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Experiences of newly registered nurses transitioning from nursing student to registered nurse: a qualitative systematic review
  1. Jennie Brady1,2,
  2. Michael J Tatterton1,3
  1. 1 School of Nursing and Healthcare Leadership, University of Bradford, Bradford, UK
  2. 2 Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
  3. 3 Bluebell Wood Children's Hospice, North Anston, UK
  1. Correspondence to Dr Michael J Tatterton, School of Nursing and Healthcare Leadership, University of Bradford, Bradford, BD7 1DP, UK; m.tatterton{at}

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Background and purpose

  • This is a summary of See et al.1

  • Newly registered nurses experience high levels of emotional exhaustion, stress and burnout, with high attrition rates in the first-year post-qualification.

  • The purpose of this review was to consolidate the available evidence on the experiences of newly registered nurses transitioning from the role of student nurse to that of registered nurse.


Results and areas for future research

  • Thirty-one studies were included in the review, comprising thirty qualitative and one mixed-method study.

  • A total of 452 newly registered nurses were enrolled across the studies from Australia, Canada, Singapore, England, Nepal, Netherlands, Pakistan and Taiwan.

  • Four themes were identified: knowledge deficit, overwhelming clinical practice, importance of workplace support and the meaning of ‘being a nurse’.

  • Twenty-four studies discussed how newly graduated registered nurses experienced anxiety, stress and fear in relation to ‘not knowing enough’ during the transition process.

  • wenty-three studies cited newly registered nurses’ feelings of being overwhelmed with: a lack of staffing, high workload, high acuity patients, fast-paced environment and lack of experience.

  • Future research should focus on the development of effective reality-based education initiatives to prepare students for their role as a registered nurse, and to reduce ‘reality shock’ and on structural empowerment strategies focusing on workplace support.

Take home messages

  • Newly registered nurses often experience feelings of inadequacy and ill-preparedness in relation to knowledge deficits and limited exposure as students.

  • Formal, standardised preceptorship programmes and support from colleagues and preceptors help newly registered nurses transition into their new roles, and have a positive impact on their learning experience, patient safety, and motivation to remain in nursing.

  • Universities and organisations should consider using technology, such as virtual reality, to create more reality-based education opportunities to help prepare student nurses for registration.

Ethics approval

Not applicable.



  • Twitter @JennieBrady, @MJTatterton

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.