perceived by the new graduate nurse. The discrepancies in the data were examined and recommendations made for additional research, regarding selection and evaluation of preceptors of the new graduate registered nurse within the hospital environment.

Abstract: The transition from student to registered nurse is a challenging and often stressful time in a nurse's career. This thesis is a case study research project that explores the graduate nurses' perceptions of preceptorship as a strategy to support this transition at Lakes District Health Board (DHB). As a provider of graduate nurse programmes since 1995, Lakes DHB has provided preceptorship for the nurse in the initial period of clinical practice. Annual evaluation by questionnaire identified that this has been applied in a range of ways in different clinical settings with varying degrees of effectiveness. Further inquiry into graduate nurses' perceptions of the preceptored experience during the first twelve weeks of practice within Lakes DHB forms the basis of this research project. The intention is to utilise this insight to further inform the development of preceptor education programmes and application of the preceptor role in the practice setting. Using the case study research method, data has been collected from fourteen participants using semi-structured interviews, focus groups and secondary data from the previous year's questionnaire undertaken by preceptors and graduate nurses. Thematic analysis of the data has resulted in two categories, each with three associated themes. The first category relates to functional factors in the way the preceptorship role is applied. This explores the role of the Clinical Nurse Educator (CNE), organisation within the unit and the teaching of clinical skills. The second category relates to psychosocial considerations and includes the graduate's sense of being scared and advocacy of the preceptor, socialisation and team support, and the preceptor's own experience as a registered nurse. Recommendations from the research include the allocation of a dedicated preceptor selected with consideration for relational ability; complementary rostering and workload allocation to ensure that the preceptor and graduate nurse work together; early notification when preceptor arrangements break down; implementation of a clinical coaching plan; and strengthening the CNE's role as a leader facilitating and supporting preceptorship in the units. Opportunities for further research that arise from the study include the perceptions of the preceptors and the nursing leadership in clinical areas. Structuring the application of preceptorship, to ensure that all of these aspects are woven throughout the graduate nurse's transition results in Korowai Aroha, a cloak of covering for a supported transition that facilitates the development of practice.

Abstract: The aims of this study were to determine the prevalence of horizontal violence, or bullying, experienced by nurses in their first year of practice; to describe the characteristics of the most distressing incidents experienced; to determine the consequences, and measure the psychological impact, of such events; and to determine the adequacy of training received to manage horizontal violence. An anonymous survey was mailed to 1169 nurses in New Zealand who had registered in the year prior to November 2000 with a response rate of 47%. Many new graduates experienced horizontal violence across all clinical settings. Absenteeism from work, the high number of respondents who considered leaving nursing, and scores on the Impact of Event Scale all indicated the serious impact of interpersonal conflict. Nearly half of the events described were not reported, only 12% of those who described a distressing incident received formal debriefing, and the majority of respondents had no training to manage the behaviour.

Abstract: Use of health assessment skills is undeniably part of everyday nursing practice, guiding nursing decisions and a part of facilitating patient outcomes. Undergraduate nursing education in New Zealand includes the use of health assessment skills within the context of nursing practice. The registered nurse working in their first year of practice is required to use effective assessment skills to identify potential risks to a patient's health, while learning to adjust to the many other demands of practice, but little research has explored these experiences. The purpose of this research study was to describe the experience of using health assessment skills within the first year of practice as a registered nurse. Using a qualitative descriptive method, informed by phenomenology, interviews were conducted with six newly graduated registered nurses working within a New Zealand setting. Findings of this study revealed that graduates endeavour to incorporate the skills of health assessment taught at undergraduate level into their practice. Six main themes of health assessment philosophy; tuning in; mobilising health assessment skills; recognition; anxiety; and identification and facilitation of outcomes can be aligned with Benner's (1984) model of skill acquisition. The author suggests that these research findings are useful to inform nursing education, clinical practice and further research. An awareness of these graduate experiences provides opportunities for nurses in both clinical practice and education to facilitate and support graduate nurses' of health assessment within their nursing practice.