F on ie s in Public Heal h 01 on ie sin.o g
S ess in no ice nu ses in new
wo k en i onmen s: a sys ema ic
e iew
ÁngelaNa bona-Gál ez
1, JuanJesúsGa cía-Iglesias
2*,
DiegoAyuso-Mu illo
3, GuadalupeFon án-Vinag e
4,
JuanGómez-Salgado
2,5*, ReginaAllande-Cussó
6,
Ja ie Fagundo-Ri e a
7, Is aelMacías-To onjo
8 and
Ca losRuiz-F u os
2,5
1 School o Doc o a e, Uni e si y o Huel a, Huel a, Spain, 2 Depa men o Sociology, Social Wo k and
Public Heal h, Facul y o Labou Sciences, Uni e si y o Huel a, Huel a, Spain, 3 Gene al Nu sing
Council o Spain, Mad id, Spain, 4 Spanish Ins i u e o Nu sing Resea ch, Mad id, Spain, 5 Sa e y and
Heal h Pos g adua e P og amme, Uni e sidad Espí i u San o, Guayaquil, Ecuado , 6 Depa men o
Nu sing, Facul y o Nu sing, Physio he apy and Podia y, Uni e si y o Se ille, Se illa, Spain, 7 Cen o
Uni e si a io de En e me ía C uz Roja, Se illa, Spain, 8 Depa men o Rehabili a ion, FREMAP Huel a,
Huel a, Spain
Backg ound: Inexpe ienced nu sing ca e can comp omise he quali y o ca e
and he well-being o pa ien s. The aim o his s udy was o assess he main
sou ces o s ess encoun e ed by nu ses and no ice nu ses in a se ing no
p e iously expe ienced.
Me hods: A sys ema ic e iew was conduc ed ollowing he PRISMA o ma in
Pubmed, Scopus, Web o Science, and CINAHL elec onic da abases in Ma ch
2024. A o al o 395 s udies we e iden i ied, o which 16 me he inclusion
c i e ia. Selec ion was made on he basis o opic ele ance and me hodological
quali y, assessed using he c i ical ools o he Joanna B iggs Ins i u e (JBI).
Resul s: A o al o 16 s udies we e included in his e iew. O he 16 selec ed,
10 we e c oss-sec ional s udies, 3 we e coho s udies, 2 we e quali a i e, and 1
was a sys ema ic e iew. The s udies e ealed ha he main s esso s o no ice
nu ses included ime managemen , wo kload, and in e pe sonal ela ionships.
The esul s unde line ha o ganiza ional ac o s, such as lack o suppo and
high wo k demands, play a key ole in gene a ing s ess.
Conclusion: Iden i ying and add essing he key challenges aced by no ice nu ses,
such as wo kload, adjus men o he en i onmen , p o essional expec a ions, and
in e pe sonal ela ionships, is c ucial o sus ain hei p o essional engagemen
and ensu e he quali y o heal h ca e. This unde s anding is essen ial o c ea ing
e icien policies and p ac ices ha enhance he occupa ional well-being and
s abili y o nu ses in he wo k o ce.
Sys ema ic e iew egis a ion: h ps://www.c d.yo k.ac.uk/p ospe o/display_
eco d.php?ID=CRD42024520651, CRD42024520651.
KEYWORDS
nu ses, occupa ional s ess, p o essional bu nou , psychological adap a ion, men al
heal h, clinical compe ence
OPEN ACCESS
EDITED BY
Ca la Viegas,
Ins i u o Poli écnico de Lisboa, Po ugal
REVIEWED BY
Sem a Bulbuloglu,
Is anbul Aydın Uni e si y, Tü kiye
Xu ong Zheng,
China Medical Uni e si y, China
*CORRESPONDENCE
Juan Jesús Ga cía-Iglesias
[email p o ec ed]
Juan Gómez-Salgado
[email p o ec ed]
RECEIVED 12 July 2024
ACCEPTED 18 Oc obe 2024
PUBLISHED 30 Oc obe 2024
CITATION
Na bona-Gál ez Á, Ga cía-Iglesias JJ,
Ayuso-Mu illo D, Fon án-Vinag e G,
Gómez-Salgado J, Allande-Cussó R,
Fagundo-Ri e a J, Macías-To onjo I and
Ruiz-F u os C (2024) S ess in no ice nu ses
in new wo k en i onmen s: a sys ema ic
e iew.
F on . Public Heal h 12:1463751.
doi: 10.3389/ pubh.2024.1463751
COPYRIGHT
© 2024 Na bona-Gál ez, Ga cía-Iglesias,
Ayuso-Mu illo, Fon án-Vinag e,
Gómez-Salgado, Allande-Cussó,
Fagundo-Ri e a, Macías-To onjo and
Ruiz-F u os. This is an open-access a icle
dis ibu ed unde he e ms o he C ea i e
Commons A ibu ion License (CC BY). The
use, dis ibu ion o ep oduc ion in o he
o ums is pe mi ed, p o ided he o iginal
au ho (s) and he copy igh owne (s) a e
c edi ed and ha he o iginal publica ion in
his jou nal is ci ed, in acco dance wi h
accep ed academic p ac ice. No use,
dis ibu ion o ep oduc ion is pe mi ed
which does no comply wi h hese e ms.
TYPE Sys ema ic Re iew
PUBLISHED 30 Oc obe 2024
DOI 10.3389/ pubh.2024.1463751
Na bona-Gál ez e al. 10.3389/ pubh.2024.1463751
F on ie s in Public Heal h 02 on ie sin.o g
In oduc ion
The nu sing p o ession is an essen ial pa o he heal h ca e
sys em, bu aces signi ican challenges ha h ea en i s s abili y, such
as wo k- ela ed s ess, high s a u no e , and he complexi y o
newly g adua ed nu ses in adap ing o he wo kplace. These p oblems
need o beu gen ly explo ed and add essed (1).
S ess among nu sing s a is a widesp ead phenomenon ha
a ec s no only he physical and men al heal h o p o essionals, bu
also he quali y o he ca e hey p o ide (2). This is compounded by
high expec a ions, o e whelming esponsibili ies, and limi ed
empowe men in hei daily wo k (3). Ala mingly, a i ion a es in
nu sing a e mo e han wice as high as in o he heal h p o essions,
which ep esen s a signi ican gap (3).
The ansi ion o newly g adua ed nu ses om he academic
en i onmen o he wo ld o wo k is a di icul p ocess ha b ings
men al and psychological p essu es (4). Upon en e ing clinical
p ac ice, hese p o essionals expe ience s ains anging om di icul y
in communica ion o e hical dilemmas and o e whelming wo kloads
(5). Lack o adequa e skills and guidance con ibu e o inc eased s ess
and o en o he onse o emo ional exhaus ion and bu nou (4).
The COVID-19 pandemic has wo sened he exis ing human
esou ce sho age in he nu sing p o ession and has inc eased he
p essu e on no ice nu ses, who ace a mo e demanding and
challenging wo k en i onmen (6). I is c ucial o unde s and how job
s ess du ing he i s yea o employmen impac s on nu ses’ heal h
and on he quali y o pa ien ca e. This s udy seeks o ela e he esul s
ob ained o o ganiza ional and en i onmen al ac o s ha may
in ensi y o educe s ess, wi h he aim o p o iding a deepe insigh
in o how hese ac o s in luence he adap a ion o no ice nu ses.
Recen ly, he s udy o job s ess in nu sing has gained mo e
impo ance, especially h ough Bakke and Deme ou i’s Job Demands-
Resou ces model (7). This heo y analyses how he speci ic demands o
nu sing wo k, such as emo ional dis ess and i s in ensi y, a e ela ed o
he esou ces a ailable o cope wi h hese demands. Unde s anding his
makes i possible o iden i y he causes o wo k- ela ed s ess in nu sing,
highligh ing he impo ance o managing hese demands and p omo ing
esou ces ha enhance nu ses’ well-being (7). This heo e ical app oach
will se e as a basis o explo ing how he demands and a ailable esou ces
may in luence he expe ience o no ice nu ses when en e ing he
wo kplace, which is one o he main objec i es o he s udy. In his ega d,
ano he possible p oblem o newly g adua ed nu ses is he gap ha may
exis be ween he heo e ical con en s lea n so a a uni e si y and he
eali y shock ha , in some cases, comes wi h he need o ca y ou a ask
in a sho pe iod o ime (8).
The heo y by Benne (9) on Nu sing Compe ence De elopmen
highligh s ha as nu ses gain expe ience and skills, hey a e aced wi h
inc eased esponsibili ies, which can in u n aise hei s ess le els.
The ansi ion om no ice o expe nu se in ol es aking on mo e
complex oles and making impo an decisions, which adds o he
emo ional and psychological bu den. The e o e, s a egies o manage
s ess and p o ide suppo du ing hei ca ee a e essen ial (9).
Lack o nu sing expe ience can a ec bo h he quali y o ca e and
he well-being o pa ien s. No ice nu ses o en ind i di icul o
handle complex si ua ions o o deal wi h pa ien s wi h pa hologies
hey a e un amilia wi h o ha e no deal wi h be o e, which can a ec
hei decisions and hei pe o mance. In addi ion, un amilia i y wi h
he hospi al en i onmen and p o ocols gene a es anxie y and
unce ain y, u he complica ing hei wo k. I is essen ial o p o ide
aining and men o ing p og ams o suppo nu ses as hey mo e in o
mo e specialized oles (10).
Newly g adua ed nu ses may expe ience insecu i ies ela ed o
hei lack o expe ience, di icul ies in in eg a ing in o wo k eams,
and in unde s anding hei p o essional ole (11). These ac o s can
make nu ses mo e ulne able and u n hem in o “second ic ims”
a e an ad e se pa ien ca e e en , a e m coined by Wu (12) which
desc ibes he emo ional dis ess su e ed by heal h p o essionals a e
expe iencing such a si ua ion. I is es ima ed ha almos hal o hem
could go h ough his expe ience a some poin in hei ca ee s, which
se iously comp omises hei well-being and job pe o mance (13).
The speci ic aim o his s udy is o in es iga e he ela ionship
be ween s esso s a ec ing no ice nu ses and hei ansi ions in
a ious wo k se ings. In doing so, i seeks o p o ide a holis ic iew
o he ac o s ha inc ease ulne abili y o s ess, and also o iden i y
possible in e en ions o acili a e a smoo he ansi ion and minimize
he nega i e e ec s o s ess on he quali y o ca e p o ided o pa ien s.
O e all, his s udy ep esen s an analy ical jou ney aimed a assessing
he main sou ces o s ess expe ienced by nu ses and no ice nu ses in a
se ing new o hem. The objec i e o his e iew is o p o ide a
comp ehensi e and de ailed o e iew o he challenges aced in he
nu sing p o ession by explo ing di e en app oaches and pe spec i es,
wi h a iew o p o iding aluable insigh s ha will con ibu e o he
o mula ion o mo e e ec i e policies and p ac ices ha ocus on he well-
being o p o essionals and he quali y o pa ien ca e.
Me hods
S udy design
A sys ema ic e iew was conduc ed ollowing he guidelines o he
PRISMA s a emen (P e e ed Repo ing I ems o Sys ema ic e iews
and Me a-Analyses) (14).
Da abases and sea ch s a egy
The sea ch was ca ied ou in he Pubmed, Scopus, Web o Science,
and Cumula i e Index o Nu sing and Allied Heal h Li e a u e (CINAHL)
elec onic da abases on he basis o he key wo ds ha he esea ch
ques ion yielded, ollowing he CoCoPop s a egy (15) (Table1). These
da abases we e selec ed on he basis o hei ele ance and wide
ecogni ion in he ield o heal h sciences and Nu sing, hus ensu ing a
comp ehensi e and ep esen a i e e iew.
The Medical Subjec Headings (MeSH) hesau us was consul ed
using hese keywo ds, yielding he desc ip o s Disabled Pe sons, Ba ie s,
and Uni e si ies. To imp o e he sea ch s a egy and ensu e ele an
TABLE1 CoCoPop o ma : keywo ds (Spain, 2024).
Condi ion S ess
Con ex Wo king in se ings no p e iously expe ienced
Popula ion No ice nu ses/nu ses
Resea ch ques ion Wha is he p e alence o s ess in no ice nu ses and nu ses
wo king in a new se ing no p e iously expe ienced?
Na bona-Gál ez e al. 10.3389/ pubh.2024.1463751
F on ie s in Public Heal h 03 on ie sin.o g
s udies we e cap u ed, synonymous e ms we e also included using
Boolean ope a o s AND and OR. Table 2 shows he sea ch s a egy
applied du ing he sea ch p ocess pe o med on 02 Ma ch 2024 o each
o he abo e da abases. The sea ch s a egy was limi ed om 2014 o 2024.
Selec ion c i e ia
The ollowing c i e ia we e used o selec he a icles:
Inclusion c i e ia:
1 Language: Only o iginal a icles published in English, Spanish,
F ench, o Po uguese.
2 Type: o iginal a icles, me a-analysis, sys ema ic e iews, sho
communica ion, and case epo s.
3 Popula ion: nu ses and no ice nu ses acing si ua ions no
p e iously expe ienced, conside ing no ice nu ses as hose
wi h less han 1 yea o nu sing wo k expe ience.
4 A icles measu ing any o he ollowing alues and/o e ec s:
• S ess le el o nu ses and no ice nu ses in si ua ions hey ha e
no expe ienced be o e.
• S esso s inhe en o he nu sing p ac ice.
Exclusion c i e ia:
1 S udies ha we e classi ied as being o low scien i ic- echnical
quali y a e applica ion o he quali y assessmen ool we e
excluded. This assessmen was ca ied ou by wo e iewe s
independen ly, bo h o whom de e mined he me hodological
quali y o he selec ed s udies.
2 A icles ha did no di ec ly add ess he esea ch ques ion and
hose ha we e no ela ed o he objec i es o he e iew we e
excluded, ensu ing ha all included s udies made a meaning ul
con ibu ion o unde s anding he s ess o no ice nu ses in
new wo k se ings.
3 Ce ain ypes o publica ions, such as opinion a icles,
edi o ials, and le e s o he edi o we e excluded, as hese ypes
o a icles do no p o ide empi ical da a ha con o ms o he
objec i es o his e iew.
Da a collec ion and ex ac ion
Two esea che s conduc ed independen sea ches, elimina ed
duplica e s udies, and selec ed a icles o inclusion based on p e iously
es ablished c i e ia a e eading he abs ac and i le. Subsequen ly, he
ull ex o po en ially eligible s udies was e iewed by he same wo
au ho s, and decisions o include o exclude s udies we e made by
consensus. Any disc epancies we e esol ed by a hi d au ho .
Me hodological quali y assessmen
The me hodological quali y o he selec ed s udies was independen ly
de e mined by wo e iewe s by using he C i ical App aisal Tools o
T ials o he Joanna B iggs Ins i u e (JBI) a he Uni e si y o Adelaide
(16). These ools enable he assessmen o a s udy’s me hodological quali y
and he iden i ica ion o any po en ial bias in i s design, conduc , and/o
analysis. To ensu e consis ency and eliabili y in he assessmen , he
e iewe s me be o e s a ing he p ocess o discuss and uni y c i e ia. The
e sions o quan i a i e c oss-sec ional s udies (8 i ems), quali a i e
s udies (10 i ems), sys ema ic e iews (11 i ems), and coho s udies (11
i ems) we e used, wi h a cu -o poin o 6 o he i s wo and 8 o he
las wo o accep hei inclusion in his e iew. This e alua ion p ocess is
de ailed in he Supplemen a y ma e ial, which also includes a able
summa izing he quali y sco es o each included s udy.
Resul s
A o al o 395 e e ences we e iden i ied by applying he ini ial
sea ch s a egies, which we e hen sc eened acco ding o he opic o
TABLE2 Sea ch s a egy used o each da abase (Spain, 2024).
Da abase Sea ch s a egy Resul s
Pubmed (no ice nu s*[Ti le/Abs ac ] OR newl* g adua e nu s*[Ti le/Abs ac ] OR junio nu s*[Ti le/Abs ac ] OR newl* nu s*[Ti le/
Abs ac ]) AND (Psychological S ess[Ti le/Abs ac ] OR Li e S ess[Ti le/Abs ac ] OR Psychological Dis ess[Ti le/Abs ac ] OR
Emo ional Dis ess[Ti le/Abs ac ] OR Emo ional S ess[Ti le/Abs ac ] OR Job s ess[Ti le/Abs ac ] OR Occupa ional S ess[Ti le/
Abs ac ] OR Wo k- ela ed S ess[Ti le/Abs ac ] OR Wo kplace S ess[Ti le/Abs ac ] OR P o essional S ess[Ti le/Abs ac ] OR Job-
ela ed S ess[Ti le/Abs ac ]) Fil e s: om 2014–2024
109
Scopus (TITLE-ABS-KEY (“no ice nu s*” OR “new* g adua ed nu s*” OR “junio nu s*” OR “new nu s*”) AND TITLE-ABS-KEY
(“Psychologic* S ess*” OR “Li e S ess*” OR “Psychological Dis ess” OR “Emo ional Dis ess” OR “Emo ional S ess*” OR “Job
s ess*” OR “Occupa ional S ess*” OR “Wo k- ela ed S ess*” OR “Wo kplace S ess*” OR “P o essional S ess*” OR “Job- ela ed
S ess*”)) AND PUBYEAR >2013 AND PUBYEAR <2025
101
Web O Science “no ice nu s*” OR “new* g adua ed nu s*” OR “junio nu s*” OR “new nu s*” (Topic) AND “Psychologic* S ess*” OR “Li e S ess*”
OR “Psychological Dis ess” OR “Emo ional Dis ess” OR “Emo ional S ess*” OR “Job s ess*” OR “Occupa ional S ess*” OR “Wo k-
ela ed S ess*” OR “Wo kplace S ess*” OR “P o essional S ess*” OR “Job- ela ed S ess*” (Topic) and 2024 o 2023 o 2022 o 2021
o 2020 o 2019 o 2018 o 2017 o 2016 o 2015 o 2014 (Publica ion Yea s)
136
CINAHL AB (“Psychologic* S ess*” OR “Li e S ess*” OR “Psychological Dis ess” OR “Emo ional Dis ess” OR “Emo ional S ess*” OR “Job
s ess*” OR “Occupa ional S ess*” OR “Wo k- ela ed S ess*” OR “Wo kplace S ess*” OR “P o essional S ess*” OR “Job- ela ed
S ess*”) AND AB (“no ice nu s*” OR “new* g adua ed nu s*” OR “junio nu s*” OR “new nu s*”). Fil e s: om 2014 o 2024
49
To al 395
Na bona-Gál ez e al. 10.3389/ pubh.2024.1463751
F on ie s in Public Heal h 04 on ie sin.o g
FIGURE1
Sea ch esul s (Spain, 2024).
his e iew. Finally, 16 s udies we e selec ed (Figu e1), o which 10
we e desc ip i e c oss-sec ional s udies, 3 we e coho s udies, 2 we e
quali a i e s udies, and 1 was a sys ema ic e iew.
Fou a icles we e ound o ha e been conduc ed in China (1, 3,
17, 18), 2in Taiwan (6, 19), 1in he UK (2), 1in he Ne he lands (20),
1in Oman (4), 1in he Uni edS a es (5), 1in Sou h Ko ea (21), 1in
B azil (13), 2 in Canada (22, 23), 1 in Denma k (24), and 1 in
Jo dania (25).
In 10 o he 16 selec ed s udies (1, 3, 5, 6, 13, 17, 19–21, 24), he
sample consis ed o newly g adua ed nu ses, while in 1 o he selec ed
s udies (17) he sample consis ed o nu ses wi h 1 yea o expe ience.
In ano he selec ed a icle2 he sample consis ed o no ice nu ses a
he beginning o hei ca ee , a 6 mon hs, and a 12 mon hs. In
ano he s udy, he sample consis ed o nu ses wi h less han 2 yea s o
expe ience (22), and ano he s udy in ol ed nu ses wi h less han 3
yea s’ expe ience (23). The las a icle o beincluded (4) was an
in eg a i e e iew including 21 e iew a icles.
Among he in e en ions, he NSS scale was used (1–3), and also
he PSS (17, 18) in some o he s udies, while sel -s uc u ed
ques ionnai es we e u ilized in o he in es iga ions (3, 6, 13, 19, 21,
25). Ano he s udy used bo h he PSS ques ionnai e and he
CD-RISC-25 (25). The NWI-R (23) and CERQual (24) ques ionnai es
we e also used in o he a icles.
The JBI c i ical app aisal ool was used o assess he included
s udies, which sco ed medium-high o bo h c oss-sec ional
obse a ional s udies and quali a i e s udies.
Table3 shows he cha ac e is ics o each o he 16 s udies included
in his e iew. The s udies we e classi ied by hei au ho s, yea o
publica ion, coun y, design and objec i e, pa icipan s, ins umen ,
and main esul s. Addi ionally, he esul s o he JBI c i ical app aisal
ool we e included.
Discussion
In a ious s udies, such as he one by Fang e al. (3), mul iple
s ages in which new nu ses expe ience a ying le els o wo k- ela ed
s ess ha e been iden i ied. P ominen ac o s include ime
managemen , wo kload, and in e pe sonal ela ionships. These
indings a e consis en wi h p e ious esea ch, such as he one
conduc ed by Feeg e al. (5), which emphasizes he signi icance o ime
managemen and adap a ion o he wo k en i onmen as sou ces o
s ess. The analysis highligh s he inhe en complexi y o he nu sing
wo k en i onmen , whe e ime managemen , managemen skills, and
in e pe sonal ela ionships play a c ucial ole in emo ional well-being
and p o essional pe o mance (5). This app oach is consis en wi h he
s ess model p oposed by Laza us and Folkman (26), which sugges s
ha he way people iew wo k demands and hei abili y o cope wi h
hose demands a e key o unde s anding how hey deal wi h s ess
(26). The e o e, unde s anding hese ac o s is essen ial in o de o
de elop e ec i e suppo and aining s a egies o help new nu ses
ace and o e come challenges h oughou hei ca ee s (5).
Na bona-Gál ez e al. 10.3389/ pubh.2024.1463751
F on ie s in Public Heal h 05 on ie sin.o g
TABLE3 Cha ac e is ics o he s udies included in he sys ema ic e iew (Spain, 2024).
S udies Con ex S udy objec i e Type o
s udy
Pa icipan s Me hods Main indings Quali y o
s udies
Fang e al. (3) Fujian (China) To analyze changes in occupa ional
s ess in new nu ses du ing he i s
yea o employmen
Analy ical
s udy
Rec ui ed new nu ses
(n = 127)
NSS Chinese e sion The esul s showed ha new nu ses had mode a e o high le els o
s ess in all ou s ages, wi h he highes s ess le el a 4 and
8 mon hs o employmen and he lowes s ess le el a 12 mon hs;
he di e ences in s ess sco es a di e en ime poin s we e
s a is ically signi ican (). The ends in each s esso dimension
a ied ac oss di e en pe iods. The highes sco es we e o p essu e
caused by “ ime alloca ion and wo kload,” which peaked in mon h
8. The same end was obse ed o s ess om “pa ien ca e” and
“wo k en i onmen and equipmen .” “Managemen and
in e pe sonal ela ionships” sco ed he highes o e all s ess sco e
a he s a o employmen be o e declining. The lowes s ess sco e
was om “wo k en i onmen and equipmen ” a he s a o
employmen , and he lowes was om “managemen and
in e pe sonal ela ionships” om mon h 4 onwa d
6/8
Halpin e al. (2) London (Uni ed
Kingdom)
To in es iga e ansi ion in newly
quali ied nu ses h ough an
explo a ion o hei s esso s and
s ess expe iences du ing hei i s
12 mon hs pos -quali ying
Coho s udy Newly g adua ed
nu ses: a he ime o
quali ica ion (n = 288),
6 mon hs la e
(n = 107) and
12 mon hs la e
(n = 86)
NSS Wo kload was consis en ly he highes epo ed s esso wi h
inadequa e s a ing and managing mul iple ole-demands gi en as
explana ions. Inci ili y wi hin he wo kplace was a no ed s esso .
Con e sely, being pa o “a good eam” p o ided a ci il,
suppo i e, acili a i e wo k en i onmen . En e ing nu se
educa ion wi h p e ious heal hca e expe ience had a media ing
e ec on he epo ed equency o s esso s
8/11
Hoe e e al. (20) G oningen (The
Ne he lands)
Ge ing insigh in he mos c ucial
o ganiza ional job s esso s o
no ice nu ses’ p o essional
commi men and whe he he job
s esso s a e media ed h ough
nega i e emo ions
Coho s udy No ice nu ses (n = 18) Semi-s uc u ed elec onic
dia y ha assesses:
1. O ganiza ional j ob
s esso s
2. Emo ions
3. Wo k commi men :
measu ed using he scale
(RECS-E)
Pa h modeling e ealed ha lack o suppo om colleagues,
nega i e expe iences wi h pa ien s and con on a ions wi h
exis en ial e en s we e mos s ongly nega i ely ela ed o
p o essional commi men h ough nega i e emo ions. O he
indi ec ly and nega i ely ela ed o ganiza ional job s esso s o
commi men we e complexi y o ca e, lack o con ol and wo k-li e
imbalance; only con lic ing job demands, and lack o con ol
ela ed o p o essional commi men di ec ly
8/11
Lab ague and
McEn oe-Pe i e
(4)
Masca e
(Oman)
To app aise and syn hesize
e idence ela ing o new nu ses’
s ess expe iences du ing he
ansi ion pe iod
Sys ema ic
e iew
21 e iew a icles PRISMA New nu ses pe cei ed low o mode a e le els o s ess mainly om
hea y wo kloads and lack o p o essional nu sing compe ence.
Indi idual and o ganiza ional ac o s ha migh con ibu e o hei
s ess expe iences we e a ely explo ed
9/11
(Con inued)

Na bona-Gál ez e al. 10.3389/ pubh.2024.1463751
F on ie s in Public Heal h 06 on ie sin.o g
TABLE3 (Con inued)
S udies Con ex S udy objec i e Type o
s udy
Pa icipan s Me hods Main indings Quali y o
s udies
Zhang e al. (1)Shanghai
(China)
To de e mine di e ences in
occupa ional s ess le els o newly
g adua ed nu ses a di e en ime
poin s du ing he i s 3 yea s o
p ac ice; o iden i y po en ial
subg oups o nu ses who pe cei e
di e en occupa ional s ess le els
o e ime; and o e alua e
di e ences in iden i ied subg oups
based on demog aphic and wo k-
ela ed cha ac e is ics
Analy ical
s udy
Newly g adua ed
nu ses wi h no
expe ience (n = 152)
NSS The en i e sample o newly g adua ed nu ses expe ienced a
signi ican dec ease in occupa ional s ess du ing he i s 3 yea s.
The bes - i ing g oup-based ajec o y model desc ibed h ee
dis inc i e ajec o ies: low occupa ional s ess (19.1% o sample);
medium occupa ional s ess (67.1%) and high occupa ional s ess
(13.8%). The low occupa ional s ess subg oup had a highe
p opo ion o nu ses om Shanghai, and he majo i y we e
employed as con ac -based nu ses. In compa ison, he high
occupa ional s ess subg oup had he la ges p opo ion o nu ses
om o he p o inces (ou side o Shanghai), almos hal o
pa icipan s we e employed as “bianzhi” nu ses, and he majo i y
epo ed o beassigned p ecep o by shi
6/8
Feeg e al. (5) New Yo k
(Uni ed S a es)
To unde s and he expe iences o
new nu sing g adua es in hei
wo k en i onmen and he
pe cei ed s esso s du ing hei
ansi ion o he ole o a
compe en nu se
Quali a i e
s udy
Newly g adua ed
nu ses (n = 1,456)
NSNA su ey Responden s el ha a high nu se/pa ien a io was no sa e o he
pa ien s unde hei ca e. Responden s also el ha hey could no
p o ide comple e ca e o hei pa ien s. Responden s el ha he e
was no enough ime o comple e pa ien ca e
A e he i s ca ego ical analysis, he esea che s elabo a ed on
how indi idual i ems e ealed meaning ul s a emen s o how new
g adua es we e ying o ind “balance” in hei wo k, hei
expec a ions, and hei in e ac ions wi h o he s. The opics ha
eme ged ela ed o esponden s’ o e all “balance,” e lec ing
en i onmen al s ess (“My wo kload is highe han Iexpec ed”);
expec a ions abou onesel (“I do no know e e y hing Ineed o
know”); and in e ac ions wi h o he s ha a ec ed hem (“My
ela ionships wi h o he s a e di icul ”)
9/10
Zhu e al. (18)Shanghai, Hong
Kong and Taipei
(China)
o explo e and compa e s ess,
coping, p o essional iden i y and
wo k locus o con ol o new
g adua e nu ses among Shanghai,
Hong Kong and Taipei.
Analy ical
s udy
Nu ses wi h 1-yea
expe ience in he
hospi al (n = 591)
• PSS Ques ionnai e
• Chinese ai coping
s yle ques ionnai e
• Nu se p o essional
iden i y scale
• Wo k locus o con ol
scale (Chinese e sion)
The newly g adua ed nu ses in Shanghai had signi ican ly lowe
(p < 0.05) wo k s ess sco e (2.65 ± 0.67) compa ed wi h hei
coun e pa s in Hong Kong (2.99 ± 0.69) and Taipei (2.94 ± 0.60).
Newly g adua ed nu ses in Shanghai ended o choose posi i e
coping o deal wi h s ess ul si ua ions, whe eas hose in Hong
Kong would bemo e likely o adop nega i e a i udes (p < 0.05).
The newly g adua ed nu ses in Taipei had he lowes le el o
p o essional iden i y (3.25 ± 0.55, p < 0.05), and hei wo k con ol
ended o beex e nal (46.13 ± 6.20). In con as , hose in Shanghai
(52.75 ± 6.04) and Hong Kong (59.41 ± 7.29) ended o becon olled
in e nally
6/8
(Con inued)
Na bona-Gál ez e al. 10.3389/ pubh.2024.1463751
F on ie s in Public Heal h 07 on ie sin.o g
TABLE3 (Con inued)
S udies Con ex S udy objec i e Type o
s udy
Pa icipan s Me hods Main indings Quali y o
s udies
An e al. (21) Gwangju (Sou h
Ko ea)
To examine u no e in en ion
le els and iden i y he ac o s
a ec ing u no e in en ion o new
Gene a ion Z nu ses, ocusing on
job s ess and sleep dis u bance
Analy ical
s udy
New nu ses (n = 133) S uc u ed ques ionnai e
including da a on job s ess,
sleep dis u bance, and
u no e in en ion
Mos nu ses we e women (91.7%) and app oxima ely wo- hi ds
wo ked in he su gical wa d (n = 61, 45.9%). Tu no e in en ion
was 12.8%, a e age job s ess was 40.11 ± 90.7, and a e age sleep
dis u bance was 42.39 ± 15.27. New g adua e nu ses’ u no e
in en ion was associa ed wi h job s ess (OR = 1.07, 95% CI = 1.02–
1.12) and sleep dis u bance (OR = 1.19, 95% CI = 1.05–1.35), and
his model explained 47.7% o he a iance. S udy indings
de e mine ha job s ess and sleep dis u bance we e signi ican
p edic o s o u no e in en ion in new nu ses a he eigh h week
a e joining he hospi al
8/8
Zhou e al. (17) Jiangsu,
Zhenjiang
(China)
To in es iga e some possible job
s ess ac o s ha could in luence
newly ec ui ed nu ses’ beha io o
ei he con inue o discon inue hei
job wi h hei o ganiza ion
Analy ical
s udy
No ice nu ses in 20
Chinese hospi als
(n = 564)
PSS Ques ionnai e. The e ec s o six job s esso s om he pe cei ed s ess scale we e
es ima ed. The esul s showed ha ou s esso s, s ess om aking
ca e o pa ien s (β = 0.111, p < 0.01), s ess om oles and wo kload
(β = 0.129, p < 0.001), s ess om co-wo ke s and daily li e
(β = 0.323, p < 0.001) and s ess om lack o p o essional knowledge
and skills (β = 0.137, p < 0.001), om he pe cei ed s ess scale had
a signi ican impac on u no e in en ion among nu ses
8/8
Chen e al. (19) Keelung
(Taiwan)
To de elop an Objec i e S uc u ed
Clinical Exam (OSCE) o e alua e
no ice nu sing p ac i ione s’
clinical compe ency, wo k s ess,
p o essional con idence, and ca ee
sa is ac ion
Quasi-
expe imen al
s udy
No ice nu ses (n = 55) P e-pos ques ionnai e
(modi ied om a Nu sing
Compe ency Ques ionnai e,
a S ess scale, and
Sa is ac ion wi h Lea ning
scale)
Among he no ice nu sing p ac i ione s, 41 o hem (74.5%) passed
he exam wi h a mean sco e o 61.38 ± 8.34. The e was a
signi ican ly highe passing a e among nu ses who we e wo king
in medical-su gical wa ds (85.7%) and he in ensi e ca e uni -
eme gency depa men (77.8%) compa ed o no ice nu sing
p ac i ione s wo king in o he uni s. All he no ice nu sing
p ac i ione s a S a ion A had poo pe o mance in assessing
pa ien s wi h a e e . OSCE pe o mance was mo e associa ed wi h
educa ional a ainmen and wo k uni , a he han he gende .
Finally, he pa icipan s showed s a is ically signi ican inc eases in
hei clinical compe ency, con idence in hei p o essional
compe ence, sa is ac ion wi h he clinical p ac ice, and dec eased
wo k s ess a e he OSCE
9/9
(Con inued)
Na bona-Gál ez e al. 10.3389/ pubh.2024.1463751
F on ie s in Public Heal h 08 on ie sin.o g
TABLE3 (Con inued)
S udies Con ex S udy objec i e Type o
s udy
Pa icipan s Me hods Main indings Quali y o
s udies
Chen e al. (6) Chang Gung,
Chiayi (Taiwan)
To explo e egis e ed nu ses’
compe ence in nu sing ca e and
hei in en ion o s ay in hei
cu en wo kplace
Analy ical
s udy
No ice nu ses
(n = 333)
S uc u ed ques ionnai e o
assess ac o s ela ed o
nu sing compe ence based
on he essen ials o
baccalau ea e educa ion o
p o essional nu sing
p ac ice
The esul s o he p esen s udy e ealed ha he majo i y o he
no ice nu ses’ wo kplaces a ied signi ican ly among he ansi ion
shock. The no ice nu ses had he compe ence o p o ide quali y
ca e ela ed o pa ien e hics, end-o -li e ca e, and isk p e en ion.
Howe e , he no ice nu ses had he lowes a e age sco e in
“u iliza ion o ca e models, implemen a ion, and leade ship in he
eam,” indica ing a lack o adequa e p ac icum expe ience in
leading ca e eams. The esul s indica ed ha he no ice nu ses
who ook in ec ion ca e ela ed cou ses in baccalau ea e nu sing
p og ams we e mo e amilia wi h ele an concep s and had
g ea e awa eness o ca e ela ed concep s. The esul s indica ed
ha he pa icipan s we e willing o s ay in hei cu en nu sing
wo kplace and ha ca e compe ence was posi i ely co ela ed wi h
in en ion o s ay. In en ion o s ay was nega i ely co ela ed wi h
clinical s ess. The s epwise eg ession analysis e ealed he
ollowing signi ican p edic o s o in en ion o s ay: clinical s ess,
equency o ca ing o in ec ious pa ien s in he wo kplace,
ecei ing nu sing cou ses in he wo k ield, and he equency o
ca e o pa ien s in p o essional nu sing ca ee s
7/8
Ale i e al. (13) São Paulo
(B azil)
To desc ibe he p e alence o newly
g adua ed nu ses as second ic ims
o ad e se e en s and o know he
condi ions o suppo ecei ed in
heal h ins i u ions
Analy ical
S udy
Nu ses (n = 138) Online ques ionnai e on he
cha ac e is ics o he
pa icipan s, he ins i u ion,
and ad e se e en s
A o al o 240 esponses we e ob ained, o which 138 we e
conside ed o analysis. Mos o he pa icipan s we e women,
ecen nu sing g adua es. A signi ican pe cen age had wo ked as
nu sing assis an s o echnicians be o e g adua ing. Many we e
s udying in specializa ion o p o essional esidency. Mos o hem
had no ins i u ional onboa ding aining when hi ed and did no
know he e m “second ic im.” A ound 27% had been in ol ed in
ad e se e en s, mainly ela ed o medica ion. A e hese e en s, he
majo i y epo ed nega i e eelings and insecu i y, bu only 59.5%
el hey had ecei ed suppo . Some pa icipan s had ecei ed
punishmen . No signi ican di e ences we e ound be ween hose
who had ecei ed eedback on hei aining and ec ui men
pe iod and hose who had no , in e ms o being in ol ed in
ad e se e en s
6/8
(Con inued)
Na bona-Gál ez e al. 10.3389/ pubh.2024.1463751
F on ie s in Public Heal h 09 on ie sin.o g
TABLE3 (Con inued)
S udies Con ex S udy objec i e Type o
s udy
Pa icipan s Me hods Main indings Quali y o
s udies
Dames (22)Canada To analyse how li e expe iences and
uni e si y educa ion in luence
newly g adua ed nu ses’ abili y o
manage s ess, main ain emo ional
cong uence, and h i e in hei
wo k, o educe he isk o bu nou
and achie e ca ee success
Quali a i e
s udy
Female nu ses unde
he age o 40, wi h less
han 2 yea s o wo k
expe ience, in B i ish
Columbia, Canada
(n = 8)
Th ee 60-90-min in e iews
wi h each pa icipan . The
i s wo in e iews we e
conduc ed 1–2 weeks apa ,
and he hi d in e iew, 3–4
weeks la e
The mos in luen ial hemes ha eme ged om he unde g adua e
ac o s, which in e play o impac cong uence and one’s abili y o
h i e in hei no ice nu se ole we e equen sel -ca e, ecei ing
p ac icum and job placemen ad ice ha p omo ed cong uence
and iden i y o ma ion, cu iculum componen s ha el pe sonally
and p o essionally ele an . The impo ance o se ing au hen ic
goals, he abili y o ac as change agen s and he de elopmen o
sel -compassion we e also highligh ed. Howe e , sel -ca e was
pe cei ed as a symbolic a he han a p ac ical concep , and some
pa icipan s el p essu e o ollow ca ee pa hs ha did no align
wi h hei p e e ences, leading o s ess and dissonance. Emo ional
managemen and pe sonal-p o essional cong uence eme ged as key
elemen s in mi iga ing bu nou
8/10
Laschinge e al.
(23)
Canada To in es iga e ac o s in luencing
new g adua e nu ses’ success ul
ansi ion o hei ull p o essional
ole in Canadian hospi al se ings
and o de e mine p edic o s o job
and ca ee sa is ac ion and
u no e in en ions o e a one-yea
ime pe iod in hei ea ly
employmen
Coho s udy Newly g adua ed
nu ses in Canada wi h
less han 3 yea s o
expe ience (n = 406)
NWI-R Au hen ic leade ship, pe cep ions o s uc u al empowe men , and
pe son-job i we e mode a e a bo h ime poin s, dec easing
signi ican ly o e ime. A bo h ime poin s, new g adua es el ha
hei wo k en i onmen was suppo ing, main aining high a es o
job and ca ee sa is ac ion, as well as low u no e in en ions.
Signi ican co ela ions we e ound be ween pe son-job i and
psychological capi al (Psycap) wi h job sa is ac ion. In addi ion,
cynicism and Psycap we e iden i ied as signi ican p edic o s o job
sa is ac ion and u no e in en ions
7/11
Al Hadid e al.
(25)
Sal (Jo dania) To examine he impac o ca ing o
pa ien s wi h COVID-19 on ca ee
decisions, esilience, and pe cei ed
sel -e icacy among newly hi ed
nu ses in Jo dan. I also es ed
whe he s ess, esilience, and o he
ac o s would p edic in en ions o
s ay among new nu ses who ca e
o pa ien s wi h COVID-19
Analy ical
s udy
Newly hi ed nu ses
(n = 300)
• Demog aphic
cha ac e is ics
• PSS
• CD-RISC-25
mos newly hi ed nu ses epo ed low o mode a e le els o
occupa ional s ess, and only a ound hal o hem showed low o
mode a e esilience. In addi ion, he majo i y picked nu sing as
hei p e e ed job, exp essing a high le el o au onomy in decision-
making as well as exis ing wo k condi ions ha we e un a o able
and as a esul a ec ed hei decision o con inue in nu sing. Only
inancial e u n was a signi ican p edic o o s ay in nu sing
among nu ses in his s udy. Examining he in luence o ca ing o
COVID-19 pa ien s on newly hi ed nu ses’ ca ee decisions is
sugges ed as well as he de elopmen o in e en ional p og ams o
imp o e hei well-being
7/8
(Con inued)