Being confident in practice: A study on the influences on confidence in new graduate nurses

The purpose of this study was to understand influences on new graduate nurses’ confidence in their nursing practice. Confidence is a self-belief that an affirmative outcome will be achieved in a situation, and is influenced by factors individual to each person. New graduate nurses commence nursing practice feeling somewhat confident or not confident at all, and this feeling of confidence changes and evolves over their first year of practice as they navigate transition from a nursing student to a professional nursing role. Being confident is an important attribute of a nurse as it assists nurses to make decisions in their practice to achieve the outcomes they, or their patients and families and/or whanau require. Being confident will assist new graduate nurses to perform clinically, and to help them to face any challenges in their practice.  This study used the principles of Appreciative Inquiry as a methodology. Appreciative Inquiry is a flexible and positive approach to research, placing an emphasis on dialogue, collaboration and affirmation. It sought to discover what was working well with regards to confidence and its influences for the new graduate nurse. Utilising the elements of Appreciative Inquiry, I have analysed the dialogue of nine new graduate nurses who shared their stories of their nursing practice. Five themes were identified: firstly understanding confidence and the subthemes of self-awareness, knowing confidence, defining confidence, reflection, self-doubt, over-confidence, and feigning confidence; secondly developing a professional identity with the subtheme of resilience; thirdly relationships with the subthemes of collegial relationships, culture of the environment, the patients’ influence, feedback, and trust; and the fourth theme of developing learning and experience with the subthemes of learning and knowledge, experience, and critical thinking and decision making, and finally the fifth theme of looking to the future.  The study dialogue identifies influences on the nurses’ confidence, and their reflective practice particular to each nurse which consistently permeate their nursing practice. Recommendations are made for further nursing practice, education and research.