The Challenges of Transition to Practice Expressed Through the Lived Experience of New-to-Practice Nurses




transition to practice, lived experience of new nurses, patient safety


Visual Abstract

Background: The nurse’s transition into practice is challenging. The need to facilitate a safe transition into practice and retain nurses is crucial in today’s healthcare.

Objective and Design: The qualitative study aim was to describe the lived experiences of new nurses’ safe transition into practice and their perceptions of functioning as safe practitioners.

Method: This descriptive, phenomenological arm of a larger, mixed methods study (Safety Transition Education to Practice study) interviewed 11 nurses with varied clinical backgrounds regarding their first six months as licensed nurses. Semistructured, one-to-one interviews with nurses representing geographical locations across the nation were conducted. Colaizzi’s method of analysis was used to extract themes.

Results: The data revealed five themes with subthemes. The most universal theme was lack of practical knowledge (skills dexterity, real-world knowledge), followed by impostor syndrome, safety culture (unsafe environment, lack of supplies, lack of mentoring/management), internalized fear, and seeking the sage.

Conclusion: The experiences support the understanding that transition to practice is overwhelming and uncertain. Academic faculty and practice nurses’ cooperative efforts can aid novice nurses in safe transition to practice through academic curriculum enhancement, preceptors, and nurse residency programs working toward narrowing the academic practice gap.

Author Biographies

Rebecca Toothaker, PhD, RN, Commonwealth University Bloomsburg Campus, School of Nursing

Rebecca Toothaker ( is an associate professor at Commonwealth University, Bloomsburg Campus. She has over 15 years of nursing education experience. Her primary teaching focus is foundations and medical-surgical nursing, and her research focuses on pedagogy, generational learning styles, and safety in practice.

Marijo A. Rommelfaenger, PhD, RN, University of Wisconsin-Milwaukee

Marijo A. Rommelfaenger is an assistant clinical professor at the University of Wisconsin-Milwaukee College of Nursing. She also currently serves president of the Wisconsin League for Nursing. Rommelfaenger’s interests are in strengthening the nursing workforce through support for personal and professional growth for all nurses.

Randi Sue Flexner, DNP, FNP-BC, RN, Rowan-Virtua School of Osteopathic Medicine

Randi Sue Flexner, a board-certified family advanced practice nurse since 1998, earned her doctorate in nursing practice in 2013 from Temple University, and became board certified as a nurse educator in 2021. She has worked in academia for over 20 years, part time and full time in both undergraduate and graduate levels of nursing education. Dr. Flexner’s research has primarily focused on quality and safety in nursing education, with a main clinical focus of health promotion, disease prevention, and management.

Lora K. Hromadik, PhD, RN, Indiana University of Pennsylvania

Lora K. Hromadik is a professor at Indiana University of Pennsylvania. She has been a nurse for 42 years with over 25 years of nursing education experience. Her education focuses on adult health, instructional design, and outcomes assessment. Her research focuses on patient safety in both clinical practice and educating nurses to be safe practitioners.


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How to Cite

Toothaker, R., Rommelfaenger, M. A., Flexner, R. S., & Hromadik, L. K. (2022). The Challenges of Transition to Practice Expressed Through the Lived Experience of New-to-Practice Nurses. Patient Safety, 4(4), 11–17.



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