Assessment Task Overview
Transitioning to professional practice is a critical phase for the novice Registered Nurse. Managing professional role requirements, organisational technologies and team dynamics while on shift can be challenging. This is often accompanied by changed personal circumstances, with graduates balancing shift work, working full time and socialisation with friends and family. The case study below highlights the professional and personal challenges you may face as a Graduate Registered Nurse.
Critically analyse the following case study to answer the essay questions.
Case Study Background
Alex is a Graduate Registered Nurse (RN) who is 8 weeks into his first graduate rotation at the local metropolitan, tertiary hospital. He is currently working on a gastrointestinal ward which cares for medical and surgical patients. For the first four weeks Alex worked alongside his nurse preceptor, predominately rostered on morning shifts. Alex has just completed his first five (5) night shifts yesterday morning, and is back on an afternoon shift today (Saturday).
Alex is still trying to manage his roster and other commitments like playing sport and catching up with friends. Today, Alex is feeling tired and frustrated because he slept through his alarm this morning and missed a family breakfast to celebrate his sister’s birthday. He is also disappointed that the he can’t watch tonight’s football game with his friends.
Alex has arrived 15 minutes prior to this shift starting. On arrival, he realises that he hasn’t worked with the Nurse-in-Charge before but there are other nurses on the shift that he has met.
Alex feels a little nervous, but he knows two (2) of the patients he has been allocated from his recent night shifts and he is allocated a further two (2) patients who are to be discharged this afternoon. He has not arranged a discharge before so he prioritises these activities as he prepares his shift planner.
A short time later the Nurse-in-Charge tells him that his patient allocations have changed due to skill mix. A different nurse will arrange one (1) patient discharge and Alex will be receiving a new patient from Emergency Department.
Alex feels overwhelmed with the admission, discharge and post-operative patients. He is unsure how he will cope with the rest of his shift. Alex has not looked after a patient with end-stage-liver-failure-before but he decides he must push on, and soon it is time for handover.
At handover, Alex realises that after he had given Ms O’Sullivan an antiemetic, he had set the observation machine to take automatic observations. However, he had forgotten to go in and check this patient for the last 3 hours. Alex has not yet completed the admission documentation for Mr Maple. The nurse he his handing over to rolls her eyes when this information is handed over. Additionally, he has not completed any of his patient notes on the computer on wheels (COWS) machine. Alex stays 30 minutes after the end of his shift to complete his work.
Following his shift
On his commute home, Alex feels really stressed and is not sure if Ms O’Sullivan has experienced any post-op complications. He is frustrated with himself that he may have missed other things this shift and that he had to stay late to finish his patient notes. At home, he spends some time reflecting on his shift and plans to ask his nurse preceptor for any advice/tips on their next shift together.
Alex appears to be struggling during his clinical shift. He also seems to be having difficulty maintaining a work/life balance. Critically analyse the case study to help you answer the following essay questions.
1. Determine and justify whether the graduate RN met (or did not meet) their role and responsibilities as an RN during his shift. Support your discussion with at least two (2) of the Nursing and Midwifery Board Australia (NMBA) Registered Nurse Practice Standards (2016) (LO1 & 3).
2. Construct at least three (3) recommendations as to how the graduate RN could have undertaken this shift differently. Consider in your discussion the knowledge, skills and attitudes inherent in the RN role, including utilisation of technology and teamwork skills, and support your discussion with literature (LO2, 3, 5 & 6).
3. Transitioning from student to Graduate Registered Nurse can be difficult. Construct at least two (2) evidence-based strategies that could be implemented to promote resilience, build capacity, and support work/life balance during the graduate RN’s transition period (LO3, 4, 5).