School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.
School of Nursing & Midwifery, Western Sydney University, Penrith, NSW, Australia.
J Clin Nurs. 2018 Jan;27(1-2):355-362. doi: 10.1111/jocn.13930. Epub 2017 Aug 18.
To describe the experiences of registered nurses who transition from acute to primary health care (PHC) employment.
Internationally the provision of health care in PHC settings is increasing. Nurses are moving from acute care employment to meet the growing demand for a PHC workforce. However, little is known about the transition experiences of these nurses.
A sequential mixed-methods study comprising a survey, and semi-structured interviews. This study reports on survey findings relating to the transition experience.
Convenience and snowballing techniques were used to recruit 111 registered nurses who had transitioned from Australian acute settings to PHC employment within the last 5 years. An online survey gathered data relating to personal and professional demographics, type of PHC setting and transition experiences.
Most respondents (n = 90, 81.1%) reported receiving some orientation, although the length and content varied considerably. Those working in metropolitan locations were more likely to report concerns associated with their orientation, with respondents from rural or remote locations more likely to have access to a preceptor than city/metropolitan respondents. Just under half of respondents found prioritising workload (n = 47; 42.7%) or organisational knowledge (n = 45; 40.9%) difficult or very difficult, and 47.7% (n = 53) felt isolated or unsupported. 49.5% (n = 55) reported being overwhelmed with the new role either sometimes or regularly. Barriers to transitioning successfully included limited employer support to attend professional development activities.
Availability of specific support measures may assist in the transition process. Findings from our study should be considered by employers when recruiting nurses new to PHC, and when designing orientation and ongoing education programmes.
This study highlights the challenges faced by nurses who transition from acute care into PHC employment. Understanding the barriers and facilitators to successful transitions enhances the process for future recruitment and retention of PHC nurses. This evidence can inform managers, educators and policymakers in developing support programmes for nurses moving into PHC.
描述从急症护理过渡到初级卫生保健（PHC）工作的注册护士的经验。
在国际上，PHC 环境中的医疗保健服务不断增加。护士正在从急症护理工作中转移，以满足对 PHC 劳动力不断增长的需求。然而，对于这些护士的过渡经验知之甚少。
一项包括调查和半结构化访谈的顺序混合方法研究。本研究报告了与过渡经验相关的调查结果。
使用便利抽样和滚雪球技术招募了 111 名在过去 5 年内从澳大利亚急症环境过渡到 PHC 工作的注册护士。在线调查收集了与个人和专业人口统计学、PHC 环境类型和过渡经验相关的数据。
大多数受访者（n=90，81.1%）报告说接受了一些定向培训，尽管培训的长度和内容差异很大。在城市地区工作的人更有可能报告与定向相关的问题，而来自农村或偏远地区的受访者比城市/都会区的受访者更有可能获得导师。近一半的受访者发现优先处理工作量（n=47；42.7%）或组织知识（n=45；40.9%）困难或非常困难，47.7%（n=53）感到孤立或不受支持。49.5%（n=55）报告说，他们有时或经常对新角色感到不知所措。成功过渡的障碍包括雇主支持参加专业发展活动的有限。
提供具体的支持措施可能有助于过渡过程。我们的研究结果应引起雇主在招聘新到 PHC 的护士时的重视，并在设计定向和持续教育计划时考虑。
本研究强调了从急症护理过渡到 PHC 工作的护士所面临的挑战。了解成功过渡的障碍和促进因素可以增强未来招聘和留住 PHC 护士的过程。该证据可以为管理者、教育者和政策制定者在为转入 PHC 的护士制定支持计划方面提供信息。
