The mediating effect of job embeddedness on the nursing work environment and transition shock among new nurses: A cross-sectional study

This study aims to investigate the status of transition shock and test the mediating effect of job embeddedness on the nursing work environment and transition shock among new nurses. Transition shock, primarily experienced during the first two years of employment, manifests itself as an unsettling or discordant experience among new nurses, which is caused by the gap between theoretical learning and clinical practice. This is a cross-sectional survey study, following the STROBE guidelines. A cross-sectional study was conducted among 435 new nurses from November to December 2022 in Hunan Province, China. The participants were recruited to complete a sociodemographic information questionnaire and rank 3 standardized scales of transition shock (Cronbach's alpha = 0.918), job embeddedness (Cronbach's alpha = 0.890) and nursing work environment (Cronbach's alpha = 0.946). Then, the data were analysed by SPSS 26.0 and mediation testing was performed using Hayes’ PROCESS macro (Model 4). A p value of < 0.05 was deemed statistically significant. The mean score with standard deviation of the transition shock scale in new nurses was 88.86 (22.50). The place of origin, working months and weekly working hours were the significant sociodemographic factors that affected the transition shock score in new nurses. Transition shock was found to be negatively related to both job embeddedness (r = -0.468, p < 0.001) and nursing work environment (r = -0.416, p < 0.001), while job embeddedness mediated the relationship between transition shock and nursing work environment (R2 = 0.262, F = 30.455, p < 0.001). New nurses from rural areas and with longer weekly working hours are more prone to transition shock. Those with 6-12 months of employment experience more pronounced transition shock than those with less than 6 months. In addition, the nursing work environment can not only directly influence transition shock for new nurses but also indirectly influence it through job embeddedness. These findings provide a basis for hospitals to develop strategies to effectively address transition shock in new nurses and ultimately solve the nursing shortage issue.