Professional Recognition, Reality Shock and Nurses' Well-Being After the Bologna Reform in Spain: A Qualitative Study...

Background/Objectives: The Bologna Process and the European Higher Education Area consolidated the transition of nursing education in Spain from diploma-level training to a university degree framework. Although previous research has examined newly graduated nurses' transition to practice, less attention has been paid to how key informants involved in educational reform interpret its long-term professional implications, including their potential relevance for nurses' well-being. This study explored key informants' perspectives on the implications of the Bologna Process and the Nursing White Paper on nursing education and professional development in Spain. Methods: An exploratory qualitative study was conducted using in-depth semi-structured interviews with six key informants involved in nursing educational reform in Spain. Interviews were conducted between June and November 2025, audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis. Results: Three main themes were identified: (1) academic professionalization and the generation of professional expectations; (2) structural misalignment between university-based professionalization and clinical practice; and (3) Reality Shock, professional identity and nurses' well-being. Conclusions: From the perspective of key informants, Reality Shock may be understood not only as an individual transition difficulty, but also as a possible expression of structural misalignment between academic professionalization and healthcare organizations. These findings suggest that strengthening nurses' well-being may require organizational strategies that translate educational reform into professional recognition, autonomy, leadership opportunities, and coherent career development.