Professional commitment development in novice nurses. A quantitative multiple case study.

Abstract

Background: In the transition period from nursing student to nurse professional, Novice Nurses (NNs) experience professional identity development, whereof commitment and exploration level are important aspects. During the first years in clinical practice, intentions to commit to the profession are consolidated, and decisions are made about staying or leaving the first job. As commitment is an antecedent of intention to leave, gaining insight into its evolution in NNs may lead to new approaches for retaining them within the profession. Aim: To explore the course of professional commitment development in NNs working in hospital in the first or second year after graduation. Method: This quantitative study had a multiple-case study design. The sample (18 NNs) of a previous longitudinal study, performed in a University Medical Centre in the Netherlands, was used. The main study parameter was professional commitment development. The sub-variables commitment, exploration, instability, and positive and negative emotions regarding work were measured at three time points with the Groningen Identity Development Scale. Median scores were used to differentiate individual commitment status (Diffusion, Foreclosure, Moratorium, or Achievement), of which the sequence resulted in classifying participants in different trajectory types. Results: Four trajectory types were identified: Stable (n=10), Fluctuating (n=2), Progressive (n=5), and alternating Moratorium-Achievement (MAMA)-cycle (n=1). No regressive trajectories were found. In general the commitment was strong and participants had positive feelings about their commitment. Conclusion: The majority pursued a stable trajectory, but also change trajectories were present. The general strong commitment implicates that the attachment to the profession is strong. However, the prevailing foreclosed status in the trajectories makes it unpredictable how the commitment will develop after an assumed future exploration period. Recommendations: Repeatedly assessing and evaluating commitment strength of NNs during the first and second year in clinical practice after graduation is recommended.