Aim This study explores the perceptions and experiences of nurse managers involved in implementing the Lean management system in a western Canadian province. Background The provincial government of Saskatchewan, Canada implemented a multi‐million dollar investment in the Lean management system to transform health care delivery by reducing waste and increasing efficiency of processes and outcomes. Method This qualitative exploratory study employed semi‐structured interviews with 14 nurse managers in urban and rural health regions in one Canadian province. Results Six themes outline the difficulties nurse managers experienced in juggling role responsibilities alongside a poorly‐implemented change system with scarce resources. Conclusions The results showed tensions in the implementation of a Lean model adapted in the context of health care organizations. The expectations for nurse managers to be pivotal players in the implementation of transformative healthcare practices that promote and sustain strategies to reduce waste, improve coordination, and increase patient safety requires investment in leadership development. Implications for Nursing Lean management systems significantly impact the roles of nurse managers who require adequate resources and training to successfully adapt. The results of this study may be used for more effective support mechanisms for nurse managers.

Virtually, no published research is available on the relationship between employing newly graduated nurses (NGNs) in the emergency department (ED) and the advancing of nursing practice and the optimization of patient care outcomes. Traditionally, nurses hired into these practice areas have required advanced skills in clinical assessment and experience with a variety of situations that were assumed to offer them a framework by which they could recognize and respond to potentially life-threatening changes in a patient's status. This qualitative study explored the issues of integrating NGNs into the ED. Findings clearly established the challenges to integrating NGNs into this practice context. The intersection of variables included a low level of clinical predictability accompanied by high acuity; an increased level of practitioner autonomy combined with high levels of risk when applying decision making to patient outcomes; and the potential for devolution of professional identity in the face of highly intense, morally conflicted, and socially nuanced care situations.

There is a growing concern in education and healthcare that we are not adequately preparing or transitioning newly graduated nurses (NGNs) into the workplace. N

The transition from student to practitioner for newly graduated nurses is impacted by their physical, social, professional, and practice environments. COVID-19, global insecurity, institutional restructuring, and “acute on chronic” staffing shortages have increased the immediate burden experienced by emerging nurses. As detailed through the historical development of Duchscher's Stages of Transition Theory and Transition Shock Model, theorization of the transition process offers graduates, their educators, and workplace managers key areas of support opportunities for these new practitioners. In part 1 of a 2-part article series, this article explores how novel new graduate supports have been developed and delivered in partnership with nonprofit groups, government bodies, and employers across much of Canada. For nurse stakeholders, theorists, and beyond, support for the transition period of new nurses remains anecdotally, evidentially, and fiscally advisable, with an increasing urgency due to rising human capital pressures.