Adjustment Challenges among Newly Recruited Nurses and Their Impact on Patient Safety and Professional Identity in Khyber-Pakhtunkhwa, Pakistan

Abstract

Newly recruited nurses often struggle to adjust from academic learning to independent clinical practice. In KPK, Pakistan, heavy workloads, limited mentor-ship, organizational pressures, and a theory–practice gap intensify these challenges, affecting professional identity and patient safety. Understanding these issues is key to improving nurse retention, professional development, and care quality. Objective: This study aimed to assess the adjustment challenges experienced by newly recruited nurses in KPK and examine their influence on professional identity formation and bond to patient safety practices. Methodology: A quantitative cross-sectional design was used among BSN graduates ≤6 months clinical experience, working as newly hired staff across various districts of KPK. Data were collected through a self-administered online questionnaire distributed via Google Forms. to assessed demographic characteristics, transition challenges, professional identity indicators, and patient safety attitudes using a five-point Likert scale. Sample random sampling were applied. Data were analyzed using SPSS version 26. Descriptive statistics summarized participant characteristics, while Cronbach’s alpha (0.72) confirmed acceptable internal reliability. Results: A total of 69 newly recruited nurses completed the survey. Participants frequently reported transition shock, workload pressure, limited senior support, and difficulty applying theoretical knowledge in clinical settings. These challenges negatively affected the development of professional identity and consistent adherence to patient safety protocols. Conclusion: Strengthened transition-to-practice programs, improved mentor-ship, and supportive clinical environments are needed to promote safe practice, reduce burnout, and enhance retention of newly recruited nurses in KPK.