Challenges Of The New Graduate Nurse/Midwife

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Critically discuss the challenges that may be encountered by the new graduate nurse/ midwife in one of the following areas within this domain:

1. Practicing within an evidence-based framework

According to The Nursing and Midwifery Board of Australia (NMBA: 2012, p.6)

decision-making within a sound risk management, professional, regulatory and legislative framework is a considered, rational process that enables nurses to work to their full and potential scope of practice.

The NMBA sets out Statements of Principles which provide guidance to nurses regarding processes that will help to ensure that ‘safety is not compromised’ regarding decision making about nursing practice. According to the NMBA, the fundamental motivation for any decision about a care activity is to meet clients’ health needs or to enhance health outcomes. Decisions regarding activities are made in a planned and careful manner and: ‘only where there is a justifiable, evidence-based reason to perform the activity’ (NMBA: 2012, p.6). Furthermore, the NMBA points out that nursing practice decisions are more effective in a collaborative context of planning, risk management, and evaluation. Thus, organisational employers/managers, other health workers and nurses’ work together in sharing a combined responsibility to design and maintain: environments (including resources, education, policy, evaluation and competence assessment) that support safe decisions and competent, evidence-based practice to the full extent of the scope of nursing practice.

This position of the NMBA is also backed up by Australian Nurses Federation Competency Standards (ACHS) for registered nurses. As Barnard (2012, p.243) points out, the ACHS Evaluation and Quality Improvement Program (EQ...

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...rst 6 months of practice, a finding confirmed by Duchscher (2001). With experience, new nurses find that they are able to cope up with an increasing number of different clinical problems and develop confidence after managing similar situations in an acceptable manner over time. Their relationships with expert nurses change and they are more likely to engage in interdependent decision- making and clinical judgement. They are distressed, however, if their judgements differ from those of more experienced nurses (Benner et al. 1996). New nurses focus on caring aspects of nursing only after they gain confidence in their abilities to cope up with the more obvious demands of client and nursing unit situations. With experience, they report more involvement with clients and families, and a return to the holistic care that they conceptualized as students (Duchscher 2001).

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