High turnover is a prime cause of today’s nursing shortage, and is often the result of job dissatisfaction and burnout. At particular risk are Graduate Nurses (GN), who struggle to feel competent as they transition from the academic environment to the hospital environment. Using an exploratory case-study research design utilizing a multi-method approach that consisted of five data collection methods, this study explored the relationships between the design and layout of the physical environment, GN interaction patterns, opportunities for informal learning and support, stress, and the gaining of necessary competencies. The five data collection methods used were shadowing of the Graduate Nurse using the Clinical Work Measurement Tool, a Registered Nurse and GN survey, GN blood pressure measurements, GN weekly Competency ratings, and focused interviews. Results showed a correlation between increasing competency ratings and decreasing blood pressure. The results also demonstrated the importance of “backstage” areas such as break rooms and med rooms for informal learning, social support and the unit’s cohesion. The GN interacted infrequently with doctors in any area, however, which supports previous research on the work patterns of nurses. This research suggests that formal approaches to GN Orientation, which focus on the effective one-on-one interaction with a designated mentor, can and would benefit by purposeful design interventions that increased the likelihood of more interaction across disciplinary boundaries.
Adams, R. (2008) The role of physical design and informal communication and learning in gaining competency and reducing stress among graduate nurses. Unpublished Master’s thesis, Cornell University.
Hammer, S. (2008) The role of physical design and informal communication and learning in reducing stress and gaining competency among new nurse graduates. Unpublished Master’s thesis, Cornell University.