TheChallenges and the Opportunities Experienced by the Student whenTransitioning to a Graduate Nurse
TheChallenges and the Opportunities Experienced by the Student whenTransitioning to a Graduate Nurse
Thenew nurses who have just graduated are going into the workforce andfinding that they do not have either the confidence or the practiceexpertise to navigate the highly intense, and dynamic clinicalenvironment. The escalating patient acuity levels, as well as thenursing workload, have burdened the clinical environment (Weinstein& Brooks, 2014).According to the theory of transition, the nursing students usuallygo through the journey of becoming, where the newly graduated nursesadvance through the phases of doing, being, and finally, the stage ofknowing. Moreover, this journey entails some ordered processes, whichare anticipating, learning, performance, adjusting, concealing,revealing, questioning, separating, exploring, rediscovering, andfinally, engaging. Nonetheless, this journey is usually evolutionary,and ultimately transformative for every participant, although, it isnot always strictly progressive, linear, or prescriptive.
Theyear of transition often offers a mediated entry into the professionof nursing, where the graduate nurse infuses the patterns of learningto cope, adjustment and understanding when and how to seek supportand assistance. The graduate nurses want recognition as competent,coping, and proficient, hence, they are usually thoughtful aboutdefining, as well as adapting the present role. Thus, it follows thatthe finest elements of alteration are getting the support, beingaccepted, as well as being welcomed into the group, and having acherished contribution. Therefore, the transition eminence ofgraduates affects the retention outcomes because it influences thedesire of the graduates to continue practicing (Yoder-Wise,2015).As much as this transition offers a myriad of opportunities to thegraduate nurses, it also presents an equal measure of challenges.
Opportunitiesexperienced by student nurses when transitioning to graduate nurses
Acquisitionof interdisciplinary communication skills
Duringorientation, the new graduates are trained on how to interact at apersonal level with the other staff in terms of communication. Areport indicates that graduate nurses in Australia require propercommunication skills training including conflict resolutions, andinterdisciplinary role-play conversations (Weinstein & Brooks,2014). They, therefore, know what to do in any patient situation withno one there to guide them.
Thegraduate nurses often want transparency and visibility from theleaders giving them guidance. There is a link between the employednurses and the graduates, that assist the graduates to obtainbeneficial feedback, hence promote dialogue (Yoder-Wise, 2015). Theintentional connection of new nurses to seasoned and successfulnurses enables them not to be isolated, therefore, guides them onseeking assistance.
Meetingof regular preceptors who emphasis on positivity
Whennew nurses are assigned to an individual and their schedulesconsistency of the preceptor experience is improved. Dealing with apreceptor lowers chances of frustration felt by the newly graduatedsince they learn about the conflicting information therefore, knowthe procedures and rules of an organization. New graduates inAustralia highly valued the encouragement they received frompreceptors(Stein-Parbury, 2011).Despite the challenges faced by new nurses, encouraging commentaries,accomplishments made, and the preceptors’ express-reports indicatea professional validation. The graduate nurses acknowledge theprofessional care sessions and enjoy discussing the understandingsthat transform people in the nursing practice with their receptors.The positive experiences should be celebrated and be regularly sharedwith staff and preceptors within organizations.
Supportedin the entire first year
InAustralia, the transition programs for the newly graduated nurseslast between three and six months. Currently, the graduates willbenefit from longer-term support including, debriefing opportunities,additional development of clinical judgment, and enhancement ofskills. The commendation for long-standing assistance is in line withthe theoretic phase of obtaining nursing competence, which recognizesthat the beginner nurses lack a clear understanding of the newpositions, which they are expected to execute(Kenefick & Young, 2013).Moreover, the findings give support to the conceptual framework ofthe graduate nurse, which recommends the new nurses to go throughthree phases. They include undertaking, understanding, and being inthe first year of practice, and strong support is required in everystage. Simulations used to elucidate and provide the new nurses withchances to exercise professional and collegial communication withinthe required setting, with feedback and debriefing are useful.
Joiningand becoming active in professional associations
Thegraduates attend conventions and meetings nationally and locally.They should get on committees and run for office. It is helpful asone will find information and support, develop leadership skills,negotiation skills, and communication ability which are attributes ofan effective nurse(Joel & Kelly, 2011).One`s resume will be impressive since the knowledge and informationbase will be enhanced.
Attendingcareer fairs and conventions
Thegraduate nurses are given opportunities to attend student lunches,recruitment occasions, the Australian Association for nurse’sconventions, and the career fairs for nursing. The events give thegraduates a sense of what is available in their field and what thefuture holds for them. Since each employer offers differentorientation programs, benefits, and specialty internships, one willhave time to consider the facility that best suits them(Corbett & Hill, 2011).After these, one makes inquiries and contacts based on informeddecisions. Hence, the salary will not be the only motivating factorfor looking for the job. Educational offerings on clinical topics,career development, and professional concerns like speaking andwriting are also available. Additionally, one meets representativesof professional associations and institutions of higher learning toplan for the future.
Availabilityof volunteer programs
Thegraduate nurses gain valuable experience through volunteering. Theycan volunteer for the Australian Red Cross, search in the yellowpages for social services and contact the organizations that interestthem(Huber, 2012).If interested in a specialty they look for the related volunteer workoffered, for example, with an interest in pediatrics, one volunteersto work in a medical day care center. The resume will look great withmuch experience great contacts will be made, and confidence builtwill be recommendable.
Availabilityof networking opportunities
Itentails building and maintaining professional relationships. Since noone succeeds alone, the graduates need to seek help and support. Itinvolves meeting new people, developing relationships, and keeping intouch with them continuously(Vallano, 2015).It is a support team as it offers advice and information, hence, areal source of inspiration. Through networking, many people get goodjobs. One should keep in touch with their instructors and classmatesafter graduation, as well as health professionals one developed arelationship with while in school. It can be a speaker at aconference, or a nurse in one’s community(Holmes, 2012).Keeping in touch can be through sending cards, emails, or makingphone calls to them. They should not only be contacted when somethingis required of them. One can come up with business cards as part ofone’s professional image. It will remind people of who one is andthe way to reach them, which is essential for professionalnetworking. They should be carried at all times because one neverknows whom they will meet and where.
Thechallenges of student transition to graduate nurse
Thenew graduate nurses usually undergo a lot of bullying at theirworkplace. It is unfortunate to note that bullying has a tremendousimpact on both the bullied graduate nurses and on the workplace ingeneral (Bauman, 2013). The issue usually confronts the victims (newgraduate nurses) who are described as the oppressed group.
Astudy conducted in the US reported that a myriad of new graduatenurses undergoes workplace bullying during their first year. Some newgraduate nurses were given questionnaires to fill in concerning theviolence at their place of work, including verbal abuse, violence,sexual harassment, or mobbing and physical abuse (Corbet & Hill,2011). A sum of 521 new graduate nurses filled the questionnaire 102(19.6 percent) reported having experienced physical violence, 268(51.4 percent) had been subjected to verbal abuse, and 155 (29.8percent) reported to have been subjected to mobbing/bullying.Additionally, 67 of the participants (12.9 percent) said that theyhave been sexually harassed. Moreover, most reported that working onnight shifts increased the chances of sexual harassment.
Onthe other hand, a similar report conducted in Australia determinedthat most of the new graduate nurses are usually bullied. Bullyingoften took place in the critical care (18 percent), operating room (9percent), surgical care (23 percent), emergency areas (12 percent),and in the obstetric care, at 18 percent (DeFer, Knoche, &Sateia, 2013). The perpetrators of these new graduate nurses includedthe physicians (8 percent), the nurse managers at 14%, the chargenurses at 17 percent, and the senior managers (24%), and otherhospital staff.
Bullyingthese new graduate nurses has both the psychological and thephysiological effects on them. It also has an adverse implication onthe patient care and the organization as whole (Feldman, Alexander, &Greenberg, 2011). It makes these new nurses experiencedissatisfaction in the workplace, lower morale and decreasedproductivity. It thus threatens their well-being, making them offerlow-quality care.
Cultureand Reality Shock
Whenthe new graduate nurses leave the classroom setting, they usuallyleave behind the culture of the college student, which they are morefamiliar with, which they have mastered, and the one they are mostcomfortable in. They then join the hard culture of acute care nursingthat has a lot of inefficiencies, overload, high acuity andcomplexity (Holmes, 2012). As such, the culture shock usually putsthese new nurses into confusion and role strain, as they leave behindthe role of the student nurse, and embrace the registered nurse role.
Inthe contemporary investigation conducted in Canada concerning thecultural shock of the graduate nurses by Kenefi & Young (2013),800 graduate nurses were presented with questionnaires to fill in.156 participants (19.6%) reported having experienced the languagedifficulties with the patients, as well as among the staff. 200 (25%)members said that their religious beliefs affected theirperformance. For instance, some Muslim patients could not accept tobe attended to by a female graduate nurse (Kenefick & Young,2013). More so, 123 participants, 15.4% reported having differentsocial behavior from their colleagues, which included different timemanagement. Lastly, due to culture shock, 40% (320 participants) ofthe new graduate reported having been discriminated due to theirethnicity and race. Additionally, about 75% stated that they foundmost of the thing at the workplace very different from what theyexpected. As such, most of them claimed that they took most of thetime “acting” like a nurse as they were not yet aware of how to“be” a registered nurse. According to Fraser et al (2014), suchan act in nursing literature is called the imposter phenomenon.
Theculture shock can also be brought about by the role transition of thegraduate nurses. The role transition can be defined as the experienceof a person linked to joining the new community of practice (Huber,2012). It a process that is developmental, and dynamically connectedto the critical tasks, emotional work, as well as diffusion throughthe boundaries of role, to assume another new identity with knowledgeand values for the new role. From the same study, the new graduatenurses under investigation confirmed that they get the confusion ofidentity as they become a novice in their new practice (Kralick &Van Loon, 2011). However, the reason can be the lack of understandingconcerning the functioning of the organization, thus becoming achallenge striving to reform their identity as they maintain thelinks with practice.
Thecompetency and technical skill challenges involve both the specialtyspecificity of care and the generic competencies in the day-to-daynursing practice, which is supposed to have been acquired in theacademic education. Astudy was conducted in Germany to investigate the perception of thenew graduate nurses to the theory-practice gap, and their practicallearning, including how it affects them in the new fields ofpractice. A sample of 61 graduate nurses participated in the study bycompleting the surveys (McIntyre & McDonald, 2012). A largenumber of the new graduate nurses (90%) reported that the supervisionof the nursing preceptors was insufficient. Additionally, all of themsaid that the simulation of patient care units was insufficientlyprepared. Only 40% had the chance to practice their skills duringtheir first year in the nursing profession. The theory-practical gapperceived by the respondents was 78%. Thereis typically a knowledge gap between the theoretical base and thepractical dealing with the patients, especially during the nursingconsultations, as well as doing the physical examinations. To thesenursing graduates, the lack of abilities to develop some proceduresis regarded a lack of preparation and competence in the professionalpractice (Bauman, 2013). As such, there are times when the graduatenurses feel vulnerable and believe that they deserve the criticismdirected to them (Stein-Parbury,2011).To do away with this challenge, they usually look for support fromtheir colleagues. Nevertheless, this always fails to indicatesatisfaction and success, because their incompetence was evidenced,and confirmed by themselves.
Onthe other perspective, the high complexity care continues to be achallenge to the new graduate nurses, particularly because thecourses of specialization are usually inaccessible, or nor available.Most of the time, the new graduate nurses get subjected to the highcomplexity care, which leaves them with a lot of stress (Hart, 2014).They are usually placed in the areas that are super-specializedimmediately after school, causing a lot of conflicts for the nurses,and furthermore, causing some extent of risk to the patients. As aresult, the newly graduated nurses usually feel anxiety, anguish, andeven insecurity to give care to the patients in the units that havehigh-complex care.
Thenew graduates are usually overworked. The senior nursing staffusually considers the new graduate nurse as a person who is supposedto do everything, citing that he or she will only gain experienceafter doing so. As a result, these new nurses encounter someexpectations that are not realistic (Holmes,2012).The employers often demand the long working hours from them, and moreso, the employers expect a mentally demanding output from them. Inmost cases, the excessive demands are often accompanied with highaccountability and bullying of the graduate nurses. The researchstudy was conducted in Brazil to determine if team leadership was achallenge to the graduate nurses. From the study, of 300participants, 52% reported that they viewed themselves asincompetent, lacking the leadership skills (Joel & Kelly, 2011).63% said that when they embraced the leadership role, the seniornurse despised them saying that they lacked credibility to lead.Moreover, 55% stated that they felt inferior when they were to workwith a team of more experienced nurses, and thus, contributing was aproblem to them. Apparently, the results of this study show thechallenges of the new graduate nurses.
Additionally,it is usually a challenge for any individual to work in a team, andmore so, to manage it. As such, it is an enormous challenge for thenew graduate nurses to be leaders in a team, given the prejudice ofbeing young, and having petite experience. It is usually difficultfor the new graduate nurses to conquer the credibility of the team,and this becomes a big problem for them. Additionally, taking therole of management poses a massive challenge to the graduates due tothe lack of practical experience, lack of healthy relationship withthe team, as well as the lack of political preparation (Kenefick& Young, 2013).The reason for the management challenge can be attributed to the lackof sufficient training in their education, which rarely addresses thecomplexity of managing or supervising people.
Thechanging from being a student to being a new graduate nurse can bestressful, challenging, as well as exciting. It is a common thing forthe student nurse to be insecure concerning their ability andcompetence to step into the nursing profession. Nonetheless, thetransition provides the students with the opportunities andchallenges in the equal measure. Some of the opportunities presentedto them include the acquisition of the interdisciplinarycommunication skills, being linked to leadership, meeting theconsistent preceptors who focus on the positives only, as well as theopportunities available for networking. More so, the graduates getthe support throughout their first year, and they can join and becomeactive in the professional associations.
Onthe other hand, the transition is very challenging. At one moment,the student nurse is handling just one or two patient. After thetransition, the graduate nurse is supposed to be accountable for morethan six patients, which is very overwhelming. As such, the graduatenurse is subject to excessive demand, leading to pressure.Additionally, they are subjected to high-complexity care, they arerequired to learn the critical way of thinking, and more so, they arefaced with the challenges of team leadership and managementdifficulties. Furthermore, the graduate nurses face the challenge ofinadequate technical and competence skills.
Thebullying allegations must be investigated, and the organization mustbe responsible. To implement this, policies need to be in place tohandle the investigations concerning bullying and “zero tolerance”when it is confirmed to be present (Hart, 2014). Moreover,whistleblowing needs to be encouraged, and the victims should beallowed to present their grievances to the seniors.
Recommendationfor culture and reality shock
Copingwith culture and reality shock depends on the personality of theperson. Nonetheless, the new graduate students can significantlybenefit from mentorship programs, which can assist them to balancethe culture and reality shock with their transition. The relationshipbetween the graduate nurses and their mentors should be mutual, andable to determine the strategies to support during the new workplaceadaptation (McDonnel, 2010). Nevertheless, the success will alwaysdepend on the enthusiasm, commitment, drive, and personalities ofboth the new graduate nurse and the mentor.
Recommendationfor theory-practice gap
Theeducation systems of nursing should reexamine the current practicallearning methods and look for the ways that will better prepare thenurses of the future generation. Bridging the gap will enhance thestudents’ opportunities for learning and their working conditions.More so, the students need to get the motivation to learn as theyreflect on practice (Holmes, 2012). The learning institutions shouldalso offer the teaching based on evidence, which reflects the presentnursing environment. Lastly, the senior nurses should support thedevelopment of the new graduate nurses as this will empower them toperform.
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