The journey from the academic halls of nursing schools to the high-pressure environments of hospital wards marks a profound transformation for newly graduated nurses. This transition, often euphemized as “onboarding,” in reality encompasses a complex psychological upheaval known colloquially as “transition shock.” The recent study published in BMC Psychology by Ibrahim, Safi, Darwish, and colleagues in 2025 takes a pioneering dive into the intricate nexus of stress, locus of control, and coping strategies that shape the initial professional experiences of newly minted nurses.
Transition shock, as defined by nursing scholars, is not merely a fleeting discomfort but a critical phase marked by emotional turbulence, cognitive dissonance, and role ambiguity. For newly graduated nurses, this shock can manifest as anxiety, overwhelming responsibility, and an acute awareness of gaps between academic preparation and clinical realities. The implications of such stress extend beyond individual well-being, potentially affecting clinical performance, patient safety, and staff retention rates in healthcare institutions.
The study’s authors adopted a multifaceted approach to dissect the psychological variables underpinning transition shock. Central to their inquiry was the concept of locus of control, a psychological construct originally formulated by Julian Rotter, that delineates the extent to which individuals perceive their outcomes as contingent upon their actions (internal locus) or external forces beyond their control (external locus). This cognitive orientation has been linked to resilience and adaptive coping across numerous domains but its role in nursing transition remains underexplored.
Within the nursing context, an internal locus of control may empower novices to approach clinical challenges with agency, perceiving adverse events as manageable through skill and perseverance. Conversely, an external locus could exacerbate feelings of helplessness, amplifying stress when faced with the unpredictable and often chaotic nature of clinical settings. The intersection of such cognitive frameworks with emotional stressors forms a dynamic landscape that the study meticulously mapped.
In addition to psychological orientation, the researchers investigated coping strategies employed by new nurses. Coping, broadly categorized into problem-focused and emotion-focused mechanisms, dictates how individuals regulate their emotional responses and practical problems. Effective coping strategies can mitigate the deleterious effects of transition shock, fostering resilience and facilitating professional growth. However, maladaptive coping may entrench stress and impair functioning.
The methodology involved a comprehensive survey of newly graduated nurses across multiple healthcare institutions. Participants responded to validated scales measuring perceived stress levels, locus of control orientation, and preferred coping mechanisms. Statistical analyses then illuminated correlations and predictive relationships, unveiling patterns that resonate with both theoretical expectations and surprising nuances.
One of the salient findings from the study was the significant association between an internal locus of control and lower perceived stress during the transition period. Nurses who believed they had control over their professional environment reported more proactive coping, such as seeking information, skill enhancement, and peer support. This internalization of control acts as a psychological buffer, attenuating feelings of overwhelm and fostering confidence.
In contrast, nurses endorsing an external locus of control reported heightened stress and a tendency towards emotion-focused coping strategies, including avoidance and denial. Such approaches, while temporarily soothing, may hinder problem resolution and exacerbate long-term psychological strain. These insights underscore the importance of cognitive frameworks in shaping nurses’ adaptation processes.
The study also highlighted the critical role of institutional support in moderating transition shock. Environments that promote mentorship, professional development, and psychosocial support enhance nurses’ sense of control and provide avenues for effective coping. The authors argue for systematic integration of psychological training into nursing curricula and orientation programs, emphasizing resilience-building and locus of control awareness.
From a practical standpoint, these findings have profound implications for healthcare administrators and educators aiming to retain competent nursing staff. Transition shock, if unaddressed, contributes to burnout and attrition, exacerbating the global nursing shortage crisis. By fostering environments that cultivate internal locus of control and teach adaptive coping, institutions can promote sustainable workforce stability.
The intricacies underlying transition shock also reveal a rich terrain for future research. Longitudinal studies tracking nurses’ psychological trajectories over the first critical years of practice could illuminate the durability of coping strategies and the evolving locus of control. Additionally, qualitative investigations might unpack the subjective experiences and contextual factors influencing stress and adaptation.
Crucially, this research intersects with broader psychological theories of stress and control, integrating nursing-specific dynamics with established frameworks. It bridges gaps between abstract constructs and real-world phenomena, offering an evidence-based lens to view and address one of nursing’s most pressing challenges.
Moreover, technological advances such as virtual reality simulations present novel opportunities to prepare nursing students for clinical realities, potentially mitigating transition shock by providing experiential learning in controlled settings. The integration of psychological insights with innovative training modalities heralds a promising frontier.
The study’s timing also resonates with the ongoing global health challenges that have intensified frontline stressors. The COVID-19 pandemic, for instance, has spotlighted the strain on healthcare workers, underscoring the urgency of understanding and ameliorating transition-related stress in new nurses who enter an already burdened system.
In conclusion, the research by Ibrahim et al. shines a vital spotlight on the psychological dimensions of newly graduated nurses’ transition into practice. By elucidating the roles of stress, locus of control, and coping strategies, the study provides a roadmap for enhancing nurse well-being, clinical performance, and patient care quality. The findings compel healthcare stakeholders to rethink orientation and support mechanisms, integrating psychological empowerment as a cornerstone of nursing practice sustainability.
As the nursing profession continues to evolve amidst shifting demographics and healthcare demands, embracing the complexity of transition shock and equipping new nurses with the cognitive tools to navigate it emerges as a critical priority. This study not only enriches academic discourse but offers actionable intelligence poised to transform nursing education and clinical integration. The path from student to nurse is fraught with psychological challenges, yet, with informed strategies, it can be a journey of resilience, growth, and enduring impact.
Subject of Research: Psychological factors influencing newly graduated nurses during the transition from academic training to professional practice, focusing on stress, locus of control, and coping mechanisms.
Article Title: From student to nurse: exploring transition shock through stress, locus of control, and coping strategies in newly graduated nurses.
Article References:
Ibrahim, R.K., Safi, M., Darwish, A. et al. From student to nurse: exploring transition shock through stress, locus of control, and coping strategies in newly graduated nurses.
BMC Psychol 13, 957 (2025). https://doi.org/10.1186/s40359-025-03315-6
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