Predictors of Transition Shock Among Newly Graduated Nurses, Sri Lanka: A Descriptive Cross- Sectional Study on the Roles of Self-Efficacy, Professional Nursing Values, and Practice Environment

Background South Asian countries, including Sri Lanka, face some of the most severe shortages of nurses globally, creating significant challenges for healthcare delivery. One contributing factor to this crisis is the high dropout rate of newly graduated nurses worldwide, often attributed to an unsuccessful transition from the role of nursing student to that of a practicing clinical nurse. This critical transition period can be influenced by multiple personal, professional, and organizational factors, directly impacting retention and job satisfaction. Objective This study aimed to assess the factors influencing the transition period to professional roles among newly graduated nurses with a Bachelor of Science degree in Nursing, with a particular focus on identifying predictors of transition shock. Methods A descriptive cross-sectional study was conducted in government hospitals within the Colombo District. A consecutive sample of 102 newly graduated nurses from six universities, all employed in hospitals in Colombo, was recruited. Data were collected using four standardized, pre-tested (N = 10), and self-administered instruments: the General Self-Efficacy Scale, the Professional Nursing Values Scale, the Practice Environment Scale of the Nursing Work Index, and the Transition Shock Scale. Data were analyzed using descriptive statistics to summarize demographic and contextual variables, followed by multivariate statistical analyses to determine significant predictors of transition shock. Results Graduate transition shock was found to be significantly associated with monthly income (p = 0.005), type of hospital (p = 0.017), hospital bed capacity (p = 0.021), and the personal motivation or reason for becoming a nurse (p = 0.007). Furthermore, self-efficacy and professional nursing values emerged as significant predictors of transition shock, indicating that higher self-efficacy and stronger professional values are associated with lower transition-related stress. Conclusion The findings highlight the urgent need for targeted interventions to facilitate smoother professional transitions for newly graduated nurses. Strategies such as workload reduction, structured reward and recognition systems, the establishment of formal preceptorship and mentorship programs, and initiatives to enhance general self-efficacy and strengthen professional nursing values are recommended. Implementing such measures could not only reduce transition shock but also improve job satisfaction, retention, and the overall stability of the nursing workforce in Sri Lanka and similar contexts.