Eugene Teoh 

Background:
The term reality shock has fittingly been used to express the novice nurses’ (NN) reaction upon recognising the apparent mismatch between their clinical experience, values and ideas imbibed when they first transit from a student to a NN. 

Methods:
This study aimed at examining the effectiveness of the new hospital nursing orientation programme for NNs in increasing job satisfaction and reducing work-related stress in their transition to practice journey. A validated questionnaire was used to survey the NNs. 

Results:
A total of 151 nurses were recruited into the study, comprises 86 for the control and 65 nurses for the intervention group. 

The new nursing orientation programme has showed to significantly increase the autonomy of the nurses from 3rd month to 6th month [mean (SD) 3rd month vs 6th month: 3.66 (0.52) vs 3.86 (0.47); p = 0.019]. 

In terms of reducing stress, it was observed that lower stress level were reported at 3rd month, for all aspects including conflict with physicians, uncertainty, inadequate preparation, conflict with other nurses, lack of support, workload, and also death and dying. 

Significant decrease in stress was observed from week 1 to 3rd month in terms of inadequate preparation [mean diff (95%CI): 0.238 (0.044, 0.432); p = 0.017], workload [mean diff (95%CI): 0.285 (0.079, 0.490); p = 0.007], and also death and dying [mean diff (95%CI): 0.187 (0.069, 0.305); p = 0.002]. 

Discussion & Conclusion:
The old hospital nursing orientation programme does not seem to be effective in promoting job satisfaction and reduce stress for nursing staff, by indicating no significant difference in all aspects except conflict with physicians. The new hospital nursing orientation programme has reported increased autonomy and decreased stress level of NNs. 

References (maximum three)