Transitioning to nursing practice in Lebanon: Challenges in professional, occupational and cultural identity formation

Abstract

The aim of this study was to identify the challenges graduates from three of Lebanon’s leading universities face as they transition from the role of student to first year registered nurse. Focus group discussions and one joint interview were conducted with 16 first year registered nurses transitioning to practice in university medical centers in Greater Beirut. Thematic analysis was used to summarize the challenges faced by the graduates. Initially, three descriptive themes were used to summarize the data: classroom learning, workplace realities, and “wanting a life”. Together the three themes indicted that classroom instruction of baccalaureate nursing students in Lebanon raises expectations for ideal practice that cannot be realized in clinical units with high workloads and nursing shortages. As a result, first year registered nurses are made to feel unwelcome unless they compromise their values and adapt quickly to the pace of work. The three initial themes were revised deductively from the perspective of ego-identity theory to explain the relationship between transitioning to nursing practice and identity formation in late adolescence and early adulthood.  If the pressures of identity formation are not addressed, first year registered nurses in Lebanon will be at risk for acquiescing to task-centered practice, abandoning bedside care for administrative roles, or leaving nursing. The evidence for this conclusion will interest nursing faculty, hospital administrators, nurse leaders, registered nurses, physicians, and nursing students.