Understanding the enrolled nurse to registered nurse journey through a model adapted from Schlossberg's transition theory

Abstract Background Substantial numbers of Enrolled Nurses (ENs) enrol in higher education programs to undergo the transition to Registered Nurse (RN) with the experience described as containing numerous challenges. Objectives This paper reports on a synthesis of the literature that explores the experiences of ENs undertaking a program of study to convert to RN. Consequently, a model is developed to identify educational interventions and resources to enable a successful transition for these students. Design A narrative review was completed with thematic synthesis of the literature guided by Schlossberg's Transition Theory, and Thomas and Harden's framework for systematic analysis of qualitative studies. Data sources CINAHL, Scopus, ProQuest Central and Health Collection were searched. Review methods The databases were searched for English language journal articles, theses and grey literature published from 1987 to 2016 from Australia, New Zealand, the United Kingdom, Canada and the USA. The key search words included truncations of: “enrolled nurse”, ‘licensed practical nurse’, “transition”, “conversion” and “experience”. This resulted in the identification of 33 related articles for review. Results Themes and sub-themes developed from the literature synthesis were integrated into an ‘EN to RN Transition model.’ The four stages of the model reflect the experiences of the ENs as they overcame the various challenges they encountered during their transition to RN. The model was used to develop recommendations that may improve their transition experience and decrease attrition. Conclusion This paper reports on a synthesis of the literature, and presents a four stage model, that reflects the experiences of ENs in their transition to RN. Recognising the elements within each stage can assist educators develop strategies and provide educational resources to enhance the EN journey.