Transition to Professional Nursing

Introduction to Transition to Professional Nursing

This assessment outlines the transition to professional nursing practice. The background of the case study determines the struggle faced by a novice registered nurse (RN). Transition from a nursing student to a new graduate nurse of a hospital will never being an easy task. Moreover, this transition can be demanding, challenging, and stressful for the newly qualified nurses. These challenges are more complex form the situations they confront during their classroom studies. It is difficult to maintain the balance between professional role requirements and personal life (Hampton et al., 2020). All novice registered nurses will face this struggle individually while working. While on shift, it is often challenging task to manage the team dynamics and organizational skills. So, it is necessary to gain well equipped correct knowledge before getting the transition to workplace. To give the best care to the client, it is important to maintain the teamwork and effective communication and skills with the new registered nurses. Moreover, government is also supportive towards the nurse transition state and provided a ‘preceptorship framework’ to develop their careers. This framework recommends to improve the nursing education and professional development to provide high-quality work (Mellor & Gregoric, 2016).

Discussion on Transition to Professional Nursing

By analyzing the case study of Alex, it is clear that he is facing several difficulties while managing his roster. He is tired and frustrated with himself that he may missed other things during shift or get late while finishing his work. Although he comes 15 minutes early to his duty and work extra 30 minutes after end of duty, but still he is still not able to maintain work/life balance. After getting home also he used to think about his shift planning.

The major responsibility of newly graduated nurse is to provide the best possible care to the patients. It is important for a new nurse to get fit into the role and establish positive and productive working relations with other staff members. To work collaboratively with the healthcare team and actively participate following the duties can lead to the proper nursing care of the patient. It is the utmost responsibility of graduate nurse to clarify their doubts or unclear questions and other decisions which they don’t understand properly, because even if they work as team still, they are only responsible for their decisions. They must use evidence-based healthcare practices to enhance the nursing strategies and patient care (Murray et al., 2017). During transition period, nurses must understand their roles and responsibilities as professionals, and are able to make decisions about delegate tasks. Delegation is when one person appoints his/her task to someone else. Statistics defined that approximately 60% of the nursing staff consists of novice registered nurses, which lacks the professional skills of delegation. Contradictions may arise among the theoretical and practical experience for graduated nurses, because theoretical they have taught about the work word values, but practically they would have to face the delegations. Delegation is a skill which is really needed to be learned by a newly registered nurse. Moreover, it is also important for RN to develop a proper plan for their practice (NMBA standard 5, 2016). The planning and communication of nursing practice is the prime importance of the RN to follow in their duties.

Graduate nurses meet their roles and responsibilities depending on the situation. Sometimes, it is easy to tackle the patient, but on the other hand it is equally difficult sometimes to manage the balance between work and personal life. As in case of Alex in the mentioned case study, he is not able to maintain the work/life balance due to the workload of the new profession. Although, it is recommended to undertake working strategies to provide the best care to his patients. The strategies followed by the RN in decision making and providing safe and best quality of nursing care to the patient are critical in nature. To meet the role of RN, it is necessary to use ethical framework for making decisions and develop safe and new practices for patient care. This also support the Nursing and Midwifery Board Australia (NMBA, 2016) Registered Nurse Practice Standard number 1, which justifies the critical thinking and analysis of nursing practice.

Registered nurses have several skills and knowledge which they can use for utilisation of technology and teamwork skills, such as-

They can work in various healthcare sectors, like nursing care as well as government facilities.
They know how to interact with elderly patient and deal with them.
Other skills like communication, teamwork, maintaining positive environment are also inherent in the RN.

The recommendations followed by the graduate nurses is to develop skills by help of the available preceptorship, develop patience while monitoring the patient, respect all the team members and patient regardless of their age or background, and always be confident while working. Graduate nurse must follow the five-phase model while undertaking their shifts for development of organization, named as “team spirit model”. Initially this model says that it is important to introduce ourselves with other team members and share each other’s outlook and point of view. This will help in building trust within the team members. The second stage is about to share the vision and assumptions of ourselves related to work with the team. Third phase is to do the assigned work as a team. Moreover, celebration of recognition is also important to get the nurse encouraged with their role, and sharing of success stories will lead to make the team bond stronger. This is the fourth stage of the model. The last stage is to ensure the effective communication among the team members with a guiding principle of ‘seek first to understand and then to be understood’ (Hussein et al., 2017). Overall, this model is a way to open up and start team interaction for the graduated nurses, so it is highly recommended. Moreover, as per the case study views, the graduate RN could have undertaken this shift differently by following the recommendations shown below-

As in the case study, Alex face several issues while doing his duty. To relive his nervousness and anxiety, healthcare staff and other professional nurses must encourage his work and build a positive relationship and bond with RN to make them more comfortable with their working schedule.
Delegation is also faced by Alex in the study. Novice RN might don’t have sufficient knowledge to tackle with the delegation task. So, it is also important to provide them sufficient information to deal with the situation of delegation. Also, they must have knowledge about basic life support, and blood extraction before getting into professional field.
Another important recommendation is to undertake the internship programs, mentorship and preceptorship provided by the government to get prepared to work as professional nurse. To reduce the stress of new graduate nurse and enhance their job satisfaction, transition-work programs must be conducted.
Alex has faced tiredness and frustration while maintain his roster and work/life balance. To maintain the physical and mental health along with the work is equally important. So, it is recommended to do more physical exercises such as meditation or yoga to deal with this stressful condition and maintain the mental health.

(Mellor & Gregoric, 2016).

New graduate nurses not only face happiness and excitement, but they also go through uncertainty, anxiety and stress. This may be the time when they question themselves that weather their decision of carrier choice is right or not and weather they will be like other professional nurses or not. The insecurity and unsure feeling about their own ability is common factor in new nurses. Nurses daily deals with wide information of patients, due to which they have limited time to gain new knowledge or evidence-based findings from other professional nurses and healthcare staff. Some common difficulties faced during transition from student to graduate registered nurse are:

Theoretical and practical gaps
Decision-making process
Care of complex patients with comorbid diseases
Management of time
Medical administration
Skills for assessment and documentation of patients
Less expertise to execute technical skills
Shift work and accountability
Developed competition in planning and organizing
Deal with unexpected events or mistreatment
Performance anxiety and stress
Lack of access to experienced mentors (Wong et al., 2018).

Although there are several difficulties faced by the novice nurses, but with some cautions they can easily deal with this situation and maintain their work/life balance during this transition period. These strategies are discussed below:

By help of adequate staffing patterns
Openly communicate to other nurses and mentors
Approach leaders for support
Orientation programs and trainings with realistic goals
Proper guidance from senior staff members
Establishment of constructive feedback
Take support while dealing with complex patients that are at state of deuteriation
Meditate or exercise regularly to reduce the stress levels
Seek for help by mentors, nursing leaders, or other co-workers whenever required (Murray-Parahi et al., 2016).

There are several evidence-based strategies that could be implemented to promote resilience, build capacity, and support work/life balance during the graduate RN’s transition period. This can be made possible by the management of healthcare organization as-

The managers can support and encourage the graduate nurses so that they will feel more motivated, secure and comfortable with their work. In the mentioned case study also, Alex feels nervous while for his nursing activities. So, it is important to provide support and sufficient introductory period of learn the new job for nurses to build confidence in them. Moreover, Implementation of different approaches like internship programs, professional practice of skills, preceptorship, and mentorship are carried out to promote the building capacity of graduate RN and provide them support to maintain their work balance.
Providing real-life clinical experience during education can promote resilience among the graduate nurses. Problem solving and various analytical skills should be practiced before working as a nurse to develop their professional skills. The manager should also take the responsibility for well-being of the graduate nurse by providing them personnel, finance and feedback to learn. These measures will eventually help them to learn how to make balance between the work pressure and personal life (Transition to professional nursing practice, 2020).

Conclusion on Transition to Professional Nursing

Finally, by this study it is concluded that it is not easy for novice registered nurse get instantly familiarize in the new working environment with other healthcare professionals. They need to develop their skills and learn to manage their time and work/life schedule. To work efficiently, it is necessary to be in a healthy professional relationship within the team. It is the responsibility of new registered nurse to fit well into the team, so that every member of the team can work effectively. Nurses daily deals with wide information of patients, due to which they have limited time to gain new knowledge or evidence-based findings from other professional nurses and healthcare staff. To meet the needs of new graduate nurse, immense support should be provided by the other team members of healthcare system. This will help in building confidence and trust in them while working. For providing the best possible care to the patients, it is utmost important to maintain the teamwork and effective communication and skills with the new registered nurses.

References for Transition to Professional Nursing

Hampton, K. B., Smeltzer, S. C., & Ross, J. G. (2020). Evaluating the transition from nursing student to practicing nurse: An integrative review. Journal of Professional Nursing. doi: 10.1016/j.profnurs.2020.08.002

Hussein, R., Everett, B., Ramjan, L. M., Hu, W., & Salamonson, Y. (2017). New graduate nurses' experiences in a clinical specialty: a follow up study of newcomer perceptions of transitional support. BMC nursing, 16, 42. doi: 10.1186/s12912-017-0236-0

Mellor, P., & Gregoric, C. (2016). Ways of being: Preparing nursing students for transition to professional practice. The Journal of Continuing Education in Nursing,47(7), 330-340. doi:10.3928/00220124-20160616-10

Murray, M., Sundin, D., & Cope, V. (2017). New graduate registered nurses’ knowledge of patient safety and practice: A literature review. Journal of Clinical Nursing,27(1-2), 31-47. doi:10.1111/jocn.13785

Murray-Parahi, P., Digiacomo, M., Jackson, D., & Davidson, P. M. (2016). New graduate registered nurse transition into primary health care roles: An integrative literature review. Journal of Clinical Nursing,25(21-22), 3084-3101. doi:10.1111/jocn.13297

Nursing and Midwifery Board Aphra (NMBA). (2016). Registered nurse standards for practice. Retrieved from: https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-for-practice.aspx [Accessed 28 Aug. 2020]

Transition to professional nursing practice. (2020). Place of publication not identified: SAGE PUBLICATIONS.

Wong, S. W., Che, W. S., Cheng, M. T., Cheung, C. K., Cheung, T. Y., Lee, K. Y., . . . Yip, S. L. (2018). Challenges of fresh nursing graduates during their transition period. Journal of Nursing Education and Practice,8(6), 30. doi:10.5430/jnep.v8n6p30

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