title: Nurses' perceptions and experiences of work role transitions: a mixed methods systematic review of the literature.
abstract: OBJECTIVE
  To understand nurses' perceptions and experiences of work role transitions.
  
  
  BACKGROUND
  Globally an uncertain healthcare landscape exists and when changing work roles nurses experience periods of transition when they may not cope well. A greater understanding of work role transitions may help facilitate workforce retention and successful careers.
  
  
  METHODS
  Mixed methods systematic review.
  
  
  METHODS
  Six data bases were searched for peer reviewed primary empirical research, published in English language between January 1990 and December 2014, supplemented by hand and citation searching.
  
  
  METHODS
  Evidence for Policy and Practice Information and Co-ordinating Centre methods for systematic reviews principles were followed. Analysis and synthesis of the qualitative and quantitative papers was conducted separately using thematic analysis. A third synthesis combined the narrative findings and a narrative synthesis of results is presented.
  
  
  RESULTS
  Twenty-six papers were included. Across nurses' work role transitions two pathways were found: Novice and Experienced. 'Novice' comprises pre-registration and newly qualified nurses. 'Experienced' comprises, Enrolled/Licensed Practical Nurse to Registered Nurse, experienced to specialist nurse and clinical role changes. Each pathway results in different emphasizes of two themes; 'Striving for a new professional self' includes emotional upheaval and identity while 'Know how' includes competence and boundaries. Novice nurses are more susceptible to the extremes of emotional upheaval while experienced nurses' competence eases aspects of transitions while boundary issues pervade.
  
  
  CONCLUSIONS
  Informed work and educational environments are required for all groups of nurses. Using existing models of transition can facilitate successful individual transitions and develop the workplace.
authors.affiliation: The Florence Nightingale Faculty of Nursing and Midwifery, King's College London, UK.
authors.forename: Victoria
authors.initials: V
authors.lastname: Arrowsmith
authors.affiliation: The Florence Nightingale Faculty of Nursing and Midwifery, King's College London, UK.
authors.forename: Margaret
authors.initials: M
authors.lastname: Lau-Walker
authors.affiliation: The Florence Nightingale Faculty of Nursing and Midwifery, King's College London, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Norman
authors.affiliation: The Florence Nightingale Faculty of Nursing and Midwifery, King's College London, UK.
authors.forename: Jill
authors.initials: J
authors.lastname: Maben
mesh_terms: D000223:Adaptation, Psychological; D006801:Humans; D009726:Nurses / Q000523:psychology*; D017132:Workplace
keywords: literature review; mixed methods; nurses; systematic review; transitions; work role