Lead Transition to Practice – Reflective EssayAll graduates of nursing courses

Table of Contents

Lead & Transition to Practice – Reflective EssayAll graduates of nursing courses experience some degree of culture shock as they transition from the role of student nurse to registered nurse. Discuss the factors that cause this shock and reflect on the strategies you will use to overcome it.IntroductionThe transition from being a student nurse to being a registered nurse is a time fraught with different emotions. Not only will it be a happy and exciting time but there will also be a lot of anxiety, indecision and fear; it will be both a rewarding and challenging transition. It can be a time when graduates question their abilities and face challenges such as transition shock, professional isolation, exhaustion, stress and feelings of incompetence. Consequently, these challenges could lead to the graduate nurse being overwhelmed by the demands of their new role. The aim of this essay is to examine these challenges the newly qualified nurses experience as they make their transition into professional practice and to explore strategies to facilitate adjustment into their new role. 127DiscussionIn nursing the term transition shock is used to describe the experience of moving from the comfortable and familiar role of student nurse to the professional registered nurse (Wakefield 2018). Stress and expectations of oneself are major factors that contribute to transition shock (…). Many studies highlight the importance of appropriate support for newly graduated nurses and how this support can minimise the anxiety and stress a new graduate experiences (…). Appropriate support can help to build confidence through enhancing a graduates understanding of their role and their abilities (…). However, it has been identified that staffing issues, staffing attitudes and time constraints often lead to graduate nurses being unsupported (…). A key strategy to managing this issue is preceptor programs (…). Preceptor programs have offered support and helped graduate nurses develop their confidence and skills through a supportive program (…). To be able to work with an appropriate mentor will provide me with regular support and direction would be very beneficial to my transition. The confidence and competence of graduate nurses affects their ability to practice effectively in the practical environment. In 1984 Patricia Benner devised a model of skill acquisition which she determined would ease transition for graduate nurses if it was used correctly (…). Benner’s model explains how a nurses clinical competence transitions from novice to expert and is used for assessing nurses’ needs at different stages of professional growth (…). This model is not focused on how to be a nurse, rather on how nurses acquire nursing knowledge (…). According to Benner, the model of skill acquisition consists of five stages of clinical competence.1. Novice is a newly graduated nurse entering the clinical area with basic knowledge learned from clinical and laboratory areas and have little knowledge of what is required of a nurse in the clinical practice environment. They need strict guidelines and direction to ensure they perform their duties as expected by the institution. These guidelines help them learn the skills correctly while being guided by a preceptor. 2. Advanced beginner nurses are nurses who have begun to adapt to their environment and have a marginally acceptable skill level they can use in the textbook situation; however, they continue to need guidance from a preceptor. 3. Competent nurses are the nurses who have acquired some degree of mastery and can respond while under pressure in the clinical environment. They still lack the speed necessary to complete their tasks in a timely manner. The nurse achieves this level of mastery after taking care of similar patients over a period of two years.4. Proficient nurses are nurses who learned how to handle situations as a whole and can manage clinical situations using inductive reasoning. The nurse has goals and is achieving them with the knowledge base built up over their years of experience. The expert nurses can make decisions without guidance and solve complex problems rapidly all while giving efficient nursing care. The expert nurse frequently evaluates patients in a more broad context using pattern recognition compared to a novice nurses. 5. Expert nurses are able to recognise demands and resources in situations and attain their goals. These nurses know what needs to be done. They no longer rely solely on rules to guide their actions under certain situations. They have an intuitive grasp of the situation based on their deep knowledge and experience. Providing holistic patient-centred care is major concern I have entering a graduate program. Through previous clinical placements I have found that there are barriers to providing patient-centred care, issues such as lack of time to perform vital nursing tasks such as addressing a patient’s concerns and providing relevant information to both the patient and their family. Patient-centred care is recognising each patient as an individual; building therapeutic relationships with the patient and their family and involving a multidisciplinary team (…). A lack of patient-centred care can result in patient dissatisfaction and their expectations not being met. Research suggests that graduate nurses require guidance and education in order to gain confidence and empowerment (…). According to the Australian Commission on safety and quality in health care (2011), effective patient-centred care is employed through training health professionals to communicate simple information such as pharmaceutical knowledge and provide educational material which increases a patients self-assurance and understanding. Current research has found that better patient satisfaction and patient-centred care, results in a decreased length of stay; reduces readmission; decreases rates of hospital acquired infections and improves preventative services (Boulding et.al. 201). It is therefore imperative that as a graduate nurse I have an understanding about patient-centred care and am able to successfully implement appropriate interventions. Patient-centred care has encouraged me to re0think how I view and treat my patients. Current literature has highlighted the importance that patient-centred care plays in delivering quality and safe care. By developing effective communication skills, building rapport and therapeutic relationships with patients and building relationships with colleagues to be able to ask for help can ensure that every patient is receiving patient-centred care (…). 275Hostility in the work place is a challenge I am concerned I will experience as a graduate nurse. Having experienced hostility as a student nurse on clinical placements and at times having found nurses to be intimidating and unapproachable has lead to hostility being a concern of mine. It has been found that new graduates have felt resentment in the form of interpersonal conflicts; blocked learning; emotional neglect; feeling undervalues and lack of supervision (…). Consistent hostility and feeling undervalued can result in burn out and turnover of staff (…). I appreciate that during the transition period of a graduate nurse we need support and guidance which can be tedious for registered nurses, however, hostility can impact on a nurses performance, job satisfaction and patient safety (…). It is therefore imperative that I have an understanding about appropriate strategies to resolve these issues. Workplace hostility can be decreased by involving the whole nursing team, providing information on what is good and bad practice and making the staff more aware of the issues (…). Hostility in the workforce makes me apprehensive about starting out as a new gradute in the health care setting. However, from current literature I feel more confident in recognising signs of hostility and feel capable in addressing the problem with either my mentori and a senior member of staff. Certain strateiges such as; using communication tools such as ISBAR in order to appropriately address a patients concerns, not takning conflicts personally; knowing and working within my scope of practice to maintain safe and competent work and knowing my professional boundaries can help with hostility (…). By having a clearer understanding about the issue I feel confident in being able to apply these strategies when challenges with a similar circumstance. 292Self-care is vital for all nurses to ease the detrimental effects of stress in the constantly and rapidly changing health care environment and to prevent progression of those effects which lead to burnout (…). Managing work stresses becomes critical not only for patient care but also for nurses’ health and long-term tenure (…). Orem’s self care theory asserts that individuals should care for themselves to maintain health and wellbeing (…). The self-care model is comprised of emotional, physical, spiritual and psychological wellbeing being tended to (…). Emotional self-care is about having the ability to process thoughts and feelings and manage these in an appropriate manner (…). There are many different methods of managing this, however, practising mindfulness can assist in managing these stresses and improve personal health (…). For nurses improved health and self-awareness ensures optimal care can be provided for each patient (…). Managing physical wellbeing is often not a priority for nurses, ensuring to care for your back and feet is essential to minimising injury to oneself (…). Nutrition is also a vital component to physical wellbeing, by ensuring to maintain a balanced diet and enable your body to work optimally and allow you to feel your best (…). Psychological wellbeing is equally important as physical wellbeing. Psychological wellbeing can assist in preventing burnout and helping to maintain relationships with colleagues, family and friends (…). Reference List:Lewis S & McGowan B 2015, ‘Newly qualified nurses’ experiences of a preceptorships’, British Journal of Nursing, vol. 24, no. 1, pp. 40 – 43Wakefield E 2018, ‘Is your graduate nurse suffering from transition shock?’, Journal of Perioperative Nursing, vol. 31, no.1 pp. 47 – 50