Fostering graduate nurse practice readiness in context

Background: The healthcare environment is highly pressured, dynamic and demanding of staff. Existing research indicates that when graduate nurses begin work, they are not practice ready and struggle to adapt and manage their responsibilities as registered nurses. Aim: As part of a larger study, this paper examines the impact of the healthcare environment on graduate nurses' practice readiness and the factors that assist them to become practice ready. Method: Multiple case study design with 67 participants from four different professional groups employed in four healthcare institutions in one state in Australia. Grounded theory methods of data analysis, document review, and cross case analysis were utilised in this study. Findings: The healthcare system, workplace environment and quality of workplace interactions impact on actual and perceived graduate nurse performance. Graduate nurses develop practice readiness progressively along a transition continuum and attaining practice readiness is reliant on factors present in both the education and workplace environments. Discussion: Education and workplace factors collectively create the right environment for graduate nurses to flourish. Education and practice sectors need to work together to ensure graduate readiness over a four-year timeline from the commencement of nursing studies through to the end of the graduate year to ensure practice readiness. Conclusion: Creating positive workplace environments that support nursing students and graduate nurses to develop practice readiness can enhance the quality of care they provide, promote their retention in the health workforce and contribute to improved healthcare practice and outcomes. (C) 2019 Australian College of Nursing Ltd. Published by Elsevier Ltd.