The focus of this assignment will be on resilience strategies developed to

The focus of this assignment will be on resilience strategies developed to help newly registered nurses to have a lifelong nursing care. Resilience is a way of coping with stressful environment (Rush et al., 2014 and Traynor, 2017). The discussion will be on preceptorships, self-efficacy and reflection. In this assignment, a critical analysis of research, policy and other information to inform future nursing practice will be done, health care progress and the influence on adult nursing roles will be critically debated and a critical analysis of political impacts on health, nationally and globally will be done. Main body:-Global & NationalNurses’ psychological wellbeing has become a global concern due to the fact that many nurses experience stress, burnout and compassion fatigue leading them to quit their job or using bad strategies such as use of nicotine, pills and caffeine to cope with a stressful workplace (McAllister and Lowe, 2011). In China, the rate of nurses’ burnout is significantly high and it is linked to job-related issues such as low income, ratio of patients to nurses and it is acknowledged that measures should be taken to help improve resilience (Guo et al., 2017). Many researches from many countries have been conducted in order to find strategies to help nurses cope with workplace stressors. This highlights the fact that nurses’ psychological wellbeing is an issue in many other countries (Traynor, 2019). Some of the reasons for nurses’ mental health being poor could be due to the staff shortage, long shifts and a big ratio of patients to nurses, making the job harder (Smith, Carpenter and Fitzpatrick, 2015). NQN are more likely to suffer from mental illness due to their lack of experience and skills to face challenging situations (Traynor, 2017). Heinen et al. (2013) suggest that NQN can hardly balance work-related pressure and healthy working conditions. NQN are associated with burnout, stress and retention (Rush et al. 2014). The consequence could be resulting in leaving the profession (Mckee and Ashton, 2004, Rush et al., 2014). Absenteism, sick leave and even leaving the profession are some of the impact of the inabilities to manage work-related stressors (Rush et al., 2014). In the UK, a survey showed that 80% of nursing staff felt that work-related stress decreased mood and 72% stated that understaffing was recurrent, 66% therefore considered leaving the NHS or the profession (Royal College of Nursing RCN, 2014). NHS loses up to £400 million due to absence related to stress (NHS employers, 2014). Statistics state that 40,000 nurses are needed in the UK (RCN, 2016). This staff shortage is therefore putting more pressure on nurses already working and hence more work and more stress and burnout are recorded. A recent survey showed that between 2011 and 2017, more than 300 nurses and student nurses committed suicide due to overload work, feeling of not being supported (Office for National Statistics, 2008). All this highlights the critical need for resilience. According to Bjerknes and Bjork (2012) NQN need a particular support as they mostly feel on their own, isolated and lack of confidence once their university support is removed, psychological issues such as anxiety and stress and reduced working efficacy could result from that. National Institute for Health and Care Excellence NICE (2015) recommend to employers to make employees feel valued, supported and fairly treated, to offer training to enhance their competence as well as team working promotion, furthermore, the Boorman report (2009) recommends employers to care for the wellbeing of their employees by implementing a person-centred approach and prioritise the most vulnerable employees and to the employees to be engaged to the wellbeing strategy however this is not always put in place because lack of time (NICE, 2015). Stevenson and Farmer (2017) recommend employers to develop and implement mental health awareness, support struggling employees and ensure their working condition is good. Employees also need to abide to the national and trust policies, know the health and safety policy (NICE, 2015) and improve resilience however the lack of funding is a major obstacle for this to be implemented (NHS Employers, 2019).PreceptorshipsPreceptorship has been implemented to support NQ staff to transition from students and to gain sufficient confidence and develop their practice during a period of time (NMC, 2015). Sharples and Elcock (2011) suggest that a quality preceptorship program is crucial to ensure a good start for NQN. Stress associated with transition from student to qualified nurse is significantly reduced with preceptorship (Marks-Maran et al., 2013). A NQN is therefore supported within their first year by a preceptor who is an experienced nurse, the objective is to refine skills, behaviours and values and develop confidence as independent professionals (Ciocco, 2015). Myrick and Yonge (2005) and McInnes (2015) suggest that learning from an expert, give to NQN a base for lifelong learning and enable them to give confidence in providing effective patient-centred care. Preceptorship is beneficial for the employees, employers and patients (Sharples and Ecock, 2011). Baker and Pitman (2010) suggest that NQN are more skilled and confident after preceptorship training and their job satisfaction and morale are increased and fewer medication errors are made. Additionally, patient care and experience is better and sick leave is reduced (Morrow, 1984 and Lewis and McGowan, 2015). However, Brooks and Niederhauser (2010) suggest that due to busy clinical units and some non-conductive to learning, NQN are very often left on their own and do not have the support required to have the best possible start. Barker and Pittman (2010) state that NQN complain of lack of time and lack of communication with preceptors. Wilson et al. (2009) and Kamolo et al. (2017) suggest that some preceptors lack faculty support and lack preparation and training to guide NQN and most of them lack experience as preceptors. Burns et al. (2006) and Flynn and Stack (2006) suggest that poor students’ attitude and knowledge is an obstacle on successful preceptorship due to the fact that some think they know everything this is an impact on their career as over confidence leads to errors and being banned from the profession (Ciocco, 2015 and Kamolo et al., 2017). Ciocco (2015) recommends employers to ensure that experienced preceptors have sufficient time and skills to support and guide preceptees. For better preceptorships, employers need to ensure preceptees have training in quieter workplace to enable them to learn and retain. Henderson et al., (2015) suggest that due to minimal requirements to become a preceptor, many preceptors lack adequate teaching skills required for the role and lack of qualified nurses, it is therefore essential to acknowledge that not all registered nurses can be preceptors and an adequate selection should be made (Panzavecchia and Pearce, 2014).-Self-efficacySelf-efficacy is having beliefs of being able to succeed (Bandura, 1994). Resilience and innovative achievements are increased by self-efficacy (Bandura, 1994). Lenz and Shortridge-Baggett (2002) and Maxwell et al. (2011) suggest that NQN need to develop their self-efficacy to be able to work confidently. Researches have shown that the more nurses advance their academic education; the more their self-efficacy is developed. Twibell (2012) suggests that self-efficacy help build decision making as well as good care quality. Tapping et al. (2013) suggests that nurses have to believe to be able to produce desirable results in order to work confidently. Confidence is influenced by self-efficacy (Mullen, 2014). Magnusson et al. (2014) suggests that skills and knowledge are important but not sufficient if self-efficacy is missing as it enhances the link between action and knowledge. NQN are more likely to fail or make errors if their self-efficacy is low. Having high self-efficacy helps nurses to master difficult situations confidently and with interest rather than try to avoid them (Bowers, 2015). Evidence shows that learning and achievement are increased in NQN who have a high sense of self-efficacy and they also have stronger commitment at work (Green, 2014). NQN having self-efficacy tend more to set higher expectations and make them believe of an eventual success if they work hard (Cziraki et al., 2018). NQN with high self-efficacy will increase their efforts in case of a failure and work harder to avoid it in the future, however NQN in such situations will feel completely lost and diminished, could give up quickly and would think of leaving the profession. However, having too much self-efficacy and being too confident can set NQN up for failure (Peate, 2012 and Green, 2014) also, Woodward (2012) suggest that having too much self-efficacy can lead NQN to ignore or not be aware of their weaknesses which could lead to failure. It is therefore important that managers promote self-efficacy for practice as it is relevant for better employment (Peterson and Bredow, 2009). Additionally, more support, trainings must be mandatorily given to NQNs to help them develop high self-efficacy (Maxwell et al., 2011 and Muha, 2014), hospitals need to ensure that their employees’ working condition are good as the output increase when the work environment is good (NICE, 2015), developing a better manager-employee relationship to find out employees with low self-efficacy is essential and put strategies in place such as trainings, support, counselling are important for a better work environment (Stevenson and Farmer, 2017). Employees in the other hands need to acknowledge their level of self-efficacy and confidence and seek adequate support. (NICE, 2015) also, employees need to continuously upgrade themselves with knowledge and skills as the more educated they are the more confident they become.-Reflection Reflection is a specific way to improve practice. Personal feelings, thoughts and influencing factors are better from an event are better understood (Timmins and Duffy, 2011). Through reflection, self-awareness is improved, and stress reduced. Also, considerations of things not yet explored can be identified and practice issues can be directly addressed through reflection (Price and Harrington, 2010). Reflection is a way of measuring progress in professional practice (Smith, 2005). Glaze (2002) and Johns (2013) suggest that nurses are more confident in justifying and supporting their decision making and actions. There is reflection in action which during practice and reflection on action, which is analysing practice retrospectively, both are relevant in the way that it enables to identify issues as they occur and enables to differentiate the right and wrong and to act towards it later (Hibberd et al., 2014). Reflection on action can be even better as it allows to gain deep understanding after recall of feelings in a calm exploration of an issue (Chang and Daly, 2007 and Sharples, 2009). Incorporation of reflection models such as Giggs model when reflecting is beneficial as it allows purpose, depth and a systematic analysis of an event (Nuttal, 2013). The beneficial outcome of reflection is helping nurses to develop practice and increase clinical knowledge which enables them to develop clinical skills for their careers (Bulman and Schutz, 2013). Also, through reflection, work practice and interprofessional relationships are optimised and improved (Howatson-Jones, 2016). However, caution must be taken when reflecting as NQN may be too critical of themselves therefore negative and positive points must be reflectively balanced (Chang and Daly, 2007 and Jasper, Rosser and Mooney, 2013). If solutions are not found, NQN may found themselves with a sense of failure and reduced confidence (Bulman and Schutz, 2013), and this may badly affect the nursing practice as it is therefore important for NQN to acknowledge that not all issues have solutions and know their own limitations (Casey and Egan, 2014). The lack of time is also a barrier to effective reflection (Smith, 2005 and Langley and Brown, 2010). Therefore, employers need to authorise some time off work to enables nurses to reflect on their actions and verify that reflection is done properly to avoid being too critical. Also, employees need to be able to go to their employers when they find a challenging situation difficult to reflect on and are not able to make sense of it or learn anything from it (Callara, 2008 and Johns, 2013).ConclusionTo conclude, nurses globally and nationally are going through a though time due to staff shortage, big ratio of patient to nurse, it is therefore crucial to find a way to help them cope with workplace stressors. NQN are more likely to be discouraged if adequate support is not given to them from the beginning of their career. Preceptorship, self-efficacy and reflection are some of the key elements to help improve NQN’s resilience and hence, job satisfaction and if it is done properly, they may guaranty a good career start and a long-life career in nursing. However, employers and employees must work together in order to achieve a good nursing career.

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