CNA250 Nursing Practice 2

New nurses experience during transition from academia to practice

Introduction

In Australia, majority of the registered nurses are usually obtained from the newly graduated university students that have completed the bachelor Degree in Nursing. Both the recruitment as well as retention of new graduates is considered to be a very important activity to the healthcare system (Arrowsmith, Lau-Walker, Norman, & Maben, 2016). The newly recruited nurses into practice need support during the transition from being a student into a registered nurse. Clinical experience leads to development of the nursing profession .This experience is often achieved through participating or experiencing the real clinical practice.

In the ever changing healthcare environments, one thing that has remained constant is the demand for nurses. In Australia, the need for nurses is very critical at this moment than ever before. There is increase pressure under clinical practice to operate in a lean and efficient manner due to the reduced reimbursements and increased regulatory oversight (Ashley, Halcomb, & Brown, 2017). This pressure demands that nurses produced should be ready to work from the time they graduate from college.

Different stakeholders across the country of Australia should come up with different strategies that that can assist transition of the new nurses from academia to real clinical practice (D’ambra & Andrews, 2013). In this assignment, there will be a discussion on the experiences of the graduate nurses and an evaluation of different strategies that can be used.

Significance of the issue

New nurses experience different challenges as well as stressors. The common challenges include acquisition of new skills, facing new situations and finally becoming familiar with both administrative as well as organizational work structures (Freeling & Parker, 2015). Besides, some of them feel incompetent and fearful of potential mistakes. When the workplace is quite intimidating, unfriendly and disrespectful, it even becomes more challenging for the new nurses.

Studies have linked workplace incivility with distress for the new nurses. Studies have established that this has the potential to affect the quality of care they offer to the patients since the quality of care provided is determined by a dedicated as well as a cohesive workforce (Lea & Cruickshank, 2014). A comfortable working environment can empower the new nurses to provide quality care that they were taught at school. Research also link negative workplace environment to isolation and alienation that negatively affects teamwork as well as cooperation that has severe adverse effects to the patient (Mammen, Hills, & Lam, 2018). The issue of workplace experience during transition is therefore important as it provides information on some of the potential challenges that a new nurse is likely to experience so that they can be better equipped to overcome them.

Discusion

New graduate nurses experience different challenges during their transition into practice. Some of the challenges include increasing number of the patients suffering from different complex conditions as well as multiple comorbidities, bullying, variation in workforce and inadequate experienced coaches as well as mentors (Missen, McKenna, & Beauchamp, 2015). To make the matters worse, studies have found out that this issues happen simultaneously.

Stress and fatigue are the most common experience during transition. Several studies have linked this conditions due to increasing workload of managing different patients, managing relationships with the healthcare providers and their families as well as leading a team of different professional’s (Missen, McKenna, Beauchamp, & Larkins, 2016).If the new nurses are not provided with support, nurses in such kinds of situations usually become overwhelmed and exhausted. They eventually suffer from anxiety that leads to attrition.

Hospitals are admitting many patients who are suffering from different complex conditions. In Melbourne for example, statistics indicate increased cases of heart diseases, cancer, kidney diseases and diabetes (Parker, Giles, Lantry, & McMillan, 2014). The leading causes of this conditions are absent primary care, lack of access to preventive care and the limited funding. Caring for such patients with chronic conditions has been associated with distress among the new nurses.

There is an increased rate of retirement of aged nurses in Australia .In 2014 for example, more than 1234 nurses retired from the service in Australia. This is a very high number when compared to the nurses that get into the service from school (Pasila, Elo, & Kääriäinen, 2017). The increased retirement coupled with few new nurses has led to increased workloads. The retirement of experienced nurses has also made it quite difficult to provide leverage mentoring to the new nurses. Studies have linked coaching or mentorship to successful transition. Lack of coaching to the new graduate nurses has made majority of the nurses’ panic which subjects them to different mistakes during their practice.

It is very important to prevent fatigue since role ambiguity contributes to burn out among different nurses. Different studies have found out that when nurses become burn out and get detached form their work, it leads to more fatigue among the remaining nurses since they have to fill the void left by the detached nurse (Pfaff, Baxter, Jack, & Ploeg, 2013). This according to studies, leads to poor performances that is associated with poor patient safety events.

Some new nurse experience bullying at their workplace. Workplace bullying has been identified as one of the pervasive issue which hinders proper socialization of the newly graduated nurses. Studies have found that one of the reasons why bullying is common is for some nurses to establish total control of their workplace environment(Phillips, Kenny, Esterman, & Smith, 2014) .If the hospitals don’t work hard to prevent bullying, they are promoting unprofessional character. Because healthcare workers have the duty to create an environment ibn which health as well as well-being of both the patients and the nurses is promoted, workplace bullying should be addressed at all costs.

A supportive first year after graduation to the nurses is very important. Research has linked this support with better outcome in terms of patient care by the new nurses since it provides extra support as well as encouragement that is much needed in bolstering professional growth. In Australia, there is a 12 month transition program after nurse graduate from the accredited Baccalaureate program in nursing (Spence Laschinger & Fida, 2014). This transition program provides employment opportunities to the new nurse though its main agenda is to subject them to the workplace environment so that they can have a feeling that will assist them to a greater extent.

Evaluation

There are different strategies that the literature provides which can be used to position the new graduates for success. Introduction of mentorship programs is one of the strategies that can be utilized. Studies have found out that mentoring is known increase the intention of many nurses to stay in practice. Mentorship is also important since it enables the new nurses to attain competency, confidence as well as autonomy. Studies recommend that the mentorship model should be achieved in three phases. The first phase involves developing communication skills and tis are important since they develop interpersonal relationships. Collaboration is the second phase and the rationale for this phase is to ensure collaboration between the mentor and the novice. The final phase is autonomous and this where the novice is given more independence.

Resident program is another important initiative that can be used to ensure smooth transition of the new graduate nurses. This program has already been used in some of the developed countries like the United States of America and could be implemented in Australia as well. The program was initiated back in 2010 in USA dubbed The Future of Nursing. Under this strategy, graduate nurse turnover increased from 20% to 40% (Spence Laschinger, Zhu, & Read, 2016).This initiative is known to meet the educational needs of the new nurses during transition .Besides, it also boosts the confidence as well as the competence upon entry into practice. The program also has the ability to standardize orientation and stabilizing retention. Even though attrition is the biggest worry by different healthcare organizations, studies show that this program has successfully retained more than 75% of the new nurses in the past 3 years in the United States of America.

Involving new graduate nurses in the decision making process is important in enhancing smooth transition into practice. According a study by the Australian Ministry of health, it was established that involving nurses in decisions that has potential to affect their practice can make them better placed to manage different complexities that are associated with the healthcare environment. Hospitals and other healthcare organizations therefore need to implement shared governance which offers the chance to discuss the common issues that impact the new graduate nurses in practice (Zheng, Lee, & Bloomer, 2016). New graduate nurses who are active in decision making are empowered and this has shown greater staff engagement. Studies have also linked interprofessional decision making and a professional atmosphere which is believed to increase respect and confidence among the new graduate nurses.

Academic progression is a strategy that can be used to promote smooth transition among the new graduate nurse. In Australia, there are currently different healthcare reform initiatives as well as heightened complexities among the patient populations. The new nurses are therefore required to synthesize evidence based knowledge and critical thinking skills. However, this is often difficult if the nurses have not attained advance degrees. In the United States of America for example, the National Academy of Medicine provided a compelling case for the need of academic progression. This program should also be implemented within Australia. The Australian government should increase Advanced degrees among the new nurses. The advanced degrees have been linked with increased competencies such as improved critical thinking skills, improved leadership skills, comprehending the changes in the healthcare environment landscape, understanding the importance of quality healthcare and improved decision making skills. All this competencies are known to effectively incorporate the new graduate nurses into practice with much ease.

Conclusion

Transition from new nurse graduate to practice is accompanied by different experiences. The new healthcare environment has a lot of challenges in attempts to ensure that there is balance between the demand and delivery of the healthcare system. New nurses should be adequately prepared for such experiences. There are different challenges that have been previously explained such as bullying and psychological distress due to the heavy workload. Some of the solutions to the challenges have also been provided. A lot of things concerning the new paradigm of health cannot be controlled especially in healthcare. However, there are certain strategies that can be implemented so as to build the confidence of the new graduate nurse as well as their competence during their transition from academia to practice. Some of the programs include advance degrees and mentorship programs. To effectively support the graduate nurses, the healthcare organizations need to understand that both autonomous practice as well as high level of critical thinking usually develop as time goes by with enough support. Different stakeholders in the healthcare industry need to adapt to the different changes to ensure that there is continuous supply of new and qualified nurses so as to effectively meet the healthcare needs of the Australian citizens.

References

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Mammen, B., Hills, D. J., & Lam, L. (2018). Newly qualified graduate nurses’ experiences of workplace incivility in Australian hospital settings. Collegian. doi:10.1016/j.colegn.2018.08.003

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