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A Quantitative Analysis of Employment Barriers and Workforce

Integration Strategies among Newly Graduated Nurses

Nursida A. Haydin, Rn

University of Perpetual Help-Dalta, Philippines

DOI: https://doi.org/10.51244/IJRSI.2025.120800207

Received: 19 Aug 2025; Accepted: 25 Aug 2025; Published: 20 September 2025

ABSTRACT

The transition from nursing education to clinical practice remains a critical challenge for newly graduated

nurses, as systemic and institutional barriers often delay their integration into the workforce. This study

examined the extent of employment barriers, perceived readiness, and effectiveness of workforce integration

strategies among 100 newly graduated nurses employed in selected hospitals in Zamboanga City, Philippines.

A descriptive-correlational design was utilized, with data gathered through a validated structured

questionnaire. Results revealed that the most significant barriers were the employer preference for experienced

nurses (M = 3.52, SD = 0.66) and limited job openings for new graduates (M = 3.40, SD = 0.72). Respondents

perceived themselves as moderately ready for practice, with higher ratings for academic preparation (M =

3.16) and clinical skills (M = 3.11), but lower for emotional readiness (M = 2.98) and institutional support (M

= 2.75). A significant positive correlation (p < 0.05) was found between employment barriers and the duration

of unemployment, indicating that greater barriers prolonged job acquisition. Significant differences in barriers

were also noted across demographic factors such as type of school, employment status, years of service, and

time before securing employment. Mentorship, structured orientation, and continuous feedback emerged as the

most effective integration strategies.

Future Directions

Future research should adopt longitudinal designs to examine the career trajectories of newly graduated nurses

over extended periods, particularly focusing on retention, skill development, and workforce mobility.

Qualitative approaches, such as interviews and focus group discussions, are strongly recommended to capture

the lived experiences of novice nurses and to provide deeper insights into their emotional readiness. Expanding

research to include larger, more diverse samples across geographical regions and implementing probability

sampling will improve generalizability. Additionally, resilience-building and stress-management interventions

should be explored as essential components of workforce integration. Finally, given that the Philippines is one

of the largest exporters of nurses worldwide, future studies should address the implications of international

nurse migration on local workforce stability, national health systems, and global supply-demand dynamics.

The study concludes that systemic hiring preferences, limited institutional support, and readiness gaps

significantly affect the transition of novice nurses, contributing to delayed employment and professional

uncertainty. To address these issues, it is recommended that healthcare institutions establish structured

residency and mentorship programs, provide financial and emotional support mechanisms, and collaborate

with academic institutions to strengthen career-readiness initiatives. Policymakers are urged to streamline

licensure and hiring processes, expand entry-level opportunities, and institutionalize workforce integration

frameworks. A Workforce Integration Toolkit is proposed to bridge the academic-to-practice gap and promote

a smoother transition into professional nursing practice.

Keywords: Newly graduated nurses; employment barriers; workforce integration; transition to practice;

nursing readiness; mentorship; orientation strategies

INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)

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INTRODUCTION AND BACKGROUND OF THE STUDY

The transition from nursing education to professional practice is widely recognized as one of the most pivotal

yet challenging phases in the career development of nurses. Graduation signifies the completion of years of

academic preparation, yet for many, the shift to clinical practice brings uncertainty, heightened responsibility,

and the pressure of adaptation (Labrague & McEnroe-Petitte, 2018). While nursing graduates acquire

theoretical knowledge and limited clinical exposure, the transition often reveals gaps in readiness that hinder

smooth integration into the workforce.

Globally, the demand for nurses continues to increase due to population aging, the rise of chronic illnesses, and

recurrent public health emergencies. Despite this demand, newly graduated nurses (NGNs) are frequently

confronted with systemic barriers that delay their entry into the workforce (World Health Organization

[WHO], 2020). Hospitals and healthcare institutions often prefer experienced nurses, citing efficiency and

reduced training costs as justifications (Hofler & Thomas, 2016). This situation creates what has been termed

the “experience paradox,” where fresh graduates are expected to possess experience before being hired, thus

perpetuating cycles of unemployment and underemployment. Prolonged job-seeking not only erodes

confidence but may also lead to skill stagnation and attrition from the profession (Alibudbud, 2023).

In the Philippine context, nursing has long been regarded as a pathway to socioeconomic mobility and

international opportunity. The country continues to produce thousands of nursing graduates annually, many of

whom aspire to serve both domestically and abroad (Lorenzo et al., 2019). Despite this oversupply, local

employment opportunities remain limited, with many hospitals requiring prior experience before considering

applicants for staff nurse positions. Delays in licensure processing and the absence of structured transition-to-

practice programs further exacerbate the challenges faced by novice nurses (Labrague & De los Santos, 2023).

These barriers often result in prolonged unemployment or unpaid volunteer roles, fueling frustration and

disillusionment.

The researcher’s own clinical observations reinforced these trends. Many newly graduated nurses, despite

demonstrating enthusiasm and up-to-date knowledge, struggled to secure stable roles and were frequently

relegated to contractual or volunteer positions. Others reported inadequate mentorship and institutional support

during the early months of practice, leading to diminished self-confidence and professional uncertainty. These

experiences highlight the disconnect between academic preparation and workforce expectations, raising

questions about the adequacy of current systems supporting NGNs’ transition to practice.

It is against this backdrop that the present study was undertaken. By investigating employment barriers,

perceived readiness, and integration strategies among newly graduated nurses, this study seeks to provide

empirical evidence that can inform institutional interventions and policy reforms. Ultimately, addressing these

barriers is not only critical for improving employment outcomes but also essential for sustaining a resilient

nursing workforce capable of delivering safe, competent, and patient-centered care (Phillips et al., 2015).

METHODOLOGY

This study adopted a quantitative, descriptive–correlational design, appropriate for describing the extent of

employment barriers and exploring statistical relationships between barriers, readiness, integration strategies,

and unemployment duration (Creswell & Creswell, 2018; Polit & Beck, 2021).

The respondents were 100 newly graduated nurses employed in selected government and private hospitals in

Zamboanga City, Philippines. Purposive sampling was used to include nurses who graduated within the past

two years and had at least three months of professional practice. This ensured the study focused on individuals

in the critical early stages of transition to the workforce (LoBiondo-Wood & Haber, 2022).

Data were collected through a structured self-administered questionnaire, consisting of five sections:

demographics, employment barriers, perceived readiness, effectiveness of integration strategies, and

supporting comments. Items were rated on a four-point Likert scale. The instrument underwent content

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validation by experts and pilot testing, yielding acceptable reliability coefficients (Cronbach’s α ≥ 0.70),

confirming internal consistency (Polit & Beck, 2021).

Following ethics approval and institutional permissions, surveys were distributed in both paper and online

formats. Respondents were assured of voluntary participation, confidentiality, and anonymity, in compliance

with the Philippine Data Privacy Act of 2012 (RA 10173).

Descriptive statistics (frequencies, means, standard deviations) were employed to summarize profiles and

ratings. Pearson’s correlation coefficient was used to assess the relationship between barriers and

unemployment duration, while t-tests and ANOVA determined differences across demographic variables. The

significance level was set at p < 0.05 (Creswell & Creswell, 2018).

Ethical principles of respect, beneficence, and justice guided the study. Written informed consent was secured

from all participants, with strict confidentiality maintained in line with RA 10173 (Polit & Beck, 2021).

RESULTS AND DISCUSSION

The study involved 100 newly graduated nurses, most of whom were aged 23–25 years (57%), female (68%),

and graduates of private institutions (61%). More than half were employed in private hospitals (56%), and 64%

held full-time positions. However, it is noteworthy that 52% of the respondents reported delays in securing

their first job, with 25% waiting more than six months before entering the workforce. These findings align

with previous research in the Philippines showing that new graduates often face underemployment or

prolonged unemployment due to institutional hiring preferences and limited job openings (Lorenzo et al.,

2019). Globally, similar patterns have been observed, where novice nurses encounter a “waiting period” before

full integration into the healthcare workforce (Al-Rawajfah et al., 2023).

Employer preference for experienced nurses (M = 3.52, SD = 0.66) and limited job openings (M = 3.40, SD =

0.72) emerged as the most significant barriers. These results reinforce the “experience paradox” described in

nursing workforce literature, where employers demand prior experience from graduates who are just entering

the profession (Hofler & Thomas, 2016). Other barriers such as academic-to-practice transition gaps, limited

onboarding programs, and financial constraints were reported to a moderate extent. Similar findings have been

documented by Labrague and De los Santos (2023), who noted that lack of orientation and institutional support

prolongs the job-seeking period and contributes to stress among newly licensed nurses.

Respondents rated themselves moderately prepared for practice, with the highest ratings for academic

knowledge (M = 3.16) and clinical skills (M = 3.11). However, emotional readiness (M = 2.98) and

institutional support (M = 2.75) received lower ratings. These findings suggest that while nursing education

provides adequate theoretical and technical grounding, graduates continue to struggle with emotional resilience

and adjustment to real-world demands. This echoes the work of Romyn et al. (2009), who argued that while

nursing schools equip students with clinical competencies, they often fall short in preparing them for the

psychological challenges of professional nursing. In Iran, Momeni et al. (2023) similarly reported that

turbulence in workplace dynamics, lack of mentorship, and unpleasant interpersonal experiences undermine

the confidence of new nurses.

Mentorship, structured orientation, and regular feedback were identified as the most effective strategies for

easing transition into practice. This resonates with international evidence highlighting the value of transition-

to-practice (TTP) programs in improving retention and clinical competence (Rush et al., 2019; Hampton et al.,

2021). The Accreditation Commission for Education in Nursing (2023) also emphasized that mentorship and

guided learning opportunities significantly reduce “transition shock” and support early career sustainability.

A statistically significant positive correlation was found between the extent of employment barriers and the

duration of unemployment (p < 0.05). This finding confirms that systemic and institutional obstacles, such as

the absence of structured onboarding programs and employers’ preference for seasoned staff, directly

contribute to prolonged job acquisition. Similar results were reported by Al Zamel et al. (2023), who found

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that high job stress, lack of professional development opportunities, and insufficient support were linked to

early attrition and delayed employment among novice nurses.

Significant differences were observed in employment barriers when respondents were grouped according to

type of school graduated from, employment status, years of service, and time taken to secure employment. For

example, graduates of private institutions reported greater barriers compared to their counterparts from public

institutions. This may reflect disparities in training quality, hospital affiliations, and career placement support,

as noted by Santos and Geronimo (2022).

Overall, the findings underscore that while NGNs perceive themselves as moderately prepared, structural

barriers significantly delay their workforce entry. The mismatch between academic preparation and hospital

expectations creates frustration, erodes confidence, and contributes to early attrition—a concern raised in both

local and international literature (Phillips et al., 2015; Labrague & McEnroe-Petitte, 2018). Addressing these

barriers requires a multi-pronged approach: hospitals must invest in structured residency and mentorship

programs, nursing schools must strengthen career-readiness initiatives, and policymakers must ensure

equitable hiring practices and streamline licensure processes.

The evidence further highlights that workforce integration is not merely a matter of clinical readiness but also

of emotional resilience, institutional support, and systemic alignment. By investing in structured transition

programs and supportive workplace cultures, institutions can enhance nurse retention, improve patient

outcomes, and ensure a stronger, more sustainable nursing workforce.

This study demonstrated that newly graduated nurses in Zamboanga City face considerable barriers as they

transition into professional practice. The most prominent challenges identified were employers’ preference for

experienced nurses and limited job openings, which collectively delayed employment and contributed to

professional uncertainty. Although respondents expressed moderate confidence in their academic knowledge

and clinical skills, they reported weaker emotional readiness and insufficient institutional support. Statistical

analysis further revealed that greater employment barriers were significantly correlated with longer

unemployment duration, emphasizing the critical impact of systemic and institutional practices on workforce

integration.

The findings highlight that the transition from student to practicing nurse is shaped not only by individual

readiness but also by the availability of structured institutional support. Mentorship, structured orientation, and

continuous feedback emerged as the most effective integration strategies, underscoring the need for

comprehensive transition-to-practice programs. Overall, the study concludes that while nursing education in

the Philippines equips graduates with foundational competence, systemic reforms in employment practices and

institutional support mechanisms are urgently required to strengthen nurse retention, reduce attrition, and build

a sustainable nursing workforce (Labrague & De los Santos, 2023; Rush et al., 2019).

Based on the findings of this study, several recommendations are proposed to address the challenges

encountered by newly graduated nurses as they transition into professional practice. For healthcare institutions,

it is essential to establish structured residency and mentorship programs that provide guidance, supervision,

and support during the early months of practice. Such initiatives can help bridge the gap between academic

preparation and workplace demands, while mechanisms such as counseling services, peer support groups, and

orientation packages may strengthen the emotional readiness of novice nurses and mitigate transition shock.

Hiring policies should also be reviewed to open more entry-level opportunities for fresh graduates, ensuring

that hospitals do not rely solely on experienced nurses to meet staffing needs. In academic institutions, career-

readiness initiatives should be further strengthened through simulation-based training, job placement

assistance, and mock interviews, thereby equipping graduates with both technical competence and professional

confidence. Stronger partnerships between nursing schools and healthcare facilities may also facilitate

seamless integration into the workforce. Moreover, incorporating resilience-building and emotional

preparedness into the nursing curriculum can better prepare graduates for the realities of hospital practice.

From a policy perspective, government agencies and regulatory bodies should consider streamlining licensure

and employment processing to minimize delays in workforce entry. The institutionalization of transition-to-

practice programs as a national standard would also ensure that all hospitals adopt comprehensive onboarding

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frameworks for novice nurses. Additionally, providing incentives for healthcare institutions to absorb new

graduates, such as subsidies for orientation costs, may further promote equitable hiring practices. Finally,

future research should consider longitudinal approaches to examine the long-term career trajectories of novice

nurses, complemented by qualitative studies that capture the lived experiences of these professionals.

Expanding the scope of future investigations to rural and underserved regions would also yield a more

comprehensive understanding of the employment challenges faced by newly graduated nurses across diverse

contexts.

This study is subject to several limitations. First, it relied on self-reported data, which may be influenced by

recall bias or social desirability bias. Second, the sample was limited to 100 newly graduated nurses from

selected hospitals in Zamboanga City, which restricts the generalizability of findings to other regions in the

Philippines or to international contexts. Third, the study adopted a quantitative design, which provided

valuable statistical associations but limited the depth of understanding regarding the lived experiences of

novice nurses. Finally, data collection was conducted during a specific timeframe and may not capture

fluctuations in employment trends due to external factors such as policy changes, hospital staffing needs, or

public health emergencies.

Despite these limitations, the study provides important insights into the barriers faced by newly graduated

nurses and contributes to the growing evidence base advocating for structured transition programs and

supportive institutional practices.

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