A new study from the University of Florida College of Nursing and UF Health sheds light on the challenges new graduate nurses face as they enter the workforce — particularly those entering high-pressure settings like intensive care units and emergency departments.
The study was recently published in Nurse Educator, a leading peer-reviewed journal.
The research, led by Bryce Catarelli, DNP, APRN, UF Nursing clinical assistant professor, in collaboration with Lara Thompson, director of the UF Health Transition to Practice Program, analyzed more than 270 survey responses from nurses hired at UF Health between 2020 and 2023. The findings revealed that while new nurses feel comfortable asking for help and working with peers, many struggle with delegation, physician communication, end-of-life care and managing complex procedures like ventilator care and emergency responses.
Nearly 40% of surveyed nurses were hired directly into ICU or ER roles, where the demands are high. The study also revealed that stress and workload concerns were common among new nurses and have historically been a leading factor in nurse turnover
The study suggests that nursing education programs must adapt to better prepare students for these realities, incorporating more hands-on training in high-acuity scenarios.
“This research highlights the need for stronger academic-clinical partnerships,” Catarelli said. “By aligning education with actual practice challenges, we can better prepare new nurses, reduce burnout and improve retention.”
The UF College of Nursing has already begun addressing these concerns through initiatives like workplace readiness events and end-of-life care simulations, helping students gain experience in real-world conditions before graduation.
The workplace readiness event, for example, brings in hospital staff from critical care units to provide hands-on training in procedures like ventilator management, chest tube care, and emergency response. Additionally, end-of-life simulations allow students to practice providing compassionate care in a controlled environment, better preparing them for real-world experiences.
Catarelli stressed that the study included graduates of a variety of nursing programs across the state and countryand only looked at surveys from respondents who completed the one-month, six-month and twelve-month assessments.
She hopes the report illustrates the need for nursing schools to integrate data-driven curriculum changes to better equip students with the skills and resilience needed for long-term success.
The study also reinforces the importance of mentorship and residency programs. While nursing education can provide foundational knowledge, the transition to practice requires experienced preceptors and structured support systems to help new graduates gain confidence and competency in their roles.
“At some level , there’s only so much we can do as nurse educators. Some of that has to come from on-the-job training. But if there are ways that we can help lay the foundation to best support new nurses when they have those experiences, that’s really the goal,” she said.