Reality Shock

Abstract

Reality shock occurs when newly licensed registered nurses (NLRNs) begin work and find that the reality of the job does not meet their expectations. This leads to stress and job dissatisfaction, which in turn leads to staff turnover. This can negatively impact patient care, and also has a negative fiscal impact on employers. One solution to the consequences of reality shock is educating students about the reality of their future jobs before they actually enter the workforce. Another solution is to provide them with support throughout their first year of employment via a Nurse Residency Program (NRP), which can increase their sense of belonging, their confidence and therefore their job satisfaction while decreasing their stress and

2). Reality shock occurs frequently when nurses become “dissatisfied within the first 6 months of employment” (Steinmiller, 2003, p. 64A). New graduates suffer an identity crisis when they realize that the values that they are expected to adhere to in the workplace, don’t match up with what they were taught in school. Kramer further defined reality shock to include 4 distinct phases, as explained in the article Rx for Success. The Honeymoon phase occurs when a new graduate begins their first nursing job. They are excited and have high expectations. They are wanting to do their best in their new role as a nurse, and be respected by their peers. The second phase is the Shock-rejection phase, which occurs when a new nurse realizes that the values they learned in nursing school are not necessarily embraced by their place of work. They now see their workplace in a negative light. The third phase of Recovery occurs when the nurse is able to see the differences between the positive and negative aspects of their work environment. Finally, the new nurse arrives at the Resolution phase, where they are able to find resolution of “the conflict between school and work” (Steinmiller, 2003, p. 64A) and are able to get down to the business of doing their job and doing it well.

History

Reality shock has been an issue for a long time. In 1974 Marlene F. Kramer wrote the book, Reality Shock: Why Nurses Leave Nursing. A study in 2003 found that over 40% of nursing employees in a hospital setting were experiencing job dissatisfaction (Steinmiller,