New Graduate Nurses in the Emergency Department

I am writing in response to the article “Transitioning from novice to competent: What can we learn from the literature about graduate nurses in the emergency setting?” that appeared in the Journal of Emergency Nursing (2008;34:435-40). As our national nursing shortage reaches critical levels and emergency departments push capacity on a daily basis, more graduate nurses are being hired fresh out of school into the emergency setting. I began my career just over a year ago in the emergency department as a new graduate nurse, and I appreciate this article’s focus on the educational and cultural challenges faced by new graduates in this dynamic and unpredictable specialty.

The author, Anna Maria Valdez, provided a comprehensive review of the 5 stages of proficiency and the unique challenges faced by emergency nurses as they progress through each stage. Her categorization of barriers to and facilitators of success provides a framework for the development of education programs to guide the new graduate nurse to success in this challenging practice. She addresses the roles that all members of the department play in enhancing the new graduate’s experience, from managers and educators to the experienced staff nurses. I also appreciate her recognition that nurses with years of experience may encounter similar feelings as graduate nurses when switching specialties and that these nurses should be educated in a fashion similar to graduate nurses. Many of her recommendations for transitioning graduate nurses were part of my new graduate education and orientation process, for which I will be eternally grateful to my educators and hospital.

In the emergency setting, it is easy to become overwhelmed and feel isolated. I am encouraged to know that the feelings I have experienced during my transition are not unique. I applaud the author and the Journal for addressing this ever-growing segment of emergency nurses. This support and encouragement from our professional journal is another step toward retaining strong graduate nurses in emergency departments. As I work toward my BSN, CEN certification, and eventual goal of mentoring new graduates, I will keep this article in mind and continually remind myself of the challenges faced by graduate nurses in the emergency setting.