Newly graduated nurses’ occupational commitment and its associations with professional competence and work-related factors

Self-assessment assists nurses to maintain and improve their practice by identifying their strengths and areas that may need to be further developed. Professional competence profiles encourage them to take an active part in the learning process of continuing education. Although competence recognition offers a way to motivate practising nurses to produce quality care, few measuring tools are available for this purpose. This paper describes the development and testing of the Nurse Competence Scale, an instrument with which the level of nurse competence can be assessed in different hospital work environments. The categories of the Nurse Competence Scale were derived from Benner's From Novice to Expert competency framework. A seven-step approach, including literature review and six expert groups, was used to identify and validate the indicators of nurse competence. After a pilot test, psychometric testing of the Nurse Competence Scale (content, construct and concurrent validity, and internal consistency) was undertaken with 498 nurses. The 73-item scale consists of seven categories, with responses on a visual analogy scale format. The frequency of using competencies was additionally tested with a four-point scale. Self-assessed overall scores indicated a high level of competence across categories. The Nurse Competence Scale data were normally distributed. The higher the frequency of using competencies, the higher was the self-assessed level of competence. Age and length of work experience had a positive but not very strong correlation with level of competence. According to the item analysis, the categories of the Nurse Competence Scale showed good internal consistency. The results provide strong evidence of the reliability and validity of the Nurse Competence Scale.

Newly graduated nurses are entering the work force and finding that they have neither the practice expertise nor the confidence to navigate what has become a highly dynamic and intense clinical environment burdened by escalating levels of patient acuity and nursing workload. This research used qualitative methods to build on and mature aspects of the new nurse's transition experience into acute care. The theory of transition presented in this article incorporates a journey of becoming where new nursing graduates progressed through the stages of doing, being, and knowing. The whole of this journey encompassed ordered processes that included anticipating, learning, performing, concealing, adjusting, questioning, revealing, separating, rediscovering, exploring, and engaging. Although this journey was by no means linear or prescriptive nor always strictly progressive, it was evolutionary and ultimately transformative for all participants. The intense and dynamic transition experience for these newly graduated nurses should inspire educational and service institutions to provide preparatory education on transition as well as extended, sequential, and structured orientation and mentoring programs that bridge senior students' expectations of professional work life with the reality of employment.