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Transition to Practice

Introduction to Transition to Practice

The term transition can be defined as the movement of a person from one state to another, one situation to another or from one place to another (Ankers, 2018). This phase is capable of bringing about a drastic change in the daily routine of the person. These transitional phases are regulated by multiple factors such as preparation, planning or based on the knowledge of an individual. The transition of a nurse from a young nursing graduate to a professional can be filled with such parameters as well. The phase for the nurses can be full of excitement or fear, to face the new challenges they might encounter in their new phase of life (Powers, 2019). In the initial year of clinical posting, a graduate nurse can find himself or herself, in a situation never encountered before. These young graduates might lack the required skill set needed to practice their knowledge in a confident manner.

Even with the apt knowledge, these nurses lack behind on competent delivery of tasks assigned to them. In totality, without a doubt the transition phase can be complex as well multidimensional. This can be inculcated of many factors such as physical, intellectual, emotional, developmental, socio-cultural and so on, to be taken into consideration (Bakon, 2018). These factors are considered while analysing the role of graduate nurses in this phase. For these nurses to progress they need to communicate with their senior subordinates and should also be exposed to multitudes of experiences. This will be helpful in not only shaping them as an individual, but also ensuring safe clinical practice and continuity of care to the patients through a competent and collaborative approach (Dwyer, 2016).

Reality Shock

The biggest challenge that these nurses might face include the reality shock. The theoretical knowledge that is taught, can sometimes vary with the practical implications. To adjust to this phase can be quite tricky for these young graduates. This can however, be tackled by involving in enhanced communication with the senior nurses. Every work environment has a way of working (Kim, 2018). This involves work place codes and conduct, by which the whole staff abides. Prior knowledge of the same can be quite helpful in this transition phase. Some of the young graduate nurses might lack the basic knowledge on performing certain procedures. Whereas, some of these nurses can be very good in theoretical concepts, but might lack the ability to out those concepts to work. These nurses can take assistance of the experienced nurses to help with the task. When a young nurse enters a working place, they should also allow themselves sufficient time to adapt well in the work place culture. By keen observation of the system of working and noting the do’ s and don’ts, these young graduates can not only groom themselves, but can also lower the chances of errors that might occur during patient care and coordination (Kim, 2020). The important points can be noted down at the time of orientation, so that no communication gap is left behind while treating the patient. This collaborative approach can also help them in grasping newer skill sets as well. Thus, improving their overall efficacy of work, with the required competence.

Organizational Structure

It can be difficult for a new nurse to work with multiple staff initially. These young graduates lack the knowledge of the working of system, let alone coordinate with their colleagues. However, positive outcomes can only be attained, when there is a positive and supportive organizational structure. It is important that each and everyone’s view point should be included while doing so. These nursing graduates can help in building a strong leadership in the work place (Warren, 2018). They can learn clearly about the goals, objective, resources involved and the vision statement of the working place. A strong and robust communication channel should be established with the leaders in the work place. These team leaders can help in empowering participants, communicating the strong vision, providing the required resources and enabling good listening skills. All of these factors can be helpful for a young registered nurse, in knowing the dynamics of the work place and adopting themselves in accordance with the same. Strong organizational structures can also help in building a problem-solving and morale boosting environment for the young graduate nurses to work in. This will also help in these nurses in the process of enhancing their learning and being open to have an opinion of their own, as an integral part of the team (Laschinger, 2016). This team effort will also be fruitful in enhancing and improving the method of patient care and coordination in the healthcare setting. With a hearty and capable involvement of the senior nurses the prioritization of the task can be attained.

Managing Emotions

There is an underlying stress and fear in the young nurses, that despite having the required knowledge, they might fail at executing a task assigned to them, with the required level of competence. They might feel themselves being unprepared and unable to act on an independent basis. The work community as well as the atmosphere, plays a significant role in the transition experience of these young nursing graduates (Mellor, 2016). The nurses are also aware of the fact that there are certain expectations from them. This factor also might add to the anxiety of these young nurses. The perceived demand in the field of nursing can be quite high, when it comes to taking responsibilities. However, the young nurses should be true to themselves and to their seniors as well. In the initial phases of transition in the new role, these nurses should allow themselves to adapt in the new setting. Any challenges that they might face should be told to the supporting authorities. This should not only be followed for personal reasons, but to ensure patient’s safety as well, which should be the main priority. These nurses also fear about making errors in the workplace (Wildermuth, 2020). However, this should not hamper in the way of learning. One can be pen to new challenges, which will be helpful in getting a chance at learning new things and adapting coping skill sets as well. They can also try not to over push themselves beyond their bounds. This can become a potential cause of errors.

Professionalism and Conflicts Resolution

Adapting to a new working culture is not as easy at it seems. The nurses can be subjected to ton loads of work during their initial days only. It can be due to the importance of the role of nurses in the patient care and coordination. Nurses having the pivotal role in a healthcare setup, are estimated and assumed to have a certain level of expertise and competence. However, this might not be true for each individual (Rush, 2019). Some of the young graduate nurses might crumble under the pressure and given up on their profession as well. While some may be a victim of bullying by their seniors, for being too slow or being incompetent. In any of the given situation, it is the duty of the young nurses to not give up that easily. An effective therapeutic approach should be adopted to deal with the underlying stress in such situation. These nurses should not only be aware of their duties, but should also be available of their respective rights. It is mandatory to maintain a work-life balance. It is also vital from the point of view of ensuring smooth facilitation of healthy and safe clinical services to the patient (Başoğul, 2016). In case of any disorderly conduct, the same should be reported to the senior authorities for required ramifications. Help from a nurse manager can be included in the dialogue, to play the role of a mediator, negotiating the conflicts between the two parties involved (Moreland, 2016).

Expectation on Quality Improvement

As the young nurses are fresh out of college. They might be well-aware of the new and advanced technologies used in patient care. They might also have a better idea of the newer methods than their senior counterparts. This can however, be an added burden on these young graduate nurses, to excel in their respective field (Murphy, 2017). However, this change can only be brought by being constantly engaged in simulation activities and working towards inculcating these newer methods and techniques. The young graduate nurses can work in a close collaborative environment with their seniors and nurses’ leaders to help in advancing the clinical practice as a whole (Hosking, 2016). The new educative information tagged along with the experience of the senior nurses, can help in drafting advances that can be helpful in enabling patient care and coordination in an improved and profound manner. Constant evaluation of the same should also be done, so that these techniques can be calibrated accordingly, to adapt to the patient’s individual health needs and requirements. Thus, enabling overall improved healthcare outcomes in the patients.

Conclusion on Transition to Practice

Lack of confidence in the new nurse graduates can be one of the most valid reason, as to why they may feel stressed in their transition phase. There is a dire need of extensive cooperation between the young nurses and nurse leaders, to make sure continuity of care is established and patient safety and security should be promoted at all times. This will also help these aspiring graduate nurses to develop coping and management strategies, to deal with strenuous situations over the due course of time. Proper time and assurance should be given to these nurses to adapt well in their new working environment and thus assuring their full competence, while executing tasks assigned to them.

References for Transition to Practice

Ankers, M. D., Barton, C. A., & Parry, Y. K. (2018). A phenomenological exploration of graduate nurse transition to professional practice within a transition to practice program. Collegian25(3), 319-325. DOI https://doi.org/10.1016/j.colegn.2017.09.002

Bakon, S., Craft, J., Wirihana, L., Christensen, M., Barr, J., & Tsai, L. (2018). An integrative review of graduate transition programmes: developmental considerations for nursing management. Nurse Education in Practice28, 80-85. DOI https://doi.org/10.1016/j.nepr.2017.10.009

Başoğul, C., & Özgür, G. (2016). Role of emotional intelligence in conflict management strategies of nurses. Asian Nursing Research10(3), 228-233. DOI https://doi.org/10.1016/j.anr.2016.07.002

Dwyer, P. A., & Revell, S. M. H. (2016). Multilevel influences on new graduate nurse transition: A literature review. Journal for Nurses in Professional Development32(3), 112-121. DOI 10.1097/NND.0000000000000265

Hosking, J., Knox, K., Forman, J., Montgomery, L. A., Valde, J. G., & Cullen, L. (2016). Evidence into practice: Leading new graduate nurses to evidence-based practice through a nurse residency program. Journal of Perianesthesia Nursing31(3), 260-265. DOI https://doi.org/10.1016/j.jopan.2016.02.006

Kim, E. Y., Yeo, J. H., Park, H., Sin, K. M., & Jones, C. B. (2018). Psychometric evaluation of the Environmental Reality Shock-Related Issues and Concerns instrument for newly graduated nurses. Nurse Education Today61, 106-111. DOI https://doi.org/10.1016/j.nedt.2017.11.003

Kim, J. S. (2020). Relationships between reality shock, professional self-concept, and nursing students' perceived trust from nursing educators: A cross-sectional study. Nurse Education Today88, 104-19. DOI https://doi.org/10.1016/j.nedt.2020.104369

Laschinger, H. K. S., Cummings, G., Leiter, M., Wong, C., MacPhee, M., Ritchie, J., ... & Young-Ritchie, C. (2016). Starting out: A time-lagged study of new graduate nurses’ transition to practice. International Journal of Nursing Studies57, 82-95. DOI https://doi.org/10.1016/j.ijnurstu.2016.01.005

Mellor, P., & Gregoric, C. (2016). Ways of being: Preparing nursing students for transition to professional practice. The Journal of Continuing Education in Nursing47(7), 330-340.DOI https://doi.org/10.3928/00220124-20160616-10

Moreland, J. J., & Apker, J. (2016). Conflict and stress in hospital nursing: Improving communicative responses to enduring professional challenges. Health Communication31(7), 815-823. DOI https://doi.org/10.1080/10410236.2015.1007548

Murphy, L. J., & Janisse, L. (2017). Optimizing transition to practice through orientation: A quality improvement initiative. Clinical Simulation in Nursing13(11), 583-590. DOI https://doi.org/10.1016/j.ecns.2017.07.007

Powers, K., Herron, E. K., & Pagel, J. (2019). Nurse preceptor role in new graduate nurses' transition to practice. Dimensions of Critical Care Nursing38(3), 131-136. DOI 10.1097/DCC.0000000000000354

Rush, K. L., Janke, R., Duchscher, J. E., Phillips, R., & Kaur, S. (2019). Best practices of formal new graduate transition programs: An integrative review. International Journal of Nursing Studies94, 139-158. DOI https://doi.org/10.1016/j.ijnurstu.2019.02.010

Warren, J. I., Perkins, S., & Greene, M. A. (2018). Advancing new nurse graduate education through implementation of statewide, standardized nurse residency programs. Journal of Nursing Regulation8(4), 14-21. DOI https://doi.org/10.1016/S2155-8256(17)30177-1

Wildermuth, M. M., Weltin, A., & Simmons, A. (2020). Transition experiences of nurses as students and new graduate nurses in a collaborative nurse residency program. Journal of Professional Nursing36(1), 69-75. DOI https://doi.org/10.1016/j.profnurs.2019.06.006

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