• Subject Name : Nursing

Strategies for Transition Into New Nursing Practice

Nurses undergo a long phase of transition from being undergraduate to an experienced professional. Any nurse is faced with multiple challenges while managing care for the patient (Innes, 2018). The difficulty advances by multiple folds when the nurse has to be deal with the patients on an acute setting basis. It is vital that they develop various coping strategies to face these challenges. This can be done by critically evaluating the situation, through sufficient experience and with the help of team work, in order to formulate such coping strategies. This can also involve socializing with the relevant healthcare team members and getting to have an insight to the process with the help of the same. Newly graduated nurses also have a role to understand the working of the system and accept the challenges of the workplace environment. They are required to push themselves against their individual limits, in order to have a sound control over these challenges faced during their tenure. Nurses can also play a vital role in participating in work place challenges, to enhance their personal as well as professional development (Della, 2016). With the help of experience gained over the due course of time, the nurses can help the young graduates to get through this transitional phase of clinical practice. These coping strategies have to be crafted, in order to match up with the demand of professional development.

As per NMBA registered nursing standards of practice, the nurses are supposed to have capability to maintain their clinical practice. This is also vital to develop a sound and absolute clinical plan for the patient designated to enable improved healthcare outcomes for the patients (NMBA, 2016). This is also to be carried out to evaluate the overall healthcare outcomes of the patients. These standards are liable to ensure that continuing professional development for the nursing graduates is ensured. Working in an acute care setting can come up with many different challenges requiring specific roles and responsibilities to be played out. The situation can be demanding, especially for the young graduates who have recently passed out from their academics and might be unaware of the working of the system and its sound functioning around them. The codes and conducts of nursing practice can be helpful for these young graduates in defining clear objectives for them to prioritize the care as per the clinical needs and specifications of the patients. Developing and using necessary intervention tools, in sync with the multiple challenges faced by these graduates can also be fruitful in enabling care to the patient as per their individual and specific healthcare needs. Teamwork is one of the key factors required to ensure that the continuity of care to the patients is ensured (Hustoft, 2018). This also help in defining the roles and responsibilities of the team members, as per the desired framework of clinical practice and thus, managing the best possible care for the patient. The senior nurses can delegate the leadership role in this process, guiding the young graduates towards attaining their primary target of patient care and satisfaction. These professional nurses can also be held accountable for ensuring harm minimalization to the patients, by segregating the negative and positive factors pertaining to the patient care. The senior nurse in the given case study, not only lacked the ability to design an appropriate plan for the patient, but also failed to provide directions to the junior nurse assigned to her. The delay in determining the risk to the patient, led to developing adverse clinical signs and symptoms in the patient. The delay in care subjected the patient to a life-threatening risk that put her life in extreme danger. The healthcare delivery system demands the nurses to act in a collaborative manner to make sure that quality of care is rendered to the patient (Yi, 2016). The nurses that are working together should not only be guiding each other but should also be able to stand on same statement, while managing care in acute settings such as given in the case study. Setting into a new routine as well can be a bit challenging for the nurse. This might put the patient in danger, due to lack of knowledge on how to deal with the patients. The same thing can be observed in the given case study, as the triaging of patient for being critical was delayed, she was put in extreme danger (Chisholm, 2018). The lack of skills to deal with the concerning pressure can also lead to display of frustrating behaviour in the nurses. They might feel themselves as inadequate to cope up with the roles and responsibilities they might be subjected to. Frustrating situations can lead to emotional distress at working place, which might directly impact on the functional capability of the nurse and thus, leading to the development of risky environment for the patient and thus, deteriorating health status. As per the code of ethics that govern the nursing practice, nurses carry a personal responsibility and accountability for ensuring competence by continuity of learning new and advanced skill sets (The ICN Codes of Ethics for Nurses, 2012). Nurses are not only responsible for providing care to the patient, but are also accountable for maintaining a uniform standard of care, so that the care provided to the patient is not compromised at any point of time. A senior nurse should be able to judge the person’s potential and level of competence before delegating any responsibility to them. The new graduate was given the task to determine the anticipated danger to the patient, prior to estimate her knowledge on the subject. The new nursing graduate lacked the confidence to put er skills and technique to best possible use to ensure how much danger the patient was in and triage her in accordance with the same. It is the imperative duty of the nurse to maintain the standards of personal as well as professional conduct while managing care for the patient. As per the NSQHS standards of care, the nurse is supposed to recognize the early signs of deterioration in patients. This is to ensure that recognised and required interventions can be provided to the patient within the stipulated time frame (NSQHS, 2017). This is also crucial to avert any uncalled-for situation. The late recognition and irregular monitoring of the patient’s vitals led to delayed care and thus, exposed the patient to health risk. It is defined as one of the most important roles of the nurse to ensure safe and advanced clinical practices to be used in the best interest of the patients. Another major issue in the given case study is the lack of communication between the two nurses. Communication plays a crucial role in care delivery to the patients. The nurses should work to foster an environment that enables promotion of safe clinical practices within the bounds of ethical and legal considerations (Yeom, 2017). This can only be carried out with the help of open dialogue between the healthcare professionals engaged in patient care. The case demands for an effective two-way clinical communication, which is crucial to make sure that authentic and accurate information transfer is taking place between the two parties involved in the process.

Some of the common challenges faced by the nurses during their transitional phase from a novice to registered nurse can hinder with their individual as well as professional growth. Most of these nurses might lack the basic skill set and knowledge. They also tend to crumble under the workload they might be subjected to (Hoffman, 2019). Some other common area of challenge can be lack of support from senior staff, lack of communication, their pre conceived notion for the workplace and many other reasons as well (Summers, 2017). These young graduates are also found to have positive personal attitude which might seem to enhance their perseverance in this phase of transition. The best possible way to tackle with this hurdle is through the means of mentor-mentee program. Senior nurses can act as a mentor for the young nurses, guiding them through their mistakes. This will help these young novice nurses to have an insight on their short-comings and work according to the same. This system will also be helpful in enabling care by the means of effective communication between the nurses and thus, improving overall patient care through collaborative approach. Shared governance is another method by which these challenges can be overcome (Faraz, 2019). This will help in improving confidence and competency of the novice nurses in the care practice and will help them in better decision-making alone with grooming their skills. The young graduates might also feel more empowered in this process through their constant engagement in the patient care delivery and management. This is also helpful for the young nurses to be able to cope up with the stresses and complexity of the today’s healthcare environment. All the while, engaging these nurses in clinical decision making can be helpful in promoting a professional work environment (Kalensky, 2017). Resilience on the other hand can be defined as the ability to bounce back or cope up successfully with the substantial adversity. It can be described as one of the most vital coping mechanisms which is deemed of every nurses. It is helpful and important for dealing with the difficult working situations such as acute care setting and similar to the given case study (Sala, 2019). The best possible manner to enhance one’s won resilience can be accomplished through development of positive thinking and optimism. This can be attained by enabling a flexible and supportive working system for the nursing colleagues, to enable them a platform to express themselves to the fullest. It can also be attained with the help of self-reflection, at an aim to build self-esteem and remind one own self of their strengths and limitations. The nurse in the given case study needs to improve on her overall communication skills to ensure that safe and honest dialogue transfer is ensured (Thomas, 2016). This might have helped in managing the patient care more efficiently and without conducting any error. Thus, ensuring and keeping the patient safety and the top most concern, while managing care for them.

It is not easy for a novice nurse to get acquainted with the working of the system that easily. It can be a worrisome stage to go through as a part of transitional phase for the young nursing graduates, still acknowledging themselves as am integral part of the healthcare system and its compound functioning. There are new set of professional, ethical and legal protocols that are deemed to be followed, defined as per different healthcare settings. In order to work more efficiently the nurses should have a strong interpersonal skill, to maintain a robust and sound functioning professional relationship with their respective counterparts. It is the duty of the senior nurses to guide the new young graduates with the functioning of the system and to impart them on skills and techniques to impart clinical services to the patients. The nurses are also deemed to practice their skills with in the bounds of rules and regulations defined as per the code of conduct of nursing practice. These rules provide nurses with a directional and methodical approach to deal with the patients, while enlisting all of the important details. The role of comprehensive assessment of the patient is also very important, to identify the key areas of concerns and deliver care in accordance with the same. It is the sole responsibility of the nurse to craft intervention management techniques in sync with the patient’s specification and keeping them as the main center of concern. The goal is to formulate a patient-centred care approach for the patient and enable care through the same. The implementation of care plan should be according to the realistic and practical implications it can have on the patient. All of the clinical guidelines are to be justified as per the defined healthcare standards. Role of nursing leadership can also be deemed quite crucial in the process, as it directly defines the healthcare outcomes for the patients. They can enable a support system to be tailored according to the specification of the given case scenario. Thus, enabling positive and improved healthcare outcomes from the patient’s post-implementation of the same.

References for Conceptualising Moral Resilience for Nursing Practice

Chisholm, L., Zimmerman, S., Rosemond, C., McConnell, E., Weiner, B. J., Lin, F. C., & Hanson, L. (2018). Nursing home staff perspectives on adoption of an innovation in goals of care communication. Geriatric Nursing39(2), 157-161. https://doi.org/10.1016/j.gerinurse.2017.08.001

Della Ratta, C. (2016). Challenging graduate nurses' transition: Care of the deteriorating patient. Journal of Clinical Nursing25(19-20), 3036-3048. https://doi.org/10.1111/jocn.13358

Faraz, A. (2019). Facilitators and barriers to the novice nurse practitioner workforce transition in primary care. Journal of the American Association of Nurse Practitioners31(6), 364-370. https://doi.org/10.1097/JXX.0000000000000158

Hoffman, D. M. (2019). Transitional experiences: From clinical nurse to nurse faculty. Journal of Nursing Education58(5), 260-265. https://doi.org/10.3928/01484834-20190422-03

Hustoft, M., Biringer, E., Gjesdal, S., Aβmus, J., & Hetlevik, Ø. (2018). Relational coordination in interprofessional teams and its effect on patient-reported benefit and continuity of care: A prospective cohort study from rehabilitation centres in Western Norway. BMC Health Services Research18(1), 719. https://doi.org/10.1186/s12913-018-3536-5

Innes, T., & Calleja, P. (2018). Transition support for new graduate and novice nurses in critical care settings: An integrative review of the literature. Nurse Education in Practice30, 62-72. https://doi.org/10.1016/j.nepr.2018.03.001

Kalensky, M., & Hande, K. (2017). Transition from expert clinician to novice faculty: A blueprint for success. The Journal for Nurse Practitioners13(9), 433-439. https://doi.org/10.1016/j.nurpra.2017.06.005

NMBA, 2016. Retrieved from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards.aspx

NSQHS standards, 2017. Retrieved from https://www.achs.org.au/programs-services/nsqhs-standards-2nd-edition

Sala Defilippis, T. M., Curtis, K., & Gallagher, A. (2019). Conceptualising moral resilience for nursing practice. Nursing Inquiry26(3), 122-291. https://doi.org/10.1111/nin.12291

Summers, J. A. (2017). Developing competencies in the novice nurse educator: An integrative review. Teaching and Learning in Nursing12(4), 263-276. https://doi.org/10.1016/j.teln.2017.05.001

The ICN Codes of Ethics for Nurses, 2012. Retrieved from https://www.icn.ch/sites/default/files/inline-files/2012_ICN_Codeofethicsfornurses_%20eng.pdf

Thomas, L. J., & Revell, S. H. (2016). Resilience in nursing students: An integrative review. Nurse Education Today36, 457-462. https://doi.org/10.1016/j.nedt.2015.10.016

Yeom, E. Y. (2017). The influence of communication competence, nursing professionalism, and emotional labor on clinical practice stress among nursing students. The Journal of the Korea Contents Association17(4), 320-330. https://doi.org/10.5392/JKCA.2017.17.04.320

Yi, Y. J. (2016). Effects of team‐building on communication and teamwork among nursing students. International Nursing Review63(1), 33-40. https://doi.org/10.1111/inr.12224

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