Dissertations and Theses (Open Access)
Date of Award
Spring 5-2026
Degree Name
Doctor of Philosophy in Nursing (PhD)
Advisor(s)
Carina Katigbak, PhD
Second Advisor
Melanie McEwen, PhD
Third Advisor
Maja Djukic, PhD
Fourth Advisor
Kelley Slack, PhD
Abstract
Abstract Introduction: Transition-to-practice (TTP) programs play a crucial role in bridging the academic-to-practice gap for newly licensed Registered Nurses (NLRNs) and improving first-year retention rates. However, these programs may fall short in addressing the specific needs of NLRNs with neurodiversities (NLRN-ND). Neurodiversity (ND) encompasses Autistic Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Tourette Syndrome, and the 3 Ds – Dyslexia, Dyscalculia, and Dysgraphia. Unsupportive environments for disclosing neurodiversity and requesting accommodations may contribute to the 10-25% NLRNs leaving their jobs within the first year, with 1-3% exiting the nursing profession altogether. Objectives: This study aimed to (1) explore NLRN-ND experiences in their first year of nursing practice, transitioning from school to the professional nursing role, (2) examine their strategies for managing neurodiversity-related clinical challenges, and (3) describe the assistive resources and support from their TTP program. Methods: A qualitative narrative approach, employing semi-structured, video-recorded interviews captured the first-year experiences of 15 NRN-NDs either currently participating in or recent graduates of a TTP program. Results: Fifteen interviews revealed NRN-NDs possess a strong self-awareness of their neurodiversity-related limitations and utilize various self-regulatory coping mechanisms. Five key themes with eleven subthemes emerged: Self-awareness of Neurodivergent (ND) Attributes, Self-regulated Learning, Collegial Neuroinclusion, Neuroinclusive Work Environment, and Professional Integration. Participants expressed a significant need for enhanced institutional resources and tailored support structures within both the clinical spaces and TTP programs. The study illuminated the critical importance of comprehensive neurodiversity training for preceptors, leaders, and educators on neurodiversity, to cultivate psychologically safe environments conductive to learning and professional growth for all newly licensed registered nurses, particularly individuals with neurodiversity. Conclusion: NRN-NDs face unique challenges that extend beyond typical first-year stressors, highlighting the importance of their successful professional integration and acceptance. While academia has begun to address the needs of the neurodiverse student population, acute care settings must develop robust support systems to create a genuinely neuro-inclusive environment. This proactive approach is essential to cultivating a healthy work environment that retains and empowers both neurodiverse and neurotypical newly licensed RNs.
Recommended Citation
Wallace, Heather, "Newly Registered Nurses with Neurodiversities: A Qualitative Study of Their Experiences During Transition to Professional Practice" (2026). Dissertations and Theses (Open Access). 77.
https://digitalcommons.library.tmc.edu/uthson_etd/77
Keywords
Neurodiversity, Transition-to-practice, Newly Licensed Registered Nurses