New graduate nurse wellbeing, work wellbeing and mental health: A quantitative systematic review

Abstract

Background: The contribution of work to positive mental health is increasingly apparent. Transition into the workplace causes a range of stressors for new graduate nurses who experience both psychological wellbeing and illbeing in their first year of practice.

Objective: To determine published prevalence, predictors, barriers and enablers of new graduate registered nurse wellbeing, work wellbeing and mental health.

Design: Systematic review of quantitative research.

Data sources: Databases included Cumulative Index of Nursing and Allied Health Literature, Excerpta Medica database, Medical Literature Analysis and Retrieval System Online and Psychological Information. Quantitative and mixed-methods studies were considered for inclusion if published in English from 2009 to 2019 reporting primary data analysis including new graduate nurses' wellbeing, work wellbeing and mental health.

Review methods: Quantitative studies were systematically identified then screened and appraised against pre-determined inclusion criteria. Analysis was conducted by grouping according to analytical methods and results reported as a narrative synthesis.

Results: Thirty-four studies were included. The quality of the evidence was variable with just a quarter of the studies being assessed as meeting the quality criteria on all nine measures. For the new graduate nurses prevalence of wellbeing, levels of resilience, optimism, and hope were found to be high. For work wellbeing, most reported higher job satisfaction by 12-months. For work illbeing, levels of burnout were moderately high, predominantly in terms of emotional exhaustion, and stress was initially high, particularly in terms of workload, but decreased over time. For the predictors, job satisfaction was positively predicted by structural empowerment and career satisfaction, and negatively predicted by co-worker incivility, supervisor incivility and emotional exhaustion. For work illbeing, stress was a positive predictor for intent to leave. Stress reductions were associated with momentary levels of high task mastery, social acceptance and role clarity.

Conclusions: For new graduate nurses, levels of emotional exhaustion, workload and stress were moderately high to high initially, decreasing over time as the graduate nurses' job satisfaction increased. Most studies focused on the nurses' intent to resign or stay and both psychological capital and work engagement positively predicted intent to stay whereas work stress positively predicted intent to resign. Resilience and group cohesion moderated the negative effects of some variables, thus may be potential enablers of work wellbeing. The standards of research reporting or design were generally sub-optimal according to quality indicators. Systematic review registration number: (CRD42020148812).

Keywords: Graduate; Illbeing; Mental health; Nurse; Transition; Wellbeing; Work wellbeing.