Factors associated with practice readiness among newly qualified nurses in their first two years of practice.

Background:
Newly graduated nurses undergo stress and role adjustment as they transition into practice during

the first year and continue to struggle beyond the first year. Determining their practice readiness can aid in the development of interventions to facilitate workplace readiness for nurses in their first two years entering the nursing profession.

Objectives:
To examine (i) extent of practice readiness of new nurses in their role; and (ii) associations between

nurses' practice readiness and demographic and occupational variables, and reasons for choosing nursing profession.

Design:
A cross-sectional study.

Settings and participants:

A total of 445 registered nurses who graduated within the last two years and working in an academic medical centre in Singapore.

Methods:
Participants completed an online questionnaire with questions from Casey-Fink Readiness for Practice Survey and questions related to key competencies for future practice.

Results:
More than half (57.5 %) identified at least three skills and procedures which they were uncomfortable performing independently as they transition into the clinical practice, including: (i) responding to emergency (ii)

tracheostomy care; and (iii) chest tube care. The top three reasons for choosing nursing as a career were: (i) nursing is a stable industry (54.2 %); (ii) I want to help people (52.1 %); and (iii) able to work anywhere in the world (44.3 %). Nurses were most concerned with areas of trials and tribulations (42.5 %) and clinical competency (36.6 %). When compared to nurses in their first-year post-graduation, those working in their second year reported more confidence in the ability to problem solve (p = 0.003), care for a person who is dying (p = 0.004), and less difficulties in prioritizing care needs (p = 0.04). They also perceived themselves as a good problem solver (p = 0.03).

Conclusions:
It is critical to continue supporting nurses' practice readiness beyond their first year of practice in their confidence and development of skills of higher complexity.