Stages of Transition and Transition Shock

In the late 1960s and early 1970s, Marlene Kramer (1974) published her seminal research on the experience of ‘‘reality shock’’ in newly licensed nurses (NLN). Kramer claimed that this difficult journey into professional practice featured strongly in the reasons why nurses leave nursing. For over four decades, this work was used as the framework for understanding and responding to the transition experience of NLNs, despite contemporary work environments that were increasingly fraught with contradictory intents, to provide patient-centered, value-based care while navigating escalating fiscal and human resource limitations. Nursing professional development (NPD) practitioners know, all too well, the stress of NLNs as they move from the world of academia to the practice setting. Frequently, NPD practitioners are responsible to oversee these transitions, so they must be well versed in the stages and factors that affect NLNs and their intent to stay on the job. I had the good fortune to meet and interview Dr. Judy Duchscher, who has completed extensive research and publishing in this area. Dr. Duchscher shares her valuable and insightful research about the transition of NLNs in this column.