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The period of transition from a student to a newly registered nurse presents challenges and demands, which must be met with consideration and reflection. It is hard to overstate the importance of the first months in the whole career in the clinical settings. During these few months, I have to use my abilities, knowledge, skills, and competencies formed at the educational establishment in the hospital environment. In order to effectively manage challenges of transition, I will have to utilize certain strategies and tactics. The present paper will reflect on the following issues: high demands for nursing competence, translating knowledge into practice and coping with role stress.
I consider a highly developed competence to be most important for my professional integrity. It will allow me not to lose confidence and become a qualified professional. Many researchers recognize that challenging setting environments imply the presence of high expectations for the professional competence of nurses. That is why new graduates’ transition to practice presents complexities, which set certain demands not only for professional skills and competencies but also for personal abilities and qualities. After Bratt & Felzer had examined the perceptions of newly registered nurses of their professional practice, they discovered that job satisfaction is at its lowest rate during the first six months. It is vital to realize the possible severe consequences, medical errors of a nurse’s inexperience and a high level of stress for patients’ safety and care. Additionally, Chang and Hancock admit that changes in society on the whole and healthcare domain, in particular, result in the appearance of the need for sustainable nursing and increasing demands and workloads for nurses. Here belong such changes as the rapid deployment of new graduates into clinical settings, managed care, reduced lengths of hospital stays, the rising patient acuity, staffing shortages, new technologies and focus on cost-effective quality of care”.
In order to increase my job satisfaction and professional commitment, I should work at developing competencies and practical experiences necessary for particular practice setting. Besides, my strategy will be to constantly expand my education in various areas throughout the life course. There are many fields and domains, in which I would like to learn and improve, including self-knowledge, leadership, interpersonal and communication skills, cultural diversity, and many others. I think it would be advisable to participate in a special program offered at a clinic. Many researchers suggest that effective nurse programs can support new graduates in a successful transition into practice. In my opinion, one of the useful strategies proposed by such programs is regular support, communication, collaboration, and participating in professional sessions with mentors, nurse experts, and skilled facilitators. In such a way, I would be able to enhance my knowledge of particular patient population and ability to perform effectively as a part of a medical team. So, becoming an effective member of a medical team will be my strategy to accumulate necessary knowledge, skills, and competencies, and achieve productive adjustment to the hospital environment. I understand that learning to co-operate in a team will enable me to avoid job dissatisfaction, promote my professional skills, and develop my competency in decision-making. All this will be possible due to available successful role-models, which I consider to be most useful for my professional evolvement.
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To build competence, I will have to learn how to translate acquired knowledge into practice. One has to develop clinical reasoning ability and continue the ongoing development of this competency. Moreover, I will have to learn how to think like a nurse while making clinical judgments. After graduating from university, nurses have loads of theoretical knowledge. However, it will not become a part of competency at a clinical placement if a newly registered nurse does not manage to cover the theory-practice gap and translate knowledge into practice. Duchscher calls this incongruence between training and practical environment “reality shock,” which ensues after the discovery that learned values conflict with real world values of healthcare delivery service. There is a great danger in the discrepancies between the ideal of a nursing profession shaped during university education and placement reality. These can result in the internal conflict, disappointment, which, in their turn, lead to turning the creative energy of the novices into job dissatisfaction and career disillusionment.
I believe one of the effective strategies will be familiarizing myself with the institutional peculiarities of my hospital environment, concrete situational contexts and expectations associated with the nurse’s role, responsibilities, work ethic and culture. I must create a clear understanding of the expectations for a professionally practicing nurse from patients, co-workers, senior nurses, and other members of the interprofessional team. Another important strategy will be to attempt to think like a nurse, namely to accept all the responsibility and acquire confidence in the own strengths and abilities. Besides, I should develop critical and reflective thinking and enhance my self-awareness as a competent professional.
Closely approaching the issue of competence and confidence is the challenge of managing with stress presented by a new role of a registered nurse in the practice placement, called by Duchscher a “transition shock”. I need to learn how to cope with stress caused by enormous work load, responsibility, and numerous duties. As many researchers claim, emotional tension and stress can lead to severe consequences both for the nurse’s professional and personal outcomes and her/his patients. For that reason, I consider it to be one of my major targets to learn effective strategies how to cope with tension and challenges and remain productive. I want to avoid lower work satisfaction because of stress and leaving the organization. Moreover, nurses who are stressed have more conflicts with co-workers that can only worsen their stressful condition. Among other psychological problems are “feelings of inadequacy, self-doubt, lowered self-esteem, irritability, depression, somatic disturbance, sleep disorders and burnout”. Novice nurses complain that finding themselves in the situation of initial professional adjustment, they often experience anxiety, feel insecure, and also mention inadequacy and instability. Chang and Hancock indicate that the reasons for stress may be disparities between the role expectations and achievements in performance, lack of support, high demands, adjusting to shiftwork, and many other sources of tension and pressures. An additional source of stress is a change in status from a student to a professional registered nurse and incongruence between the ideals and values developed in the course of studying and the practical experience in the clinical setting. Chang and Hancock claim that the most challenging period of adjustment for a graduate is the first 3-6 months. Duchscher adds that 33-61% of newly graduated nurses in North America change their placement or even decide to quit nursing within the first year of practice. Additionally, not all the components and responsibilities of a nurse’s role and necessary competencies are clearly stated and explained in the clinical setting. As a result, a role ambiguity takes place, which is a separate challenge for new nurse graduates.
The first strategy I am going to employ is developing effective stress-coping techniques and persistent purposeful work at my own emotional sphere. I have to educate myself about tactics and strategies how to control emotions and not let them prevent me from making considerate, reasonable decisions. Moreover, it is vital improving my emotional intelligence in order to prevent negative emotions from sapping my energy and disabling my active participation in professional activities. If I learn how to effectively manage my feelings and emotions, I will be able to focus all my energy and efforts on the achievement of career goals and evolvement as a successful professional. So, another strategy will be distinguishing clear-cut reasonable goals, which will help me concentrate all my power on the achievement of decent career goals and personal outcomes. Consequently, I will be able to develop the states of emotional, intellectual and physical well-being.
Although transition into hospital environment presents a lot of challenges and complexities, it is also a sensitive period for shaping my own style and professional accomplishment. My resolution is to accept these challenges as opportunities for my personal and professional development. While striving to manage all the tasks and demands, I will improve as a nurse and become an accomplished individual.
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