Date of Award

Spring 2019

Degree Type


Degree Name

Doctor of Philosophy (PhD)


Leadership and Advanced Nursing Practice

Committee Chair

Janie Butts

Committee Chair School

Leadership and Advanced Nursing Practice

Committee Member 2

Lachel Story

Committee Member 2 School

Leadership and Advanced Nursing Practice

Committee Member 3

Kathleen Masters

Committee Member 3 School

Leadership and Advanced Nursing Practice

Committee Member 4

Kyna Shelley

Committee Member 4 School


Committee Member 5

Arlene Morris


The acuity level of patients continues to increase making it more vital than ever that new graduate Registered Nurses (RNs) be prepared to give safe, quality care when leaving their hospital’s orientation program (Spector et al., 2015). Today, new graduate RNs need orientation programs that will ensure a smooth transition into nursing practice. This involves the ability to apply higher-level knowledge and skills in everyday practice situations, thereby, maintaining quality care (Henderson, Ossenberg, & Tyler, 2015).

The purpose of this study was to identify differences between new graduate RNs’ opinions on readiness for practice, as measured by the Casey-Fink Readiness Practice Survey (Casey et al., 2011). The phases of Benner’s (1984) skills acquisition theory was used to determine at which level each participant felt they belonged. These methods were used at the beginning of hospital employment, at 4 weeks of hospital orientation, and at 8 weeks of hospital orientation. Qualitative feedback regarding the effectiveness of hospital orientation programs was collected using a focus group interview at the end of orientation.

A mixed method, descriptive comparative design was used for this research. New graduate RNs from three hospitals in central Alabama were surveyed. A convenience sample of new graduate RNs was used for the survey portion of the research. A sufficient amount of responses to the Casey-Fink Readiness for Practice Surveys was not obtained in order to identify any significant changes from the beginning of orientation programs to the end. The focus group interview included five participants and identified several areas in need of improvement, most significantly the need for a designated clinical educator and consistent preceptors. These findings are significant, specifically regarding ensuring new graduate RNs are ready for practice, which will help decrease turnover.