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The journey of transition of a nursing student to a registered nurse can come with a sea of emotions. This transitional phase can be both challenging as well exciting for the young graduates. There is a happiness in these young graduates, on entering into a new professional phase of their lives, but it also tagged along with a substantial amount of fear, anxiety and uncertainty as well (Kaihlanen, 2018). These situational scenarios can also force these individuals to often judge their own capabilities and expertise. It might also lead them to questioning, whether they have made right career choice or not. The profession of nursing involves taking care of a human life. There is always a strong subjectivity associated with clinical practices. This can also create a situation of stress and dilemma for the nursing, while managing patient care. Especially, the young nurses might feel insecure and insure about their ability as a healthcare professional as a whole (Wall, 2018). These conditions might give rise to multitudes of other issues, evidently affecting the overall delivery of safe and healthy clinical services to the patients.
There are multiple issues faced by young nursing graduates on a daily basis. Being new to the practical field of work, they might find themselves in the position of struggling with some common concerns. Some of these commonly observed concerns include time management, especially in emergent case scenarios. They might not have adequate knowledge on the basis of theoretical conceptual framework (Regan, 2017). As they lack a good amount of experience, they might also lack a sound clinical decision making. in terms of executing technical skills, they might find themselves lacking the ability to have the exact required skill set at a given point of time. These young graduates might also be lacking behind in proper documentation of assessing a patient in a holistic manner. Due to insufficient amount of experience in the clinical field and with an inadequate professional competency, these young nursing graduates might also fail to prioritize their tasks (Ebrahimi, 2016). This might land them in unwanted distress and inability to cope up with the unexpected turn of events, they might be subjected to. All these underlying factors, tagged along with performance anxiety can also be the root cause of increasing the chances of errors by multiple folds (Zoni, 2018).
There are various transitional strategies that can be used to effectively manage this transitional phase. This can vary with the team members and the workplace these young and aspiring graduates are placed into. Two of these methods can be preceptor program and mentoring program.
Mentoring can be deemed as an essential component when it comes to educating the nursing as well as the managerial staff in a workplace. Mentoring process not only helps the nurses, but it can also help in highlighting the grey areas of concerns of these graduates. It can also be a sound medium of information exchange, which can serve a medium for exchanging new ideas with the old working staff. These advanced ideas can be inculcated in daily clinical practices and will be helpful in improving the overall patient healthcare outcomes as well (Lavoie, 2020).
Mentoring can also be reflected upon as vital process in nursing, where experienced nurses can orient and educate novice nurses, helping them to acclimatize within the new environment. Through the means of this process the experienced nurses can guide the young and aspiring nurses towards purposeful and responsible action making. They can help these young graduates by educating them, guiding them, teaching them and inspiring them, to be constantly engaged in the process of continuous development. The process of mentoring is also crucial to be used in place, to help and support these young nurses with professional expertise, competency and enhancing their leadership qualities.
The process of mentorship benefits both mentor as well as the mentee, by being constantly engaged and committed towards their profession. Both personals engaged in this process can share their individual thought process and ideology (Chang, 2019). This will be fruitful in enhancing both professional as well as personal growth. This bidirectional relationship should however, be build on trust and respect for each other’s ideas and values as well. This is important to narrow down the chance of any conflicts, both in dialogue as well as ideology. Thus, ensuring harmony at the work place.
A mentor can teach the mentees on the clinical application of the theoretical concepts in the workplace. With adequate amount of experience as well as exposure to the medical field they can guide these individuals on the “Do’s” and “Don’ts” of the clinical field. Apart from imparting clinical skills, it is imperative that these healthy practices are followed with due diligence to ensure good leadership in the work place. These formal trainings can serve as a foundational ground for preparing and molding these young graduates into a professional and responsible human being as well. These mentorship programs also help in promoting and practicing evidence-based clinical services and thus, helping in reducing the chances of errors considerably. Mentor can also recognize young scholars with potential of becoming a good leader and can help them in shaping to be adequate and efficient enough to adjust in their new role (Lavoie, 2019).
Apart from giving advice on managing difficult situations, a mentor can also teach them on the common ethical and legal concerns. They can guide these young and enthusiastic graduates in learning and practicing work place ethics and thus, molding their attitudes towards a positive reinforcement in their respective behavior (Rush, 2019). The trusting relationship between the mentor and the mentee, can help with constructing long lasting professional friendship, eventually leading to staff retention in the work place, by the means of promoting healthy and robust work environment.
Support can be considered as the main factor in making sure that the transition of nursing graduates from a novice level to the advanced level is a smooth one. The role of preceptor program has been found to be quite useful for young nurses, helping them get settle in the system of working in an effective manner. The designing of these preceptor programs is done in a manner to make sure that they deliver positive and improved outcomes, within the first six months of it getting into motion (Irwin, 2018). These programs are also planned in a manner that helps the registered as well as the new nurses to get acquainted to the cultural shock they might experience after getting into the practical field of work. This narrowing of gap can be quite useful for the nurses to connect the missing link between the theoretical knowledge and framework with the practical and conceptual framework.
These preceptor programs are also crafted in a manner, that provides a robust medium of interaction between the new joiners in the field and the experienced nursing working constantly engaged in the process of patient care delivery system. By working closely with an experienced professional, young and enthusiastic nurses are able to enhance their confidence level, competence and eventually gain more autonomy in decision making process, while rendering care to the patient (Kurniawan, 2019).
The role of preceptor can not only be restricted to guiding the fellow nurses in their journey of clinical learning, but can also help them in developing their personal as well as professional attitude. This can also be deemed imperative from the point of view of overall growth of the individual as well as the process as a whole.
A supportive environment forms the foundational grounds for ensuring successful transition. The environment should encourage full participation of the newly registered nurses in the process, providing them with a window of opportunity to gain and develop their clinical skills, patient management skills and thus, improving on their overall clinical competence in enhancing patient outcomes through the means of advanced care practices (Quek, 2019). This will also be a boon for improving their confidence level in patient dealing. This transition phase should also enable the nurses to raise their individual concerns, so that they can feel welcomed and comfortable in their new working environment. This is crucial from the point of view of identifying early stages of anxiety and stress in the new nursing graduates.
Planning is another strategy that can be adopted by the experienced nursing graduates and the managerial staff involved in this process. Methodical and strategic approach is very necessary for the nursing students to get a fair chance to understand and be aware of few of the common and potential challenges and issues, that they might come across during this transition phase. This will help them in developing coping and managing strategies for future instances and will also encourage sound and prompt decision-making capacity in them (Mansour, 2019). This will also be helpful in making the process of patient care a positive inference to be referred from, rather than having a negative predisposition on the nurse as well as the patient.
Preceptor can also help these newly registered nursing graduates in taking care of themselves as well. This is imperative from the point of view of maintaining a healthy work-life balance and thus, allowing them to adapt religiously in their new role of patient care and transition at the same time (Wardrop, 2019). While this transition phase can be quite turbulent for the nurses, they are required to hold a strong ground both personally as well as professionally. This habit has to be manifested from an early stage of life, ensuring the practice to be followed with due diligence in later stages of patient care as well.
Various strategies can be followed to make sure that not only a smooth but a positive transition from student nurses to registered nurse practioners is taking place. Some of these strategies can include promoting open communication channel between different personals working at different organizational level, ensuring adequate amount of workforce to handle the work pressure, leaders should be approachable at any point of time, the administration should be all ears to the concerns and issues of the staff and should be delivering justice to the same in a non-bias manner.
The young nurses should also be provided with timely feedback for their respective actions, so that appropriate ramifications can be done in accordance with the same. The working environment should also enable staff development opportunities, to help these young students overcome their fears and hesitations. Apart from professional support, the presence of morale support is also required from the senior staff, so as to manage stress and anxiety at the work place. It is a bidirectional relation between the junior and the senior staff and therefore, if the young nursing graduates are facing any issue, they should immediately inform their senior subordinates. This can help in overcoming the difficulties in an effective and comprehensive manner and will add to the ease of smooth facilitation of the transition period of novice nurse to an advanced level nursing professional.
Chang, L. C., Chiu, C. W., Hsu, C. M., Liao, L. L., & Lin, H. L. (2019). Examining the implementation of teaching and learning interactions of transition cultural competence through a qualitative study of Taiwan mentors untaking the postgraduate nursing program. Nurse Education Today, 79, 74-79. https://doi.org/10.1016/j.nedt.2019.05.020
Ebrahimi, H., Hassankhani, H., Negarandeh, R., Gillespie, M., & Azizi, A. (2016). Emotional support for new graduated nurses in clinical setting: A qualitative study. Journal of Caring Sciences, 5(1), 11. https://dx.doi.org/10.15171%2Fjcs.2016.002
Irwin, C., Bliss, J., & Poole, K. (2018). Does preceptorship improve confidence and competence in newly qualified nurses: a systematic literature review. Nurse Education Today, 60, 35-46. https://doi.org/10.1016/j.nedt.2017.09.011
Kaihlanen, A. M., Haavisto, E., Strandell‐Laine, C., & Salminen, L. (2018). Facilitating the transition from a nursing student to a Registered Nurse in the final clinical practicum: a scoping literature review. Scandinavian Journal of Caring Sciences, 32(2), 466-477. https://doi.org/10.1111/scs.12494
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Wardrop, R., Coyne, E., & Needham, J. (2019). Exploring the expectations of preceptors in graduate nurse transition; a qualitative interpretative study. Nurse Education in Practice, 34, 97-103. https://doi.org/10.1016/j.nepr.2018.11.012
Zoni, S., Verga, M. E., Hauschild, M., Aquarone-Vaucher, M. P., Gyuriga, T., Ramelet, A. S., & Dwyer, A. A. (2018). Patient perspectives on nurse-led consultations within a pilot structured transition program for young adults moving from an academic tertiary setting to community-based type 1 diabetes care. Journal of Pediatric Nursing, 38, 99-105. https://doi.org/10.1016/j.pedn.2017.11.015
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