Role Transition from Nursing Student to Graduate Registered Nurse Assignment Answer

Subject Name : Medical Sciences

Introduction

New graduate nurses are considered to be one of the valuable assets for health care considering the huge turnover of nurses globally. However, it has been found that around 60% of new graduate nurses plan to leave the profession within the first year of employment. This trend can further worsen the ongoing nursing workforce crisis. This issue takes place when new nurses experience transition shock (Labrague& De los Santos, 2020). The transition from a nursing student to a registered nurse is an exciting yet challenging period for new graduate nurses. This period of transition is associated with various lows and highs. They are confronted with many challenges that affect their professional life and transition experiences. These unexpected burdens and responsibilities lead to transition shock. It is a feeling of anxiety, instability and inefficiency experienced while moving to a new environment for work (Ko& Kim, 2022, March). To address the issue of transition shock, it is important to have a better idea of the challenges experienced by nursing staff. This report aims to discuss the challenges in the role transition from nursing student to registered nurse and identify appropriate strategies for coping with the challenges.

Challenges

Role Expectations

Various research studies have reported issues faced during the transition period due to differences in role expectations. The study by Walker et al. (2017) explored the experience of Austrlain graduate nurse during the transition period. One of the challenges identified in the group was role-expectation-related challenges mainly take place when senior nurses had higher role expectations and new nurses fail to balance these expectations with that of self-imposed practice requirements. They reported being treated differently compared to nigh shift nurses. They were exposed to more night and weekend shift compared to other nurses. The same issue was narrated by Hussein et al. (2017). The study by Hussein et al. (2017) revealed that ward staff have unrealistic expectations of the clinical capabilities of newly placed nurses and they spend minimum time orientating to the ward. They fail to realize that as newcomers, they need sufficient time to familiarise themselves with ward layout, equipment and policies. Thus, a lack of focus on the orientation of the new nursing workforce leads to negative emotions and transition shock for them.

Workload

An intense workload is a major challenge experienced by many registered graduate nurses (Kreedi, Brown & Marsh, 2022, September). A study exploring the barriers faced by new graduate nurses in their transition phase identified intense workload as a dominant theme. They experienced an overwhelming workload compared to their experience level. As they have just started their career, they are not able to handle the excess caseload (Alsalamah & Fawaz, 2023). Similarly, the study by Joseph et al. (2022) reported 54% of the participant experienced workload issues and the issue is further compounded by their knowledge deficits and poor communication skills. The analysis by Kreedi, Brown and Marsh (2022, September) revealed that workload demand is a major challenge for new graduate RNs. Due to the nursing shortage, their workload increase and it acts as an additional source of stress for them. Thus, the intense workload is one of the stressors in the work environment that creates feelings of frustrationand intention to leave the job among newly placed nurses.

Workplace Bullying

Another common theme that has been prevalent among nurses about the barrier to smooth transition is the experience of workplace bullying. In the study by Alsalamah and Fawaz (2023), nurses revealed being bullied by their peers and now getting adequate support from them. They feel that they do not belong there and such experiences each day results in negative emotions among nurses. The impact of bullying is that it makes novice nurses hesitant to seek assistance from older nurses and it affects their progress it. It prevents them from developing into a proficient nurse in the future. Instead of focusing on their skill development, they develop the intention to leave the job. Experiences of bullying have been associated with many negative outcomes. Labrague and De los Santos (2020) reported experiencing a variety of negative emotional states during the transition period such as the experience of anxiety, depression and low self-esteem. Thus, a friendly and encouraging work environment is a key driver of a successful transition for student nurses. It gives implication to further identify organisational measures that have been taken to promote successful transition for nurses.

Strategies for Coping with the Challenges

Structured Orientation Programs

Newly graduated nurses face various challenges during the transition to practice. The three main challenges that were discussed above were workload issues, role expectations and workplace bullying (Schmitt &Schiffman, 2019). Role expectation is an issue that implies that novice nurses fail to get support in doing their work and they are pressurized by unrealistic expectations from senior nurses. One approach to resolving the issue is active support by mentors. Their action can have a favourable or debilitation effect on nursing students’ overall interest in the nursing field. They can play a role in orienting nurses to daily work roles and responsibilities (Moss & Jackson, 2019).The use of structured or staged orientation is a supportive factor that is desired by many novice nurses. It involves a written plan moving the nurse through orientation in an organized manner (Schmitt &Schiffman, 2019). By implementing structured orientation programs guided by preceptors, nurses can bridge the challenges during the transition period. It is one of the tools for successful nursing practice.

Arranging Training Workshops

Heavy workload acts as a major stressor for newly graduated nurses and they mainly regard it as one of the factors behind transition shock. It is one of the stressor as it affects work-life balance and affects both personal and professional life of nurses. It also compromises the quality of nursing care and affects well-being of nurses (Banda, Simbota & Mula, 2022). To support the nurse to practice safely and independently in a real-life environment, they should be given adequate training. Adequate training can improve their competency and lead to an increase in confidence in dealing with heavy workloads. Training can enhance their problem-solving and decision-making capabilities. Such workshop support nurses to learn new things as well as socialise with their peers (Alsalamah&Fawaz, 2023). The advantage of the training plan is that can support them to acquire competencies to successfully begin practice in the clinical environment. The increase in competency level can enhance their morale, lead to satisfaction and better commitment to their work and meet patient needs.

Fostering a Positive Work Culture

The incidence of bullying takes place when there is a lack of team orientation in the workplace and a lack of vision for maintaining a cohesive team approach. According to the study by Smith et al. (2020), fostering a team-oriented work culture can minimise the incidence of bullying and contribute to peer support. Future incidences of workplace bullying can be prevented if positive team culture is introduced in the ward. The peer and senior nurses should be encouraged to act as the source of support for novice nurses instead of putting them down through derogatory comments. To achieve this, it was recommended to increase the presence of a unit supervisor or manager on the ward. Having a supervisor physically on the ward can further foster a team-oriented attitude among nurses and can act as a deterrent to future workplace bullying incidents. New nurses should also be encouraged to actively report the incidence of bullying to stop the incidence. They can report about the issue to the manner and this step can ensure that bullying practices are put to an end (Smith et al., 2020).

Conclusion

The report summarised the key challenges faced by new graduate nurses during the transition phase and the strategies used to manage those challenges. Nurses are recognised as a major asset because of their potential to address workforce crises. However, nurses develop feelings of irritation and frustration and intention to leave the job due to several challenges during the transition period. The three major challenges that were discussed in the report were heavy workload, workplace bullying and differences in role expectations. These challenges increased their stress level and made them feel incompetent. The experience of bullying made them suffer from a lack of belongingness and the issue was found to ultimately lead to the intention to quit the job. Some of the strategies that were discussed to manage transition challenges were organizing orientation programs, arranging training for nurses and implementing peer support programs for novice nurses. Thus, nursing administrators have a critical role in implementing measures to ensure a smooth transition of student nurses to graduate nursing practice.

References

Alsalamah, Y., &Fawaz, M. (2023). Exploring facilitators and barriers for successful transition among new Saudi graduate nurses: A qualitative study. Nursing Open, 10(1), 278-286. https://doi.org/10.1002/nop2.1302

Banda, Z., Simbota, M., & Mula, C. (2022). Nurses’ perceptions on the effects of high nursing workload on patient care in an intensive care unit of a referral hospital in Malawi: a qualitative study. BMC nursing, 21(1), 136.

Hussein, R., Everett, B., Ramjan, L. M., Hu, W., &Salamonson, Y. (2017). New graduate nurses’ experiences in a clinical specialty: A follow up study of newcomer perceptions of transitional support. BMC nursing, 16(1), 1-9.doi: 10.1186/s12912-017-0236-0

Joseph, H. B., Issac, A., George, A. G., Gautam, G., Jiji, M., &Mondal, S. (2022). Transitional Challenges and Role of Preceptor among New Nursing Graduates. Journal of Caring Sciences, 11(2), 56.doi: 10.34172/jcs.2022.16

Ko, Y. J., & Kim, S. Y. (2022). Transition Shock Experience of Nursing Students in Clinical Practice: A Phenomenological Approach. In Healthcare (Vol. 10, No. 4, p. 613). MDPI. doi: 10.3390/healthcare10040613

Kreedi, F., Brown, M., & Marsh, L. (2022). The Experience of the Transition from a Student Nurse to a Registered Nurse of Kuwaiti Newly Graduated Registered Nurses: A Qualitative Study. In Healthcare (Vol. 10, No. 10, p. 1856). MDPI.https://doi.org/10.3390/healthcare10101856

Labrague, L. J., & De los Santos, J. A. A. (2020). Transition shock and newly graduated nurses' job outcomes and select patient outcomes: A cross‐sectional study. Journal of nursing management, 28(5), 1070-1079. doi:10.1111/jonm.13033

Moss, C., & Jackson, J. (2019). Mentoring new graduate nurse practitioners. Neonatal Network, 38(3), 151-159.

Schmitt, C. A., &Schiffman, R. (2019). Perceived needs and coping resources of newly hired nurses. SAGE open medicine, 7, 2050312119833216. doi: 10.1177/2050312119833216

Smith, C. R., Palazzo, S. J., Grubb, P. L., & Gillespie, G. L. (2020). Standing up against workplace bullying behavior: Recommendations from newly licensed nurses. Journal of nursing education and practice, 10(7), 35.doi: 10.5430/jnep.v10n7p35

Walker, A., Costa, B. M., Foster, A. M., & de Bruin, R. L. (2017). Transition and integration experiences of Australian graduate nurses: A qualitative systematic review. Collegian, 24(5), 505-512.

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