Supporting nursing students with transition to qualified staff nurse


The period of adjustment from nursing student to qualified staff nurse was first described as ‘reality shock’ in 1974 (Kramer, 1974) and the period of transition is still recognised as a challenging time (Edwards et al., 2015; Kumaran and Carney, 2014; Pennbrant et al., 2013; Stacey and Hardy, 2011). Recognition of the challenges of transition and support for newly qualified nurses is important, although a systematic review found that the type of support offered was less important than offering some support (Edwards et al., 2015)

Goals / purpose

A learning and teaching strategy was developed to support BSc Adult Nursing students in their transition from student to registrant. The strategy used was to review the ethical and professional practice learning and teaching resources of the final nursing module in the BSc Nursing programme. The aims were for learners to; explore what is known about transition and ‘reality shock’; think about the strategies that support transition; consider how to respond to the challenges of transition; discuss their concerns regarding transition. 

Implementation / Activity

A variety of blended learning resources were used: 

Tutorial group activities: 

  • To support presentation of the literature, to prompt discussion and to ‘make it real and relevant’ 
    • Narratives and quotations capturing the experiences of University of Leeds Adult Nursing Graduates
    • A digital story from the Patient Voices website
  • A group work decision making exercise using a scenario which reflected  
    • the literature regarding transition
    • recent Conduct and Competency Panel determinations from the nursing regulator, the Nursing and Midwifery Council

Virtual Learning Environment (VLE) resources: 

  • Guidelines and standards for professional practice 
  • Information regarding current support systems for newly qualified nurses  
  • Self-evaluation tools and tools for reflection 

Reflections and lessons learnt

Evaluation of this learning and teaching strategy was positive (N=104): 

  • 82% of learners agreed or strongly agreed that it had contributed to their knowledge of ‘reality shock’  
  • 84% of learners agreed or strongly agreed that it had prompted them to think about planning for transition 
  • 83% of learners agreed or strongly agreed that the quotations from University of Leeds Adult Nursing Graduates had helped them to think about the experience of transition  
  • 84% of learners agreed or strongly agreed that the narratives from University of Leeds Adult Nursing Graduates had helped them to think about the experience of transition  
  • 77% of learners agreed or strongly agreed that the digital story from the Patient Voices website had helped them to think about the experience of transition  
  • 79% of learners agreed or strongly agreed that the decision making exercise had helped to think about how to respond to challenges in practice 
  • 81% of learners agreed or strongly agreed that they planned to look at the VLE resources 

The discussion of any negative experiences requires sensitive facilitation so that these experiences can be seen as positive learning opportunities. This learning and teaching approach could be used by other professional groups.  

Learn more

  • Edwards, D., Hawker, C., Carrier, J. and Rees, C. 2015. A systematic review of the effectiveness of strategies and interventions to improve the transition from student to newly qualified nurse. International Journal of Nursing Studies. 52(7), pp.1254-1268. 
  • Kramer, M. 1974. Reality shock: why nurses leave nursing. Saint Louis: C. V. Mosby Co. 
  • Kumaran, S. and Carney, M. 2014. Role transition from student nurse to staff nurse: Facilitating the transition period. Nurse Education in Practice. 14(6), pp.605-611.  
  • Pennbrant, S., Nilsson, M.S., Öhlén, J. and Rudman, A. 2013. Mastering the professional role as a newly graduated registered nurse. Nurse Education Today. 33(7), pp.739-745. 
  • Stacey, G. and Hardy, P. 2011. Challenging the shock of reality through digital storytelling. Nurse Education in Practice. 11(2), pp.159-164. 

Casebook author

Helen ConveyHelen Convey, Lecturer, School of Healthcare, Faculty of Medicine and Health

Interests: exploring and developing professional and ethical practice using blended learning