New graduate nurses transition with limited experience, and with anxiety and stress. They present an increased risk of contributing to preventable errors or adverse events.The purpose was to develop an understanding of new graduate registered nurses' (RNs) patient safety knowledge and actions within the first year of registration.The longitudinal mixed-methods study was conducted using a questionnaire delivered at 3 time points (n = 68). Qualitative data were collected by semistructured interviews (n = 11).Self-reported knowledge of medical error decreased over the 3 time points. Themes emerging from qualitative data include patient safety and insights, time management, making a mistake, experiential learning, and transition.Medical errors and time management persist during transition to the RN role. New graduates reported moderate knowledge of safety and quality issues; however, questioning their own abilities overshadowed growth in their involvement in patient safety.