Transition shock and newly graduated nurses' job outcomes and select patient outcomes: A cross-sectional study

Leodoro J. Labrague*, Janet Alexis A. De los Santos

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

59 Citations (Scopus)


Aim: This study examined transition shock experiences in newly graduated nurses as well as its relative influence on job outcomes (job satisfaction, stress and burnout, and intent to leave their organisation) and select patient outcomes (missed care, adverse events and perceived quality of care). Background: Transition shock is a reality common among newly graduated nurses and has been considered an issue relevant to nursing administrators. To date, the mechanism by which transition shock perception is linked with nurse and patient outcomes remains unexplored. Methods: A descriptive, cross-sectional design was used. One hundred seventy-six newly graduated nurses (nurses with <1 year of work experience) were included in the study. Data were collected using seven standardized scales. Results: Hospital classification (e.g., being employed in a government-owned hospital) (β = 0.255; p =.001) predicted transition shock. Overall, newly graduated nurses reported greatest challenges with regard to their expectations of the actual work environment (mean = 2.60, standard deviation = 0.42) and in balancing their professional and personal lives (mean = 2.51, standard deviation = 0.35). Higher levels of reality shock were associated with adverse patient events (β = 0.821; p =.001). Conclusion: New graduates experience great challenges in balancing their professional and personal lives. Ensuring work–life balance and work readiness in newly graduated nurses may potentially reduce the occurrence of missed nursing care and adverse events. Implications for Nursing Management: Nurse managers can adequately support newly graduated nurses' transition through the implementation of empirically based transition programmes. By providing flexible work arrangement, reasonable workload, adequate nurse staffing, limited mandatory overtime and self-scheduling, nurse managers can effectively assist newly graduated nurses in attaining work–life balance.

Original languageEnglish
Pages (from-to)1070-1079
Number of pages10
JournalJournal of Nursing Management
Issue number5
Publication statusPublished - Jul 1 2020


  • missed nursing care
  • new graduate transition
  • nurse
  • patient adverse events
  • reality shock
  • transition shock

ASJC Scopus subject areas

  • Leadership and Management


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