The first year as a nurse practitioner: An integrative literature review of the transition experience

The purpose of this integrative literature review was to synthesize current knowledge about the role transition from new graduate Nurse Practitioner (NP) to novice NP to increase our understanding of how to better support NP entry into practice. The NP role was implemented in the United States over fifty years ago and has proven to contribute to patient outcomes and reduced health care costs. Proper transition experience to advanced practice nursing is fundamental to these improved patient outcomes in the hospital setting. The transition from Registered Nurse to professional NP is an important and difficult adjustment to make and may affect ongoing NP practice. The following topics were reviewed: graduate NP to novice NP transition, NP perception of preparedness, and perceived challenges encountered during role transition. A search for relevant literature was conducted in the EBSCO Host and ProQuest databases and in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and MEDLINE specialty databases. Ten articles were identified and 3 major topic areas were revealed in the analysis: role transition, perception of preparedness, and perceived challenges. Establishing role identity as an NP, developing professional relationships, and having effective mentorship emerged as key issues influencing the transition process. Training programs are rare. A need exists for additional support and education for new hospital based NPs as they transition from students to practicing clinicians. Future studies that focus on the transition experience after internships programs may provide insight into how to develop or modify educational programs for NPs that will improve or enhance their transition to expert practitioner practice.