When people change their places of work or just begin their career paths, they have to be ready to follow special norms and values, which usually requires investigation and analysis. Entering a profession is associated with adaptation, studying the expected roles, and understanding of self in a new environment (Miller, 2013). In nursing, this process is known as professional socialization when students should being work in healthcare organizations after college graduation. Many theories, values, and attitudes have been recently studied, and now, it is time to apply hose skills in practice. Socialization may be related to turnover and dismissal due to careless management or a lack of motivation. In this paper, the concept of professional socialization as a nursing politics will be discussed through the prism of organization-oriented and person-oriented care and the role of newly qualified practitioners (NQPs). Socialization is challenged by the controversies between norms, values, and abilities. However, facilitators like communication and observation help choose the most effective strategies and promote NQP transition. Professional socialization is critical in nursing as it creates a bridge between actual abilities and knowledge obtained and values and norms defined in society.
Professional Socialization in Nursing
As soon as a person gets an educational degree, it is high time to find some practical application to theoretical knowledge. It means that people should undergo a number of different processes and transformations to become a part of the chosen community or society. In nursing, this change is defined as professional socialization with a vital impact on human behavior and morality (Shahr, Yazdani and Afshar, 2019). In nursing, much attention is paid to socialization because it is a good chance for beginners to acquire the necessary knowledge and skills in their profession. According to Shahr, Yazdani and Afshar (2019), this process begins from learning the norms of family relationships and continues throughout a whole life. In Zarshenas et al.’s study, socialization includes the development of professional nurse identity that is related to past experiences and present observation. Some individuals may obtain great skills and sufficient knowledge to complete their direct duties and follow the established norms but fail to succeed because of lack of practice. Therefore, many nursing communities promote socialization as an obligatory step for NQPs.
An understanding of this concept is necessary as it shows how to deal with uncertainty at personal or organizational levels. Today, the clinical learning environment continues growing, and some authors admit its overwhelming nature when students have to deal with a complex transition from learners to competent employees (Melrose, Park and Perry, 2015). It is not enough for a person to learn everything and find a meaningful explanation. Nurses have to know how to react, make decisions, and solve problems, relying on their intuition and theories. Melrose, Park and Perry (2015) recommend dividing professional socialization into two types: organizational (structural and cultural aspects) and professional (values and responsibilities). The healthcare field is not only about doctors, nurses, and patients but about the quality of their interactions and environments under which they should work. Kowtha (2018, p. 88) states that healthcare facilities observe “better retention of employees, higher productivity, and reduced recruitment and training costs.” Gafiatulina et al. (2019) connect socialization with self-realization and the possibility to create favorable conditions for professional and personal growth. NQPs get access to enough resources to strengthen their positions and improve their self-images.
The analysis of the concept of professional socialization shows that this process may be interpreted in different ways for preparation, adaptation, or assimilation. Each aspect of socialization has its characteristics, standards, and guidelines. First, one should learn that the major socialization features are being cyclic (more competency leads to more self-confidence) and indirect (no evident relationship between the chronology of events and professionalism) (Shahr, Yazdani and Afshar, 2019). Relying on the interactionism theory that drives many social processes and human interaction, socialization is a role-taking progression in terms of which people continue their modifications under different workspaces (Shahr, Yazdani and Afshar, 2019). Second, professional socialization is not only a process but an outcome when group thinking and equal communities are promoted (Melrose, Park and Perry, 2015). Finally, socialization is always a challenge due to the existing differences between professional ideals and practice reality (cited in Salisu et al., 2019). Therefore, facilitators and recommendations are commonly developed for learners, NQPs, and nurses to support cooperation and information or experience exchange.
To succeed in socializing, nurses must follow certain recommendations and comprehend the most appropriate sources for their integration in the nursing field. De Swardt, van Rensburg and Oosthuizen (2017) develop a guide for students to follow and manage their professional and personal needs. For example, professional nurses have to be considered exemplary role models and clinical supervisors because they show how to assess their qualities, improve knowledge levels, create ethical environments, and support other care providers (De Swardt, van Rensburg and Oosthuizen, 2017). Regarding such responsibilities, it is correct to say that socialization is closely related to preceptorship. According to Ke, Kuo and Hung (2017), preceptorship is necessary for NQPs or graduate nurses to establish intense relationships, informative dialogues, and role models. However, while preceptorship enhances nurse competence, there is no direct effect on socialization or job satisfaction. Therefore, further research is required to understand the nature of tasks and explanations in nursing.
The development of mentoring relationships is an obligatory part of professional socialization. In addition, Gazaway et al. (2019) explain it as an intervention strategy to be implemented for the transition from academic to clinical achievements in nursing practice. Mentors are allowed to help the beginners to deal with their overwhelming and excitement about the opportunities they get. Their actions serve as a solid background for students to seek new knowledge and approvals of their theoretical statements and requirements. It is not always easy for a nurse-beginner to ask for a piece of advice and neglect the power to show the obtained potential. As a result, mentoring is offered to cooperate and demonstrate correct decision-making and communication with patients and families. Professional socialization enhances nursing commitment, which, in its turn, leads to thoughtful attitudes and actions (Melrose, Park and Perry, 2015). Transformation may not be identified as a part of treatment and care that the medical staff offers to patients, but this process has to be identified in nursing practice to learn the differences of organization- and person-oriented care, social norms, values, and actual abilities.
Organization-Oriented Care vs. Person-Oriented Care
The success of professional socialization is predetermined by a variety of factors, and one of them is the way of how nurses understand the required orientation in care. Many healthcare organizations work according to the standards of organization-oriented care or person-centered care (Bokhour et al., 2018; Fredericks et al., 2012; Rahimaghaee et al., 2015). First, it is necessary to establish values, define human resource management sources, and redesign jobs (Rahimaghaee et al., 2015). Second, goals and management processes are defined to guide nurses and other healthcare providers. Finally, nurses identify all orientation processes in which they can be involved in regard to their skills and knowledge (Peltokoski, Vehviläinen-Julkunen and Miettinen, 2013). Newly hired nurses are able to join specific orientation programs where they receive help in understanding their responsibilities (Schmitt and Schiffman, 2019). If structure reformation is required to support improvements and care integration, organization-oriented care is discussed. If certain opportunities for individuals are considered, person-centered care has to be offered. All these approaches and theories are integrated through professional socialization and cooperation.
Social Norms, Values, and Abilities
Socialization tactics vary, depending on organizational background, resources, and cultures. Still, its major framework remains the same as it is based on acquiring realistic skills, knowledge, social norms, and values (Perez, 2016). The relationship between these concepts cannot be ignored because if a nurse respects and follows laws for social behavior (norms) but rejects cultural or global aspects (values), a balance between skills and obligations is hardly achieved. Values are necessary to sustain professional identity, achieve work satisfaction, and improve care quality (Melrose, Park and Perry, 2015). According to Poorchangizi et al. (2019), value identification also plays a crucial role in the nursing profession to comprehend when culture, society, religion, or economics may dominate. It does not matter if an experienced or new nurse has to promote care, but attention to external and internal factors is required. Socialization includes learning about families, the existing subcultures, and self-concepts that may influence treatment processes and professional relationships (Shahr, Yazdani and Afshar, 2019). At the same time, such values as altruism, dignity, and autonomy help nurses introduce equal and fair services to all patients and develop professional relationships with colleagues.
Responsibilities of Newly Qualified Practitioners
NQPs are usually all those students who take their first steps in their transition from education to realistic practice. In most cases, this transition is defined as a stressful experience because of increased responsibility and accountability (Holmes and Whitehead, 2011). NQPs have to understand how to manage their first practical steps, delegate responsibilities, administer drugs, and set priorities within their working environment. In addition, they must pay attention to their own values and social norms that have already been studied in colleges or other academic facilities. Therefore, their professional socialization turns out to be a crucial element in practice. It happens that nurses’ expectations cannot be met because of the offered resources or implemented policies, which results in anxiety and frustration (Holmes and Whitehead, 2011). Scholes et al. (2016) state that the situation may be complicated by differences in the use of terms, depending on regulatory and statutory bodies. Instead of improving patient outcomes or treatment plans, NQPs are bothered with staff satisfaction and meeting their personal and professional needs. This type of investment is a challenge because the staff has to focus on organization-oriented care and patient-oriented care.
Nurse education undergoes a number of changes in different regions, increasing the number of NQPs worldwide. Each country has its specific rules and regulations to be followed, and new nurses want to obtain professional support from their experienced colleagues. Whitehead et al. (2016) explain that support is necessary to promote confidence, refine skills, and define values. Preceptorship programs are developed to facilitate the NQP transition to inform them about local requirements and reflect on their abilities (Price, 2013). However, not all nurses are able to understand that they need help, and they need additional strategies that show how to integrate new material.
As soon as NQPs receive all the necessary information, they can complete their direct responsibilities. First, nurses understand the importance of accountability, including responsibility in regard to patients’ best interests and competence (Cathala and Moorley, 2020a). Being no-longer students, NQPs are involved in new communication processes and critical documentation processes where they assess patients’ conditions, identify clinical issues, and enhance safety. The second aspect in practice is managing stress while doing their primary tasks (Cathala and Moorley, 2020b). NQPs listen to themselves (actual abilities), listen to colleagues (values), and contact other people (social norms). The final aspect of responsibilities covers the possibility to manage errors and learn from mistakes (Cathala and Moorley, 2020c). The most common mistakes that NQPs usually make are related to poorly organized documentation, miscommunication, wrong medication prescription or dosage, and insufficient infection control (Cathala and Moorley, 2020c). The responsibility of a nurse is to report on the mistake when it is identified and correct the situation under professional guidance as soon as possible.
Impact of Socialization on Newly Qualified Practitioners
Regarding such an impressive number of responsibilities for NQPs, professional socialization can become a significant factor in establishing and developing relationships with colleagues, leaders, patients, and other care stakeholders. Frögéli, Rudman, and Gustavsson (2019) prove that socialization has a positive impact on stress management and new nurses’ experiences because of discussion role clarity and task mastery. Nurses discuss their concerns and ask questions directly to other workers and obtain answers with real-life examples and explanations. Their engagement in these behaviors is a unique opportunity to learn how to react, what decisions to make, and how to solve problems. In addition, poor co-worker relationships result in job dissatisfaction, retention, and an increased number of medical mistakes (Kerin, 2019). There is a threat of the hidden curriculum and the differences between theoretical and practical skills (Lee and Yang, 2019). Socialization comprises several steps to orientate new nurses and explain the matter of professional culture within a particular environment. Sometimes, a simple talk with an experienced nurse is enough to predict a number of mistakes and complications.
The impact of socialization may also be discussed through emotional changes. Wilson (2016) admits that many nurses demonstrate their desire to become a part of a team in a short period, and they try to conform to routines, neglecting their personal emotions and feelings. However, the success of experienced nurses lies in the possibility of talking about events to colleagues and expressing their feelings openly (Wilson, 2016). Socialization is not only a recommendation that facilitates the first days of practice but a requirement for managing a nursing career. Religious or cultural beliefs, poor drug interaction, or patient death affect not only patients and their families but nurses and everyone else involved in a treatment process. Socialization consists of not only learning and interaction but also development and adaptation (Dinmohammadi, Peyrovi and Mehrdad, 2013). Adaptation helps NQPs become members of a community united by similar goals, available resources, and stakeholders. Students get familiar with basic values and see how other nurses combine their needs with their responsibilities (Dinmohammadi, Peyrovi and Mehrdad, 2013). Instead of just observing what other people do, new nurses continue their transition together with other obligatory tasks.
Strategies to Promote Socialization
Professional socialization introduces certain benefits to nursing and the relationships between nurses, and there are many strategies that can facilitate this process. People need to know how to recognize their professional identities in a new environment and encourage a sense of belonging to specific groups. First, it is important to understand the motives current nursing students follow when they choose this career path. Rongstad et al. recognized such reasons as helping other people, doing something useful, and having a safe job (cited in Goodare, 2015). However, if the motifs of students have already changed, the theories and nursing concepts remain the same. Therefore, the gap between theory and practice cannot be ignored, and professional supervision and assistance are required for professional socialization.
Second, it is necessary to focus on the intention that helps nurses adapt and accept new working conditions. Zarshenas et al. (2014) introduce two main categories for professional socialization – the sense of belonging and professional identity formulation. NQP must understand the presence of theory-practice incongruence as soon as they face real clinical situations. They rely on their educational experiences as a part of a strategy to enhance the sense of being useful and apply their tactic knowledge in discussions. Socialization contributes to the formation of students’ professional identity and understanding the meaning of being a nurse (Gazaway et al., 2019; Zarshenas et al., 2014). Mentorship enables students to deal with negative feelings and concerns about new practices and responsibilities. When a person has a professional mentor, such feelings as confidence and comfort about the environment are increased (Gazaway et al., 2019). The choice of role models assists NQPs in learning their expected responsibilities and understanding the main features of the chosen profession in practice. Finally, without motivation, neither of the above-mentioned strategies can work because students must use their knowledge voluntarily and confidently.
The last aspect of socialization strategies touches upon the differentiation between positive and negative outcomes. According to Moradi et al. (2017), professional socialization affects an individual, an organization, and a profession of nursing in general. On the one hand, this process aims at culturizing future nurses within a specific context and following particular ethical standards and norms (Moradi et al., 2017). On the other hand, socialization promotes individualism in terms of which students use their skills and interests to play their roles (Moradi et al., 2017). In both cases, support strategies are necessary for nurses to understand what they can do in the healthcare field.
Professional socialization is a vital part of the shift that students should take after their graduation and the beginning of their nursing careers. Relying on the current studies and the analysis of available management practices, the process of socialization is proved as a helpful tool to promote confidence, motivation, and understanding. NQPs come to hospitals and other clinical settings with a variety of skills and knowledge but lack practical experiences. Therefore, they need to learn how to cooperate, assist real people, and solve problems that directly influence human lives. Sometimes, novice nurses are able to cope with their responsibilities and obligations, and sometimes, they need professional mentors. Therefore, such strategies as role modeling, motive analysis, and differentiation between organization-oriented care and person-centered care are offered to facilitate the transition and support employees.
Bokhour, B.G. et al. (2018) ‘How can healthcare organizations implement patient-centered care? examining a large-scale cultural transformation’, BMC Health Services Research, 18(1).
Cathala, X. and Moorley, C. (2020a) ‘Skills for newly qualified nurses 1: understanding and managing accountability’, Nursing Times. Web.
Cathala, X. and Moorley, C. (2020b) ‘Skills for newly qualified nurses 2: identifying and managing stress’, Nursing Times. Web.
Cathala, X. and Moorley, C. (2020c) ‘Skills for newly qualified nurses 1: understanding and managing accountability’, Nursing Times. Web.
De Swardt, H.C., van Rensburg, G.H. and Oosthuizen, M.J. (2017) ‘Supporting students in professional socialisation: guidelines for professional nurses and educators’, International Journal of Africa Nursing Sciences, 6, pp. 1–7.
Dinmohammadi, M., Peyrovi, H. and Mehrdad, N. (2013) ‘Concept analysis of professional socialization in nursing’, Nursing Forum, 48(1), pp. 26-34. Web.
Fredericks, S. et al. (2012) ‘Discussion of patient-centered care in health care organizations’, Quality Management in Health Care, 21(3), pp. 127-134.
Frögéli, E., Rudman, A. and Gustavsson, P. (2019) ‘The relationship between task mastery, role clarity, social acceptance, and stress: an intensive longitudinal study with a sample of newly registered nurses’, International Journal of Nursing Studies, 91, pp. 60-69.
Gafiatulina, N.K. et al. (2019) ‘The role of health-saving technologies in the process of students educational and professional socialization’, EurAsian Journal of BioSciences, 13(2), pp. 1557-1563. Web.
Gazaway, S. et al. (2019) ‘Impact of mentoring relationships on nursing professional socialization’, Journal of Nursing Management, 27(6), pp.1182-1189.
Goodare, P. (2015) ‘Literature review: “are you ok there?” the socialisation of student and graduate nurses: do we have it right?’, Australian Journal of Advanced Nursing, 33(1), 38-43. Web.
Holmes, D. and Whitehead, B. (2011) ‘Are newly qualified nurses prepared for practice?’, Nursing Times, 107(19-20), pp. 20-23.
Ke, Y.T., Kuo, C.C. and Hung, C.H. (2017) ‘The effects of nursing preceptorship on new nurses’ competence, professional socialization, job satisfaction and retention: a systematic review’, Journal of Advanced Nursing, 73(10), pp. 2296–2305.
Kerin, Ú. (2019) ‘Professional socialisation processes help facilitate the transition from student to qualified nurse’, Evidence Based Nursing.
Kowtha, N.R. (2018) ‘Organizational socialization of newcomers: the role of professional socialization’, International Journal of Training and Development, 22(2), pp. 87–106.
Lee, J. and Yang, S. (2019) ‘Professional socialisation of nursing students in a collectivist culture: a qualitative study’, BMC Medical Education, 19.
Melrose, S., Park, C. and Perry, B. (2015) Creative clinical teaching in the health professions. Web.
Miller, S.E. (2013) ‘Professional socialization: a bridge between the explicit and implicit curricular’, Journal of Social Work Education, 49, pp. 368-386.
Moradi, Y. et al. (2017) ‘Outcomes of professional socialization in nursing: a systematic review’, Journal of Pharmaceutical Sciences and Research, 9(12), pp. 2468-2472.
Peltokoski, J., Vehviläinen-Julkunen, K. and Miettinen, M. (2013) ‘Newly hired nurses’ and physicians’ perceptions of the comprehensive health care orientation process: a pilot study’, Journal of Nursing Management, 23(5), pp. 613–622.
Perez, R.J. (2016) ‘A conceptual model of professional socialization within student affairs graduate preparation programs’, Journal for the Study of Postsecondary and Tertiary Education, 1, pp. 32-52.
Poorchangizi, B. et al. (2019) ‘The importance of professional values from nursing students’ perspective’, BMC Nursing, 18.
Price, B. (2013) ‘Successful preceptorship of newly qualified nurses’, Nursing Standard, 28(14), pp. 51–56.
Rahimaghaee, F. et al. (2015) ‘Organization-based self-development prescriptive model for the promotion of professional development of Iranian clinical nurses’, Iranian Journal of Nursing and Midwifery Research, 20(5), pp. 604-612.
Salisu, W.J. et al. (2019) ‘Challenges and facilitators of professional socialization: a systematic review’, Nursing Open, 6(4), pp. 1289–1298.
Schmitt, C.A. and Schiffman, R. (2019) ‘Perceived needs and coping resources of newly hired nurses’, SAGE Open Medicine, 7.
Scholes, J. et al. (2016) ‘Managing support for newly qualified practitioners: lessons learnt from one health care region in the UK’, Journal of Nursing Management, 25(2), pp. 102–109.
Shahr, H.S.A., Yazdani, S. and Afshar, L. (2019) ‘Professional socialization: an analytical definition’, Journal of Medical Ethics and History of Medicine, 12.
Wilson, J. (2016) ‘Professional socialisation in nursing: experiences of new and established nursing staff in response to patient death’, American Research Journal of Nursing, 2(1), pp. 5-10. Web.
Zarshenas, L. et al. (2014) ‘Professional socialization in nursing: a qualitative content analysis’, Iranian Journal of Nursing and Midwifery Research, 19(4), pp. 432-438.