Abstract
Background: Nursing has long been rooted in social justice, with many pioneering figures advocating for health equity in marginalized communities (Pittman, 2019; Thurman, 2017). The 31% attrition rate among New Graduate Registered Nurses (NGRNs), many of whom leave within their first year, may reflect moral distress faced in environments where equity is not prioritized (ANA, 2015; Epstein et al., 2020; National Academies of Sciences, Engineering, and Medicine, 2021). There is a pressing need for a stronger focus on preparing NGRNs to incorporate social justice into practice to improve community health outcomes.
Purpose: NGRNs undergo significant professional and personal transformations during their transition into practice. Understanding how NGRNs perceive and integrate social justice into their practice is vital for developing effective strategies to address health inequities. This study aimed to explore NGRNs’ perspectives through an interpretative, constructivist grounded theory (Charmaz, 2014, 2017, 2020) to answer: How do NGRNs understand, cocreate, process, and respond to social justice in their nursing practice?
Methods and Procedures: Twenty-eight NGRNs with 6 months to 2 years of practice were recruited via email, social media, and snowball sampling. In-depth interviews were conducted via Zoom from April 2023 to February 2024 with an average interview time of 53 minutes. Data analysis continued until saturation was reached, with line-by-line and focused coding yielding seven categories, which were refined into antecedent and attribute categories.
Results: The final theoretical coding process produced four global themes and a core category: the co-creation of a social justice identity. The framework, NGRN’s Evolving Identity of Social Justice, emerged and was connected to Emancipatory Nursing Praxis (Walter, 2017) and Duchscher’s Transition Theory (2008, 2009). This framework has important implications for nursing education, policy, practice, leadership, and research. It also highlights the need for person-centered care to achieve health equity.
Implications for Nursing and Conclusions: Fostering a social justice identity in NGRNs is crucial for their development and essential to achieving health equity. Findings support integrating social justice principles into nursing education, onboarding, and policy to empower NGRNs as they transition into practice and advocate for equity-focused care and person-centered care.
Notes
References:
American Nurses Association. (2015a). Code of ethics for nurses with interpretive statements. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/coe-view-only/
Charmaz, K. (2014). Constructing grounded theory. SAGE Publications.
Charmaz, K. (2017). The power of constructivist grounded theory for critical inquiry. Qualitative Inquiry, 23(1), 34–45. https://doi.org/10.1177/1077800416657105
Charmaz, K. (2020). “With constructivist grounded theory you can’t hide”: Social justice research and critical inquiry in the public sphere. Qualitative Inquiry, 26(2), 165–176. https://doi.org/10.1177/1077800419879081
Duchscher, J. B. (2008). A process of becoming: The stages of new nursing graduate professional role transition. Journal of Continuing Education in Nursing, 39(10), 441–450. https://doi.org/10.3928/00220124-20081001-03
Duchscer, J. E. B. (2009). Transition shock: The initial stage of role adaptation for newly graduated registered nurses. Journal of Advanced Nursing, 65(5), 1103–1113. https://doi.org/10.1111/j.1365-2648.2008.04898.x
Epstein, E. G., Haizlip, J., Liaschenko, J., Zhao, D., Bennett, R., & Marshall, M. F. (2020). Moral distress, mattering, and secondary traumatic stress in provider burnout: A call for moral community. AACN Advanced Critical Care, 31(2), 146–157. https://doi.org/10.4037/AACNACC2020285
National Academies of Sciences, Engineering, and Medicine. (2021). The future of nursing 2020-2030: Charting a path to achieve health equity. The National Academies Press. https://doi.org/10.17226/25982
Pittman, P. (2019). Rising to the challenge: Re-embracing the Wald model of nursing. American Journal of Nursing, 119(7), 36–43. https://doi.org/10.1097/01.NAJ.0000569444.12412.89
Thurman, W., & Pfitzinger-Lippe, M. (2017). Returning to the profession’s roots: Social justice in nursing education for the 21st century. Advances in Nursing Science, 40(2), 184–193. https://doi.org/10.1097/ANS.0000000000000140
Walter, R. R. (2017). Emancipatory nursing praxis: A theory of social justice in nursing. Advances in Nursing Science, 40(3), 225–243. https://doi.org/10.1097/ANS.0000000000000157
Sigma Membership
Delta Omicron
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Health Equity, Social Determinants of Health, Transition to Practice, Onboarding, Theory, Cultural Context and Care, New Graduate Nurses, New Graduate Registered Nurses
Recommended Citation
Hoying, Mary Erin; Foli, Karen J.; Simpson, Vicki; and Xu, Dongjuan, "Newly Graduated Registered Nurses Evolving Identity of Social Justice: A Novel Middle-Range Theory" (2025). Biennial Convention (CONV). 79.
https://www.sigmarepository.org/convention/2025/presentations_2025/79
Conference Name
48th Biennial Convention
Conference Host
Sigma Theta Tau International
Conference Location
Indianapolis, Indiana, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-11-26
Newly Graduated Registered Nurses Evolving Identity of Social Justice: A Novel Middle-Range Theory
Indianapolis, Indiana, USA
Background: Nursing has long been rooted in social justice, with many pioneering figures advocating for health equity in marginalized communities (Pittman, 2019; Thurman, 2017). The 31% attrition rate among New Graduate Registered Nurses (NGRNs), many of whom leave within their first year, may reflect moral distress faced in environments where equity is not prioritized (ANA, 2015; Epstein et al., 2020; National Academies of Sciences, Engineering, and Medicine, 2021). There is a pressing need for a stronger focus on preparing NGRNs to incorporate social justice into practice to improve community health outcomes.
Purpose: NGRNs undergo significant professional and personal transformations during their transition into practice. Understanding how NGRNs perceive and integrate social justice into their practice is vital for developing effective strategies to address health inequities. This study aimed to explore NGRNs’ perspectives through an interpretative, constructivist grounded theory (Charmaz, 2014, 2017, 2020) to answer: How do NGRNs understand, cocreate, process, and respond to social justice in their nursing practice?
Methods and Procedures: Twenty-eight NGRNs with 6 months to 2 years of practice were recruited via email, social media, and snowball sampling. In-depth interviews were conducted via Zoom from April 2023 to February 2024 with an average interview time of 53 minutes. Data analysis continued until saturation was reached, with line-by-line and focused coding yielding seven categories, which were refined into antecedent and attribute categories.
Results: The final theoretical coding process produced four global themes and a core category: the co-creation of a social justice identity. The framework, NGRN’s Evolving Identity of Social Justice, emerged and was connected to Emancipatory Nursing Praxis (Walter, 2017) and Duchscher’s Transition Theory (2008, 2009). This framework has important implications for nursing education, policy, practice, leadership, and research. It also highlights the need for person-centered care to achieve health equity.
Implications for Nursing and Conclusions: Fostering a social justice identity in NGRNs is crucial for their development and essential to achieving health equity. Findings support integrating social justice principles into nursing education, onboarding, and policy to empower NGRNs as they transition into practice and advocate for equity-focused care and person-centered care.
Description
This study addresses social justice in nursing practice, focusing on new graduate registered nurses (NGRNs) who experience high attrition in their first year. Using a constructivist grounded theory approach, interviews with 28 NGRNs revealed a framework for understanding their evolving social justice identity. The findings underscore the need to embed social justice into nursing education, onboarding, and policy to support NGRNs in becoming advocates for health equity and person-centered care.