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transition challenges for student nurses to grad nurses
transition to the registered nurse role
difficulties faced by new graduate nurses
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The Big transition: From student to practicing RN
INTRODUCTION
The beginning of a new graduate nurses career rarely begins easily, there seems to be a distinct disconnect between the fantasy of what it means to be a nurse and the reality of bedside nursing. Nursing school seems to feed into this disconnection, in that it does not prepare the new graduate registered nurse (NGRN) for their professional practice. What nursing school does is give the NGRN the basics, a peak into what is to come. The NGRN has to find out for themselves what the true meaning of being a nurse is and if it fits their preconceived ideas.
Once school ends and NCLEX has been passed, the NGRN has the daunting task of finding a place to begin their new career. This is a decision that should not be taken lightly, studies have shown that many NGRN’s change their place of employment or decide to leave nursing altogether in their first year of being hired, as many as 33-61%.(Duchscher, 2009) NGRN have difficulty in many areas when it comes to this big transition, they tend to have a significant difficulty with fear of failure, and the new enormous amount of responsibilities that comes with caring for patients. (Marrow, 2009) Other issues NGRN deal with are those concerning their own performance anxiety, ethical dilemmas, disillusionment, and discouragement. (Duchscher, 2009) Research has found there are facilities that have found ways around this turmoil, to maintain adequate retention of new grads.
PURPOSE
The purpose of this paper is to expose the reader to what perils previous new registered nurse graduates have succumb to. Learning from those who came before us has always been the best way to avoid the same difficulties. Many specific issues have plagued...
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Spence Laschinger, H. K., Finegan, J., & Wilk, P. (2009, November- December). New Graduate Burnout: The Impact Of Professional Practice Environment,Workplace Civility, And Empowerment. NURSING ECONOMIC$, 27(6), 377-383.
Strauss, M. (2009, May 1). Easing the Transition: A Successfui New Graduate Program. The Journal of Continuing Education in Nursing, 40(5), 216-220.
Thomas, C. M. (2010, April 10). Teaching Nursing Students and Newly Registered Nurses Strategies to Deal With Violent Behaviors in the Professional Practice Environment. The Journal of Continuing Education in Nursing, 41(7), 299-308.
Ulrich, B., Krozek, C., Early, S., Hipps Ashlock, C., Marquez Africa, L., & Carman, M. L. (2010, November- December). Improving Retention, Confidence, And Competence of New Graduate Nurses: Results from a 10-Year Longitudinal Database. NURSING ECONOMIC$, 28(6), 363-375.
Nurse horizontal violence towards new nurses and nursing students includes methodical, unwelcome or unprovoked behaviors with the intent to upset, control, humiliate, harm, or segregate (Hutchinson, Vickers, Jackson, & Wilkes, 2006). Horizontal violence can be furtive and shrewd (such as withholding information or spreading gossip) as well as obvious and direct, such as reproaching in front of other staff, false complaints, or threatening body language (Hutchinson et al., 2006). Other forms of the experience, described both in nursing and non-nursing literature, include bullying, mobbing, intimidation, and aggression (Farrell, 2001). Bullies form cliques and engage in repetit...
The national shortage of Registered Nurses (RNs) has helped generate formidable interest in the nursing profession among people entering the workforce and those pursuing a career change. According to a report issued by the U.S. Department of Health and Human Service in 2002, the national population is continuing to grow and age and medical services continue to advance, so the need for nurses will continue to increase. They report from 2000 to 2020 the predicted shortage of nurses is expected to grow to 29 percent, compared to a 6 percent shortage in 2000. With the projected supply, demand, and shortage of registered nurses and nursing salaries ever-increasing, the nursing profession can offer countless opportunities. But first one must determine which educational path to pursue, Bachelor of Science in Nursing (BSN) or Associate Degree in nursing (ADN). Most will initially be educated at the associate degree level, even though the American Organization of Nursing Executives (AONE) has recommended a baccalaureate level as a minimal for entry-level nurses. With the expanding number of RN to BSN programs available there is always the option to further one’s education at a later date. The benefits for acquiring a BSN over an ADN include a better knowledge for evidence-based practice, an increased advantage for promotion, and the necessary gateway for higher education.
There is a shortage of all health care professions throughout the United States. One shortage in particular that society should be very concerned about is the shortage of Registered Nurses. Registered Nurses make up the single largest healthcare profession in the United States. A registered nurse is a vital healthcare professional that has earned a two or four year degree and has the upper-most responsibility in providing direct patient care and staff management in a hospital or other treatment facilities (Registered Nurse (RN) Degree and Career Overview., 2009). This shortage issue is imperative because RN's affect everyone sometime in their lifetime. Nurses serve groups, families and individuals to foster health and prevent disease.
The shortage of registered nurses (RNs) in the United States has been a cyclical topic dating back to the 1960s. Only recently have employers in certain regions of the nation stated a decline in the demand for RNs. Consequently, according to the American Association of Colleges of Nursing’s (American Association of Colleges of Nursing [AACN], 2014) report on 2012-2013 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, American nursing schools denied admission to 79,659 qualified applicants from baccalaureate and graduate nursing programs in 2012. The reported decrease in job availability and rejected admissions has left many individuals to question if the nursing shortage still exists. On the other hand, some experts project that the United States will be short more than one million RNs by 2020 (Dolan, 2011). Although some parts of the country are in less of a demand than others, it is undeniable that there is a national shortage of RNs.
Newly graduated nurses lack clinical skills necessary to evolve professionally and carefully from academics to bedside practice (Kim, Lee, Eudey, Lounsbury & Wede, 2015). How scary is that not only for the patient but also for the new nurse himself or herself? While being faced with new challenges, an increasing amount of newly graduated RNs felt overcome and unqualified. Twibell and Pierre explain how new nurses express “disillusionment” about practice, scheduling, and being rewarded. Frustration and anger between employees play a huge part in NGNs resigning because of the lack of experience and knowledge of what to do in high stress situations (2012). Nursing residency programs have proven to directly improve patient care, develop critical
McNamara, S. A. (2012). Incivility in nursing: unsafe nurse, unsafe patients. AORN Journal, 95(4), 535-540. doi:10.1016/j.aorn.2012.01.020
It has been over one year since I have started the accelerated nursing program at Southern Illinois University Edwardsville. When I first started the program in fall 2014, I have no idea what nursing was like. Although I had my bachelor from another institution, everything I learned was very different compared to the information I have learned in School of Nursing. Nursing school has slowly transformed me into a graduate professional nurse based on the professional development that I have completed along the way.
However, upon securing a job, they find that things on the ground are not as they had expected them to be and this results in some of them deciding to leave the profession early. Research shows that turnovers within the nursing fraternity target person below the age of 30 (Erickson & Grove, 2011). The high turnover within the nursing fraternity results in a massive nurse shortage. This means that the nurses who decide to stay have to work for many hours resulting in exhaustion. A significant percent of nurses quitting their job sites exhaustion and discouragement as the reason that contributed to their decision. In one of the studies conducted on the issue of nurse turnover, 50% of the nurses leaving the profession argued that they felt saddened and discouraged by what they were unable to do for their patients (Erickson & Grove, 2011). When a nurse witness his/her patients suffering but cannot do anything because of the prevailing conditions he/she feels as if he/she is not realizing the reason that prompted him/her to join the nursing profession. The higher rate of nursing turnover is also affecting the quality of care nurses provide to
According to (Abdollahzadeh, 2016), the issue of incivility in nursing can be defined as “low intensity” deviant behavior with the intent to harm the target. Nurses are subjected to incivility at a higher rate than other job fields, and this concern is one that has an impact on the mental health and well-being of nurses and can lead to a reduction in job satisfaction and employee recruitment and retention
I presume the role transition from academic nursing student to Graduate Nurse will be challenging and rewarding. In their findings, the researchers Doody, Tuohy & Deasy (2012) stated that for a successful transition NGNs need to be competent in a range of domains: interpersonal skills, managing workloads, providing health information, communication, and prioritising care delivery. Although I believe I am competent in the above specified areas, I am still not confident that I would get sufficient support in the hospital environment in terms of knowledge sharing, moral support and being given constructive feedback. Constructive criticism increases confidence in the work role and reduces stress in an individual (Doody, Tuohy & Deasy, 2012). In my previous professional placements I have been able to demonstrate my competency to work in the healthcare environment. I have received positive feedback from placement educators, buddy nurses and patients. Despite being competent in a range of the above areas NGNs may still face transition shock.
The transition from student to a qualified nurse can be a stressful and overwhelming ex-perience for many newly qualified nurses. This opinion is widely upheld throughout the literature with Higgins et al (2010) maintaining that many of the problems experienced are due to lack of support during this initial transition and a period of preceptorship would be invaluable.
Kearney, N.R. (2012). Advancing your career: Concepts of professional nursing (5th ed.). Philadelphia, PA: FA Davis
Management spends several hundred dollars for each new nurse that it hire and train. Using Benner’s theory, and investing in nurse retention will decrease costs, as well as having resulted in better patient outcome. A savings of one and one- half to two times of a salary is estimated to have occurred in reducing nursing turnover (Friedman, Delaney, Schmidt, Quinn, & Macyk, 2013). During my first four to five years in my current post,. I noted there to be an increase in novice and advance nurses not staying very long. Upon doing exit interviews it was brought to my attention, that the orientation, he or she received was not enough to make them feel comfortable. The nurses felt that he or she had been rushed through orientation, and did not feel confident in dealing with some
Siviter, B. (2008) The Newly Qualified Nurses Handbook. A Survival Guide. Edinburgh: Balliere Tindall Elsevier
Hill, S. S. & Howlett, H. A. (2009). Success in Practical/Vocational Nursing: From Student to Leader. (6th ed.). St. Louis, MO: Saunders/Elsevier .