The Enablers and Barriers for Effective Transition to Practice in the Emergency Department: The Perspective of New Graduate Nurses

The transition from nursing student to New Graduate Nurse (NGN) is a critical period marked by increased responsibility and professional adjustment. This transition is particularly challenging in Emergency Departments (EDs), where high-acuity care requires rapid decision-making, prioritization, and clinical confidence. This study aimed to examine the barriers and enablers influencing the transition of NGNs into ED practice in Vanuatu.

A mixed-methods design was employed using a survey adapted to the Vanuatu context. Data were collected from 47 NGNs working in EDs across five hospitals in Vanuatu (response rate: 94%). Quantitative data were analysed using descriptive statistics, while qualitative responses were analysed thematically to identify key barriers and enablers affecting transition.

Barriers to transition were categorized into organizational, personal, and family/relational factors. Key challenges included inadequate orientation, high workload, insufficient supervision, stress, and lack of confidence. Enablers were grouped into organizational and personal factors and included supportive teamwork, mentorship, fair task allocation, and ongoing learning opportunities. Most NGNs reported that structured support and exposure to diverse emergency cases improved confidence and job satisfaction.

The findings highlight the complex interaction between individual readiness, workplace support, and health system constraints in shaping NGNs’ transition experiences. Compared with international studies, workforce shortages and limited supervision in Vanuatu appear to intensify transition challenges, underscoring the need for context-specific support strategies.

NGNs transitioning into ED practice in Vanuatu face significant challenges alongside important enabling factors. Strengthening structured orientation, supervision, and continuous learning opportunities may improve NGN preparedness, support professional development, and enhance patient care outcomes in emergency settings.