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. 2025 Aug 22;13(1):957.
doi: 10.1186/s40359-025-03315-6.

From student to nurse: exploring transition shock through stress, locus of control, and coping strategies in newly graduated nurses

Rasha Kadri Ibrahim  1 , Mirna Safi  2 , Amani Darwish  3 , Yasir S Alsalamah  4   5 , Lisa Babkair  6 , Nasiru Mohammed Abdullahi  7 , Basma Maher  8 , Manar Nasser Alotaibi  9 , Monerh Abdullah Alfalaij  10 , Shorok Hamed Alahmedi  11 , Sally Mohammed Farghaly Abdelaliem  12 , Abdelaziz Hendy  13
Affiliations

From student to nurse: exploring transition shock through stress, locus of control, and coping strategies in newly graduated nurses

Rasha Kadri Ibrahim et al. BMC Psychol. .

Abstract

Background: Newly graduated nurses often face a difficult transition from academic training to clinical practice, commonly experiencing "transition shock." This period is characterized by heightened occupational stress, reduced coping capacity, and uncertainty about role identity.

Aim: This study aimed to investigate the effects of occupational stress, coping strategies, and work locus of control on transition shock among newly graduated nurses. It also examined how marital status and clinical unit (critical vs. non-critical care) moderate these relationships.

Methods: A cross-sectional and descriptive correlational design was adopted. The study was conducted in governmental and private hospitals in Cairo, Egypt. A total of 395 newly graduated nurses (with less than one year of clinical experience) participated. Data were collected using a demographic questionnaire and four validated instruments: the Transition Shock Scale, the Occupational Stress Scale, the Trait Coping Style Questionnaire, and the Work Locus of Control Scale. Data analysis was performed using SPSS and AMOS software. Statistical techniques included Pearson correlation, multiple linear regression, and a moderated mediation analysis. Occupational stress was tested as a mediator, and marital status and unit of assignment were examined as moderators.

Results: Transition shock showed a strong positive correlation with occupational stress (r = 0.66, p < 0.01) and external WLOC (r = 0.40, p < 0.01) and a negative correlation with positive coping (r = -0.39, p < 0.01). Mediation and moderation models confirmed occupational stress as a mediator and marital status and unit assignment as moderators of stress-to-shock pathways. The model explained 64.6% of the variance in transition shock (R² = 0.646).

Conclusion: Enhancing positive coping and internal locus of control, while reducing stress, can help mitigate transition shock. Supportive workplace programs are essential for nurse retention and well-being.

Keywords: Coping strategies; Newly graduated nurses; Occupational stress; Psychological adaptation; Transition shock; Work locus of control.

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Conflict of interest statement

Declarations. Ethical approval and consent to participate: Ethical approval was granted by the Institutional Review Board (IRB) of MTI University in Cairo, Egypt. The IRB approval number is 143/2024. The study adhered to the ethical principles outlined in the Declaration of Helsinki. All participating nurses were provided comprehensive information about the study’s purpose, objectives, and potential benefits. The researchers emphasized the study’s voluntary nature, and patients could withdraw their participation without facing any consequences. Nurses were required to provide written informed consent before participating in the study. Participation was entirely voluntary, and patients had the right to withdraw at any stage without any consequences. The collected data was coded to maintain confidentiality, ensuring no identifiable information was disclosed. Consent for publication: Not applicable. Clinical trial number: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Moderated mediation model of coping strategies, occupational stress, and transition shock among newly graduated nurses
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