Newly graduated nurses' socialisation resulting in limiting inquiry and one-sided use of knowledge sources-An ethnographic study

Abstract

Aim: To explore how the socialisation into the clinical setting and interaction between newly graduated nurses and experienced nurses influences the new graduates' use of knowledge sources.

Background: Newly graduated nurses' use of knowledge sources in decision-making has been subject to an increased interest in relation to evidence-based practice. Despite interventions to strengthen nurses' competencies required for making reflective clinical decisions within an evidence-based practice, studies highlight that new graduates only draw on knowledge from research, patients and other components within evidence-based practice to a limited extent. Research exploring new graduates' use of knowledge sources calls attention to the experienced nurses' decisive role as a valued knowledge source. The new graduates' process of socialisation and their interaction with the experienced nurse raises further questions.

Methods: Ethnography using participant-observation and individual semi-structured interviews of nine newly graduated nurses from a University Hospital in Denmark. Data were collected in 2014. The study adheres to COREQ.

Results: Two main structures were found: "Striving for acknowledgment" and "Unintentionally suppressed inquiry."

Conclusions: New graduates are socialised into limiting their inquiry on clinical practice and unintentionally being restricted to using the experienced nurse as predominant knowledge source. Depending on how the experienced nurse responds to the role as predominant knowledge source, they could either limit or nurture the new graduates' inquiry into practice and thus the variety of knowledge sources used in clinical decision-making. Limited inquiry into the complexity of nursing practice indirectly excludes the use of a variety of knowledge sources, which are fundamental to an evidence-based practice.

Relevance: If clinical practice wishes to benefit from the newly graduated nurses' inquiring approach and skills within evidence-based practice, clinical practice will have to greet the nurses with a supportive culture where questioning practice is seen as a strength rather than a sign of insecurity and incompetence.

Keywords: Critical thinking; decision-making; evidence-based practice; knowledge; new graduate nurses; professional practice; role models; socialisation.