Periods and Content of Psychological Distress During Rotation-Based Training for Newly Graduated Nurses: A Six-Year Descriptive Study.

INTRODUCTION: At the University of Fukui Hospital, a national university corporation in Japan, an original rotation-based training program is implemented for newly graduated nurses. In this educational program, nurses rotate through several hospital wards before being permanently assigned to one. Each rotation requires the development of new interpersonal relationships and the acquisition of new knowledge. This study aimed to clarify the periods and content of psychological distress experienced by newly graduated nurses during rotation-based training, and to identify the timing and nature of necessary support. METHODS: This quantitative descriptive study was conducted from April 2008 to December 2013. The participants were 299 newly graduated full-time nurses working at Fukui Hospital who provided informed consent, of whom 230 (76.9%) responded to the survey and were included in the analysis. Data were collected using a self-administered questionnaire that was developed for this study. Basic statistical analyses were performed using Microsoft Excel (Microsoft Corp., Redmond, WA). Free-text responses were analyzed using text-mining software to conduct word frequency and co-occurrence analyses. The study was approved by the Ethics Review Committee of the Nursing Department of Fukui University Hospital. RESULTS: The period identified as the most psychologically distressing was the first rotation in July, reported by 177 nurses (77.0%). This coincided with the third month of employment, which is commonly associated with heightened anxiety among new nurses. Some participants commented that although the rotation provided opportunities to learn various nursing skills, it also required starting new interpersonal relationships each time. CONCLUSION: These findings suggest that support should be provided, particularly during the first rotation transition, to help newly graduated nurses build interpersonal relationships and adapt smoothly to new environments.