The profession of nursing within health care sector is focused on caring, individuals and their families along with their communities to help them achieving and maintaining the health and wellbeing and recover from illnesses faster. The transition phase for the novice registered nurses is quite difficult due to changing challenges during practice. On the other hand, it is the phase where a novice nurse can gather experience which helps them polishing their skills and competencies for future endeavours. The current study will conduct a case study analysis to understand the different challenges a novice nurse mat face while practicing and to provide evidence based recommendation for tactfully overcome the challenges.
Question 1
There are seven standards for nursing practice as suggested by Nursing and Midwifery Board, Australia (NMBA). Among those, two standards will be discussed based on which the performance of the nurse in meeting the roles and responsibilities in his practice will be evaluated. As per the standard 3 of the NMBA standard nursing practice guidelines, nurses are required to recognise and perform actions in a timely manner to the health and wellbeing of self and others. They need to use lifelong approach to their learning so that professional development of self and others can be ensured, they are required to actively engage with their profession and promote the “integral role of nursing practice” so that better health outcomes can be achieved (Nursing and Midwifery Board of Australia, 2020).
However, the nurse Alex has been identified to be stressed and tired and he has become overwhelmed with his responsibilities as they seem to change suddenly. This turmoil has led to inefficiency in documentation of patient admission and taking care of other patients also. Therefore, it can be stated that as a novice nurse, Alex could not maintain his health and wellbeing. Due to this, the standard of maintaining practice capabilities could not be effective met by the nurse.
As per the standard 5 of nursing standard practices, nurses are required to develop a plan for their nursing practice (Nursing and Midwifery Board of Australia, 2020). Under this guidance it has been mentioned that nurses are required to effectively use the data of assessment and the available evidence essential for the plan. The nursing plan is required to be developed through collaboration with other member of the professional team and until the collaborative approval of goals, actions, priorities and timeframes is agreed. The plans are required to be documented, evaluated and modified so that the agreed outcomes can be facilitated and they are required to coordinate resources for the planned actions effectively and efficiently.
However, in the current scenario, the nurse had planned discharge and prioritised the discharge requirements. As his responsibilities changed, he felt stress as he was already tired after his continuous night shift. As mentioned in the standard practice protocol, Alex could not collaborate with the other members for obtained an agreed outcome. On the other hand, he could not provide or coordinate the resource (admission documentation of Mr Maple) to the nurse he was handing over his patient. As the previously developed plan was required to be changed, Alex could not perform the task efficiently. Additionally, he had forgotten to check his patient which may be important for conducting the treatment process. However, it has been identified that the nurse sincerely planned for his assigned responsibilities though the challenged he has faced was due to lack of experience and sudden change in the patient allocation.
Therefore, it can be stated that Alex performed his task as per the guidelines of NMBA nursing standard though the effectiveness of the performance would be polished through the experience along with coping effectively with challenges (Cashin et al. 2017, p.98).
Question 2
The capabilities nurses have to meet the need of the patients using the logical thinking and skills required for nursing can be considered as nursing competencies. Considering the current scenario, some recommendations can be developed for improvement.
Therefore, it can be summarised that the relevant knowledge and skills in nursing practice are needed to be implemented efficiently by a registered nurse to avoid confusion in planning and conducting the care process. However, implementation of the knowledge, skills and competencies is highly dependent upon the experience which can be obtained gradually. For instance, as a registered nurse, Alex could effectively plan about his responsibilities such as discharge. However, the change in allocation created a haphazard situation for him which could not be tackled by the nurse due to lack of experience.
Question 3
Transition phase in nursing can be difficult for the novice registered nurses though these are the path of gathering experience that will help in performing effectively in the profession. Matheson et al. (2016, p.9) suggests that throughout the nursing practice, registered nurses are required to be engaged in self reflection. It is the way to recall the experience and helps in evaluating one’s own performance through this. This helps nurses in identifying their strengths and weaknesses which helps in developing effective nursing skills for better performance outcome. On the other hand, knowledge regarding personal competencies helps in making effective decision. Indentifying the positive skills and competencies helps in enhancing the level of self-esteem which is an important part in promoting resilience as this provides a greater sense of control. As mentioned by Naber & Markley (2017, p.67), self reflection may be crucial to identify the faults and reasons or causes behind the faults in the practice.
This helps in building capacities for preventing mistakes from occurring when similar situation arrives leading to reduction of the errors in decision making and helps in enhancing knowledge regarding the possible ways that may affect the nursing practice in future. Therefore, reflecting on daily performance to understand how the performance is going and how the modifications of abilities and skills and required for improved nursing performance. Apart from that effective work life balance is a foundation of job performance of a person (Holland et al. 2019, p.34). In order to understand the gaps between the prioritisation of tasks and to fulfil them, self reflection is essential as this will help in developing skills for maintaining functional boundaries between work and personal matters.
As observed in the current case, Alex failed to keep the work/life balance intact due to which is affecting his family relationships as well. As Alex needs to stay late in the workplace and faces difficulties in managing hospital it is affecting his personal relationships and his personal needs such as watching football game with friends.
Another strategy that would possibly help in similar scenarios is Personal and Professional developmental Plan. There is evidence that both personal and professional development plan are important to be developed so that the personal needs and aspirations can be effectively met so that those may not affect the professional performance (Houston 2018, p.41). On the other hand, professional development helps in acquiring profession relevant skills and competencies that ease out the challenges faced by the nurses on a daily basis at their workplace. In a simpler term, personal developmental plan may include activities that would help in developing personal skills such as resilience, stress management, time management and others. Developing effective strategies to cope with the difficult situation helps in promoting resilience which is highly essential for the maintaining the equilibrium and reducing overwhelming feelings. This will also help in managing stress effectively as increased personal capacity to address difficult situation may help in building confidence as well. On the other hand, professional development plan includes improvement of the nursing specific skills and competencies (AL Makkouk 2020, p.10). For instance, as mentioned earlier that use of technology (capacity building) is highly crucial for effective nursing performance. This can be included in the professional developmental plan increasing efficiency in collaborating, teamwork, communication, patient management and others. This helps in developing control over difficult workplace situation. Along with this, effective professional performance would not affect the personal life of the nurse. Therefore, personal and professional development plan along with self reflection may help in promoting resilience, building capacity and to support work life balance during the transition period.
In conclusion, a novice nurse is likely to face difficulties in managing personal life and professional life effectively due to lack of experience and understanding of the situation. As suggested by the NMBA, nurses are required to maintain their practice capacities as well as develop effective nursing plan. In spite of several efforts, the nurse in a case study faced difficulties in coping with the situation due to lack of experience and planning. It has been suggested to involve into self-reflective practices to identify personal strengths and weaknesses and more along with personal and professional development strategy to improve skills and competencies which will help in mitigating these challenges.
AL Makkouk, M. 2020. ‘A CONTINUING PROFESSIONAL DEVELOPMENT PROGRAM FOR NURSE MANAGERS.’ American University of Beirut. vol. 19 no. 1, pp. 222-234
Balestra, M. L. 2017, ‘Electronic health records: patient care and ethical and legal implications for nurse practitioners.’ The Journal for Nurse Practitioners, vol. 13 no. 2, pp. 105-111.
Cashin, A., Heartfield, M., Bryce, J., Devey, L., Buckley, T., Cox, D., ... & Fisher, M. 2017. ‘Standards for practice for registered nurses in Australia.’ Collegian, vol. 10 no. 1, pp. 125-130.
Gabrielsson, S., Sävenstedt, S., & Olsson, M. 2016. ‘Taking personal responsibility: Nurses' and assistant nurses' experiences of good nursing practice in psychiatric inpatient care.’ International Journal of Mental Health Nursing, vol. 25 no. 5, pp. 253-256.
Holland, P., Tham, T. L., Sheehan, C., & Cooper, B. 2019. ‘The impact of perceived workload on nurse satisfaction with work-life balance and intention to leave the occupation.’ Applied nursing research, vol. 49 no. 1, pp. 210-241.
Houston, G. 2018. ‘The Impacts for the Registered Nurses of the New Entry to Specialty Practice Mental Health and Addiction Nursing Programme, of the Programme, on their Personal and Professional Development.’ vol. 67 no. 9, pp. 456-459.
Matheson, C., Robertson, H. D., Elliott, A. M., Iversen, L., & Murchie, P. 2016. ‘Resilience of primary healthcare professionals working in challenging environments: a focus group study.’ British Journal of General Practice, vol. 66 no. 8, pp. 648-659.
Murray, M., Sundin, D., & Cope, V. 2019. ‘New graduate nurses’ understanding and attitudes about patient safety upon transition to practice.’ Journal of clinical nursing, vol. 56 no. 5, pp. 324-356.
Naber, J., & Markley, L. 2017. ‘A guide to nursing students' written reflections for students and educators.’ Nurse education in practice, vol. 78 no. 2, pp. 567-578.
Nursing and Midwifery Board of Australia, 2020. Registered nurse standards for practice Retrieved 16 October 2020, from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-for-practice.aspx
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