How do new nursing graduates take their place in a changing workforce with continuing changes to health care delivery and budgetary cuts in health care institutions? To understand the importance of successfully adjusting to new employment and the rate at which new graduates leave the profession, it is necessary to understand what goes on during their first months on the job. This qualitative research project was conducted over an 18-month period and focused on the initial work adjustment period. It involved 31 nursing graduates working in five different hospitals in Quebec's Estrie Region. The results indicate new graduates discover very early on that they've entered a brave new world where the work situation proves to be very different from what they have been taught. There is still a wide gap between theory and practice, and rarely are the students' expectations met with regards to providing holistic care, communicating with patients and establishing care plans. The students' precarious work situation as occasional nurses on call becomes a way of life. In the absence of job opportunities, they must develop adjustment strategies to ensure professional survival. A new type of nurse is emerging--the "functional nurse." The functional nurse learns to be available at all times, to provide care with no continuity and without any hope of ever belonging to a unit. Meanwhile, she questions herself about the quality of care she is giving and her future as a nurse.
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