Role and identity adjustment in enrolled nurses transitioning to registered nurses: A qualitative study

Background Role adjustment has been identified as a key issue for enrolled nurses transitioning to registered nurse roles. Many studies have identified the existence of role confusion for this group, but none have explicitly examined the nature of this phenomenon. Aim To specifically explore how role adjustment is experienced as enrolled nurses transition to becoming registered nurses. Methods Using a qualitative descriptive approach, three focus groups involving 18 transitioning registered nursing students and five individual interviews with registered nurse graduates were undertaken. Data were analysed using reflexive thematic analysis informed by Braun and Clarke's approach. Findings From the overarching theme of Role Confusion emerged four interrelated areas reflecting the uncertainty and disruption experienced by participants during the transition from enrolled nurse to registered nurse: uncertainty in professional identity, adapting to greater responsibility and autonomy, placements misaligned with transition needs, and managing concurrent work, study, and personal demands. Conclusions This study builds on prior knowledge on enrolled nurse to registered nurse transition beyond previously described role confusion for enrolled nurses, recognising the need for greater attention to the transition experiences of enrolled nurses as registered nurse students, particularly around the psychological and identity disruption they undergo.