Transition Of Graduate Nurse To As Being As Professional Nurse

Introduction

Transitioning is a very challenging task for a new graduate nurse from academic practice to a graduate practice. The process of this transition can be characterized as a period of adaptation into the environment and culture of clinical. A new graduate nurse can encounter various issues like a lack of clinical experience during the transition period of being a professional nurse. In the context of graduate practice and being a professional nurse, it can be explained as empathy and safe medication administration. Administration of medication is not only the task, but it also involves clinical and professional practice like assessing health issues, patients care and monitoring the effects of medication on the patient (Manias, Aitken and Dunning, 2005). Secondly, empathy is considered as an important psychological and cognitive attribute of health care providers and is recognizable as refining various aspects of health care practice including establishing good inter-personal relationship with both patients and families, improving patient’s satisfaction, history taking and clinical results, minimalizing the medication errors rate ( Williams, Brown, Boyle, McKenna, Palermo, & Etherington, 2014). These are the components of competency. A new graduate nurse needs to learn and practice more to achieve their required goal during the period of transition to be a professional nurse. This essay will try to critically analyze and discuss professional skills and those challenges to overcome during the transition of new graduate to be a professional nurse.

Critical analysis

New graduate nurses are expected to validate their competency and demonstrate various clinical and non-clinical skills. Safe medication skill is one of the very important skills that the new graduate nurse must understand and know the five rights (patient, drug, time, route and dose) of medication administration including documentation. The inexperienced nurses are one who frequently makes medication errors while administrating medication in the hospital which was increasing by 2.7% between 1994 to 2010 and reached 8.9% (Australian Commission on Safety and Quality in Healthcare, 2013). Alabdulhafith & Sampalli (2014) stated that nurses must follow the five rights of medication administration because the highest percentage of medication errors are found during the administrating stage of medication. Murray, Sundin & Cope (2019); Gluyas and Morrison (2013) both stated that new graduate nurses and their patients are more vulnerable in a healthcare environment because of their limited exposure and minimal experience to the real clinical situations. So, the nurses, especially new graduate nurses must be competent with all the right of medication which helps to deliver safe and quality care to the patient. New graduate nurses hesitate to ask for help with the seniors and take all the stress by themselves. This may be because of a lack of self-confidence and a challenging work environment. Chang & Daly(2016), studies reported that in the process of transition from new graduate nurse to being a professional nurse, there are various challenges and difficulties that are associated with this process including lack of self-confidence, emotional and physical exhaustion; frustration; loss of ideals and feeling of inadequacy. On another hand, new graduate nurses have received advice, support and encouragement from the senior experienced nurses as well as their own families and friends which helps them to reduce stress, develop competence and adjust to the clinical environment. Another skill is empathy that a new graduate nurse must learn to be a professional nurse. Williams et.al, (2014), states empathy is derived from the Greek word “empatheia”, means to understand other's feelings and it was first introduced into the doctor-patient relationship in 1918 by Southard as a means for helping therapeutics and diagnosis. Empathy plays a crucial role in maintaining a good nurse-patient relationship which helps in positive patient outcomes and organization as well. Empathy in clinical includes the ability to recognize the patient situation, moods, establish rapport and communicate therapeutically (Mercer and Reynolds, (2002). According to Cucino et.al, (2016), transition to a new graduate nurse, the nurses have to learn these skills for being a professional. William et.al, (2014), suggest that this ability can be learned and developed through basic practice and graduate professional education. As a new graduate nurse, it might take time to be empathetic. Mallidi (2017) suggests that we are challenging due to our inexperience. Thus, we need to familiarize with the culture and environment of a new organization and manage skepticism from co-works and patients. The health professional who has the ability to understand empathy cares and understands the patient's experience and has the capacity to communicate this understanding (William et.al, 2014). Empathetic statements help to provide psychological support to the patient and allows the health practitioner to look back to the aspects of a patient's health condition that need treatment. This literature also reveals the link between the ability of nurses’ empathy and the high rates of satisfaction among the patients which benefits the positive clinical results. Hence, safe medication administration and empathy are both important skills in the transition to new graduate practice to being a professional nurse.

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Discussion

This part of the essay will discuss the different theories and their views relating to the transition to graduate practice and being a professional nurse. Chang and Daly (2016), states transition from student to new graduate nurse is characterized by the period of intense adaptation and socialization into the environment of the clinical work setting. In this context, socialization is defined as a reciprocal process by which new nurses learn what other demands in their specific role and in return learn to cope and control the new clinical environment. In the context of new graduate practice, the transition process put them put the new graduate nurse in an experience of the feeling of self-doubt, fear, accountability, lack of confidence in their capability and excitement. Duchscher’s theory of the process of becoming (2008), states that those kinds of feelings and fears are reasonable because none of the nurses were trained properly and most of the nurses got full accountability without proper skill development. Duchscher’s theory of “doing” stage reflects on those new graduates who hide their emotions and feelings from their team members because they don’t know whom to trust? On the stage of “being”, after spending 4-5 months of struggle, the new graduate nurse got the awareness regarding the changes in a new working environment. They have to struggle with day to day changing duty rosters that left them feeling of self-doubt, fear and lack of accountability and self-confident; incompetent, disappointed and frustrated. All these kinds of feelings will be defensive withdrawal from their environment as they tried to improve a feeling of power to overcome their lives. This spirit inspired the new graduate nurse to overcome challenges and look forward to the long-term career goals of being a professional nurse.

Another theory that we will discuss is about the Dreyfus model (Benner, 2004) of skill acquisition (Murray, Sundin & Cope, 2019).

Another theory we talk about the Dreyfus model (Benner, 1984) of skill acquisition. This model demonstrates learning is experimental and performance is fully depending on the circumstances people face or placed in (Benner, 1984). This model suggests that one must pass through its five proficiency levels to fully develop a skill. Among the five proficiency levels, new graduate nurses upon transition are considered to have a proficiency level of the advanced beginner (Benner, 1984).

Transition to graduate practice, the new graduate nurses has professional and legal accountability for their patients. That accountability brings changes in them by putting themselves in a real environment and take full responsibility for their patients and being a professional nurse. This practice helps them in recognizing and plan a further investigation of patients based on observation. As an advanced beginner, new graduate nurses use their time and energy in remembering the guidelines and rules and can miss the patient's signs because of less exposure to those situations. Furthermore, Benner (1984) also explains that new graduate nurses need support from experienced and senior competent nurses because advanced beginners are not able to sort out what is most important? They will still experience anxiety and fear which tend to increase because of a lack of confidence and experience. They need more exposure to the clinical situation to recognize and overcome possible situations (Murray, Sundin & Cope, 2019). Advance beginners try to collect assessment data and relate with signs and symptoms but these may vary with patient circumstances and characteristics and might need the specific procedure. While struggling with those kinds of stressful experiences, it will be stressful and challenging but it will be fruitful that teach the new graduate nurses to being a professional nurse

Conclusion

In the end, the process of transition to graduate practice to a being a professional nurse is not an easy process. It consists of various stages and proficiency levels with all the clinical and nonclinical skills and real exposure to the clinical work world. A new graduate nurse must be ready to face any kind of situation and challenges. Critically analysing the situation and finding a better solution to overcome the situation with the help of competent and experienced nurses within the team will lead the new graduate nurse to the path of being a professional nurse. This essay has only represented a few issues but there are many more issues in the clinical world for the new graduate nurses. Thus, the new graduate nurse must be prepared to face any kind of situation with the right solution to overcome those situations. This will lead them towards achieving their clinical goals as being a professional nurse.

References

1. Alabdulhafith, M., & Sampalli, S. (2014). NFC-based Framework for Checking the Five Rights of Medication Administration. Procedia Computer Science, 37, 434-438. doi: 10.1016/j.procs.2014.08.065
2. Benner, P. (2004). Using the Dreyfus Model of Skill Acquisition to Describe and Interpret Skill Acquisition and Clinical Judgment in Nursing Practice and Education. Bulletin Of Science, Technology & Society, 24(3), 188-199. doi: 10.1177/0270467604265061
3. Chang, E., & Daly, J. (2016). Transitions in Nursing; Managing the transition from student to graduate nurse (4th ed., pp. 1-17). Chatswood, NSW: Elsevier Australia.
4. Cunico, L., Sartori, R., Marognolli, O., & Meneghini, A.M., (2012). Developing empathy in nursing students: a cohort longitudinal study. Retrieve from https://doi-org.ezproxy.uws.edu.au/10.1111/j.1365-2702.2012.04105Mallidi, J.R., (2017). Earning trust through empathy as a young interventionalist: “Is this your first time doing this?” Retrieve from https://www.sciencedirect.com/science/article/pii/S0735109717414306?via%3Dihub
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6. Murray, M., Sundin, D., & Cope, V. (2019). Benner's model and Duchscher's theory: Providing the framework for understanding new graduate nurses' transition to practice. Nurse Education in Practice, 34, 199-203. doi: 10.1016/j.nepr.2018.12.003
7. Williams, B., Brown, T., Boyle, M., McKenna, L., Palermo, C., & Etherington, J. (2014). Levels of empathy in undergraduate emergency health, nursing, and midwifery students: a longitudinal study. Advances In Medical Education And Practice, 5, 299-306. doi: 10.2147/amep.s66681