University of Nebraska Medical Center

Reality Shock for Nurses

Marlene Kramer coined the term “reality shock” with her 1974 groundbreaking book Reality Shock: Why Nurses Leave Nursing. This theory still holds true for those transitioning to practice today, 42 years later.

Reality shock theorizes that those new to the nursing profession go through a learning and growing transition. This process is characterized by four phases: honeymoon, shock, recovery, and resolution.

Honeymoon Phase

The honeymoon phase is a period of excitement and seeing the world through ‘rose colored glasses,’ new graduates are very excited to be joining the profession and eager to learn as much as possible. 

TIP: It is important to develop initial bonds of trust and respect between new nurses and their preceptors during the honeymoon phase, as this will be the foundation for coping with future phases.

Shock Phase

The new nurse is the most vulnerable when in the second phase, the shock phase, as this is when negative feelings towards their new profession surfaces. This is often when the new nurse realizes the expectation of the new role is inconsistent with the day-to-day responsibilities and new job responsibilities sink in. When the nurse is in a negative state, they are at risk to quit, leave their unit, or burn out.

TIP: Critical strategies to ease through the shock phase include: finding a mentor for guidance, taking care of yourself physically and emotionally (be sure to get enough sleep, eat properly, and laugh frequently), and developing a support network, which usually includes fellow nurses.

Recovery Phase

Next is the recovery phase; new nurses begin an upward climb back to the positive side. They are able to look at all sides and see the job realities with a more open perspective.

TIP: To ensure nurses stay in the recovery phase and move to the next phase, it is important they receive constructive criticism, are eased into their roles and responsibilities, and provided with strong mentors.

Resolution Phase

The fourth and final stage, which is usually around a year, is the resolution phase. This is when the nurse can see the role in perspective and fully contributes to the profession.

TIP: Even though a nurse makes it through the resolution phase, it is important to continually help them retain the positive aspects of their job in order to maintain ongoing happiness and career success.

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1 comment

  1. Tina Pease says:

    Wow – This is spot on! An excellent overview of the phases of nursing and really highlights key areas that we need to be providing additional support in for our nursing staff.

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