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The complexity of nursing and the chaos of professional practice are challenges for new graduate RNs (NGRNs) entering an acute care hospital setting (Hezaveh et al., 2013). The first year of a NGRN's professional practice has been extensively researched and found to be the most challenging time in their career (Blanzola et al., 2004; Chappell & Richards, 2015; Kramer, 1974; Martin & Wilson, 2011). The difficulties with the transition from the academic setting to the health care arena have resulted in decreased satisfaction and poor retention. NGRNs report feeling unappreciated and undersupported when trying to develop clinical judgment and time management skills (Cochran, 2017). NGRNs experience many unique challenges as they progress to being a competent nurse. Research has demonstrated that NGRNs may not have the skills necessary to monitor patients and react to a myriad of clinical situations (Duckett & Moran, 2018; Henderson et al., 2015). It is critical that novice nurses develop skills in delegation, prioritization, collaboration, conflict management, and critical thinking in order to provide high-quality, safe patient care (Walsh, 2018).
The term “reality shock” was first coined by Kramer (1974) and described as a three-phase approach to entering professional nursing practice. The first phase is the honeymoon phase, when recent graduates are excited about completing nursing school and beginning their first job. The next phase is the shock phase, when new nurses have a feeling of disillusionment with the professional role. The final phase is the recovery phase, when new nurses make decisions to adapt to the new role, return to school, or leave nursing altogether (Kramer, 1974).
In support of the early work by Kramer, Benner (1984, 2010) developed the concept of novice to expert nurse and evaluated the education of nurses. Benner et al. (2010) state, “New nurses need to be prepared to practice safely, accurately, and compassionately, in varied settings, where knowledge and innovation increase at an astonishing rate” (p. I). Benner et al. (2010) also identified that nurses and nursing students learn and work in less-than-optimal situations. Benner (1984) used the Dreyfus model and developed nursing stages: novice, advanced beginner, competent,...