Nursing and Health Sciences (2003), 5, 155–163 Research Article E. Chang and K. Hancock 10.1046/j.1441-0745.2003.00147.x Research Article155163BEES SGML Correspondence address: Esther Chang, School of Nursing, Family and Community Health, University of Western Sydney, Locked Bag 1797, Penrith South DC, NSW 1797, Australia. Email: e.chang@uws.edu.au Received 30 November 2002; accepted 12 December 2002. Role stress and role ambiguity in new nursing graduates in Australia Esther Chang, PhD, MEdAdmin, RN and Karen Hancock, PhD, BSc(Hons) University of Western Sydney, School of Nursing, Family and Community Health, Sydney, Australia Abstract The first few months of nursing have the potential to be the most challenging and stressful for new nursing graduates. The purpose of the present study was to examine sources of, and changes in, role stress 2–3 months after employment, and 11–12 months later in new graduate nurses. This study also investigated the relationship between job satisfaction and role stress. A factor analysis demonstrated that role ambiguity was the most salient feature of role stress in the first few months, while 10 months later, role overload was the most important factor explaining variance in role stress scores. There was no significant change in role stress scores over time. For the first survey, job satisfaction was significantly negatively correlated with role ambiguity and role stress. In the second survey there was still a significant negative correlation between role ambiguity and job satisfaction, but no significant correlation between role overload and job satisfaction. The findings are discussed in terms of implications for nursing education, practice and future research. Key words job satisfaction, longitudinal study, new nursing graduates, role ambiguity, role overload, role stress, stress reduction strategies. INTRODUCTION The experience of role stress in new nursing gradu- ates is relevant to nursing education and practice for various reasons. First, it informs education about whether new graduates are adequately prepared for clinical practice. Second, there is a change in societal attitudes about nursing as a career (Hemsley-Brown & Foskett, 1999), with a decline in enrollments in undergraduate nursing degrees, and therefore a need to create sustainable nursing (Chang & Daly, 2001). Third, the change in health care structure and the nature of patient treatment such as managed care, reductions in lengths of hospital stays, increased patient acuity, new technologies and focus on cost- effective quality of care have resulted in increased workloads for nurses (Garrett & McDaniel, 2001). The increased demands have negative consequences for nurses and patient care and, as discussed below, are major factors for the nursing shortage currently being experienced. This has relevance to the recruit- ment and retention of new graduates. ROLE STRESS IN NURSES Nurses who are stressed have higher absenteeism rates, lower work satisfaction and are more likely to voluntarily leave the organization (Larson, 1987; Cal- laghan & Field, 1991). They have more conflicts with co-workers (MacNeil & Weisz, 1987) which only esca- lates the problem as aggression from colleagues has been found to be a major source of stress for nurses (Farrell, 1999). They also suffer psychologically, in terms of feelings of inadequacy, self-doubt, lowered self-esteem, irritability, depression, somatic distur- bance, sleep disorders and burnout (Foxall et al., 1990). These responses compromise the quality of