Nursing and Midwifery transition 

12 August 2022

Article from July 2022 edition of INPractice

With staff shortages predicted to hit 123,000 nationally by 2030, the ANMF (SA Branch) has been called in to help future-proof the critical professions.

South Australia, like other jurisdictions domestically and internationally, is experiencing a significant increase in nursing and midwifery workforce demand. The issue of an ageing population, a parallel ageing health workforce and increasing health service utilisation by people with chronic and complex disease are significant issues. [1,2]

However, the COVID-19 health system surge and restrictions on movement, are more recent factors that see health workforce demand reach a critical point. 

Nursing workforce shortages lead to errors, higher patient morbidity and mortality rates, along with nursing burnout and dissatisfaction. [1,2] The issue of addressing nursing workforce shortages, particularly transitioning graduate nurses into the workforce, can be complex.

Reflex, unthinking programs compound the situation as supported by Kenny's systematic review that notes a 'correlation between poor graduate transition and registered nurse attrition’. [2] 

The ANMF (SA Branch) has been contracted by SA Health to review and redesign a Transition to Professional Practice Program (TPPP) for graduate nurses, midwives, and enrolled nurses.

The program redevelopment is part of the SA Health COVID-19 Nursing and Midwifery Skills Training Strategy to address the workforce demand surge and support the accelerated transition of graduate nurses to professional practice. 

The program will be co-designed and co-developed between SA Health and the ANMF (SA Branch) to ensure it is contemporary, competency and evidenced based, and professionally focused. 
The program's aim is to efficiently upskill nurses and midwives in South Australia's nursing and midwifery workforce in the pandemic environment and beyond.

For graduates transitioning to a new workplace, the process is described as one of 'learning and adjustment, and socialisation to a new culture, the workplace'. [3,4] To support positive transition experiences, programs require an evidence base and effective workplace support - characterised by a balance of consistency and efficiency. 

This is challenging given current levels of nursing and midwifery fatigue, job dissatisfaction, and burnout amongst existing staff. [1,5] However, there is a growing body of competency-based transition work that places the nurse/ midwife experience in the workplace context, and aligns work performance with standardised criteria. [6,7]

A competency-based as opposed to length of duration program is one of the issues under consideration during program development and consultation. 

'Competency' is the ability of a person to integrate knowledge, skills and attitudes, demonstrated through behaviours, in their performance of tasks. [6] Along with effective workplace support, evidence supports transition to practice programs as a strategy for preparing a stable, 'practice­ready' nursing and midwifery workforce.[3] Competency development and evidence based, workplace supported programs are a way forward, and could contribute to the development of a state-wide transition program for nurses and midwives.
Transition programs need to be evidence and competency-based, require organisational and workplace support, and in these pandemic times, need to be nimble and creative and possibly be competency as opposed to duration based. Tackling workforce shortages requires a cooperative workforce strategy that contemporises nursing and midwifery transition programs, whilst addressing current nursing issues. 

An environment that empowers and motivates nurses, offers evidence-based flexible competency-based transition programs is necessary to rejuvenate and sustain the nursing workforce. [1]


1. Haddad LM, A.P., Toney-Butler TJ. [Updated 2022 Feb 22]. Nursing Shortage, in: StatPearls (Internet). 2022, StatPearls Publishing;: Treasure Island (FL}.
2. Kenny, A., et al., Interventions to support graduate nurse transition to practice and associated outcomes; A systematic review. Nurse Education Today, 2021. 100: p. 104860.
3. ANMFSA, Discussion Paper: Transition to Professional Practice Programs (TPPP). 2022: Ridleyton, South Australia.
4. Phillips, C., et al., A secondary data analysis examining the needs or graduate nurses in their transition to a new role. Nurse Education in Practice, 2014. 14(2): p. 106-111.
5. Adelson P, F.J ., Peters MDJ, Corsini N, Sharplin G, Eckert M., COVID-19 and workforce wellbeing. A survey of the Australian nursing, midwifery, and care worker workforce. A report prepared for the Australian Nursing and Midwifery Federation. 2021, University of South Australia: Adelaide, SA.
6. World Health Organization, 2022. Global Competency and Outcomes Framework for Universal Health Coverage. Geneva. Licence. CC BY-NC-SA 3.0 IGO.
7. Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N. Evans T et al., 2010. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet 376:1923-58.

Click here to read the July 2022 edition of INPractice.