Newly graduated registered nurses’ clinical competence, professional development and work situation : In acute care hospital settings

Abstract: The overall aim of this thesis was to explore and describe newly graduated registered nurses’ self-assessed clinical competences, professional development, work situation, and perceptions of managing nursing care in complex patient situations during their first 18 months of clinical practice in acute care hospital settings.Methods: Cross-sectional and longitudinal data were collected from NGRNs with 2-15 months of work experience using the instrument Professional Nurse Self-Assessment Scale of clinical core competences II. Qualitative data were collected through focus group interviews with NGRNs after both six and 18 months of work experience.Main results: After two months of work experience, participating NGRNs rated their clinical competence as being highest in clinical leadership and lowest in professional development. Need for further training was greatest in direct clinical practice and lowest in collaborating. After 6 months of work experience, the NGRNs were not being sufficiently prepared and supported to meet responsibilities and demands. Between 2 and 15 months, clinical competence was assessed highest in ethics, teamwork and clinical leadership, lowest in professional development and critical thinking. The need for further training was highest in direct clinical practice, lowest in ethics, teamwork and clinical leadership. Self-rated clinical competence increased substantially when the NGRNs had worked between 9-15 months and after 18 months, nurses generally felt secure in their roles but faced challenges with regard to work situations that hindered their professional development.Conclusion: These results demonstrate the importance of improving NGRNs’ work situation and supporting their development of clinical competence including their need for further training, which would contribute to increased quality of care and patient safety as well as increased professional development among NGRNs.