Clinical And Non-clinical Problems In Nursing Transition Phase

Identify the clinical and non-clinical problems that arise in the transition phase of nursing.

The transition phases of nursing are one of the most challenging parts of the profession. Nurses have to cope with the different type of clinical and non-clinical challenges those come in this transition phase from being a student to a graduate registered nurse. The clinical and non-clinical skills are to be developed in a proper way to increase the efficiency of the service. It is seen that young graduate nurses face lots of difficulties in managing the clinical and non-clinical practices in the first year of their professional life. It is essential to perform a critical analysis of the issues related to the transition problem of the nursing career. The study identifies the clinical and non-clinical problems that arise in the transition phase of nursing. Management and importance of the clinical and non-clinical problems are discussed in the study. Different theoretical approaches to learning are also mentioned in the study. A self-reflection is present that depicts a personal point of view. The summary of the points is mentioned in the conclusion.

The clinical skills are essential for delivering the proper service to the patient. In the transition period, it is seen that nurses face a problem with clinical skills. One of the most important clinical skills is the intravenous catheterization. According to research most of the nurses in their transition phase have problems with starting of the intravenous channel (Fulton, 2017). Nevertheless, through proper capacity building training, it can be mastered by the nurses.  Delivering intravenous injection is another key clinical skill that lacks in the nurses who are in their transition zone. However, transition shock can be one reason for the poor performances of the nurses. Other essential clinical skills are the fundamental concepts of pharmacology and its application according to the situation analysis of the patient (Gonzol & Newby, 2013). According to the researchers, it is seen that the nurse in the transition phases have difficulties in situation analysis and setting proper doses of medicine for the patients (Özlü, Z., & Yildirim, 2018). On the other hand, if the proper support is given to the transition nurses they can acquire proper knowledge and implement them in a proper way.

The clinical skills are the most important skill that should be possessed by the nurse. It helps in proper nursing care of the patient. However, to implement the nursing care in a proper way the clinical skills like intravenous catheterization assessment of vital statistics, performing proper intravenous channels are essential (Gonzol & Newby, 2013). These skills play a pivotal role in the delivery of proper nursing care to patients.  On the other hand situational analysis and clear concept of pharmacology help in delivering proper medication to the patient in times of emergency service (Özlü, Z., & Yildirim, 2018). Performing Percutaneous endoscopic gastrostomy, tracheotomy is the major clinical skills of the present in the nursing care setting.  On the contrary, these skills have to develop through proper capacity building training and experience.

Management of clinical and non-clinical skills

The Non-clinical skills like communication, workload distribution and management should be present in the nurses. According to the researchers, it is seen that nurses in the transition phase lack communication and workload management skills (AdibHajbaghery & RezaeiShahsavarloo,  2014) On the other hand the most important non-clinical skills are the team effort or team nursing used in the profession. If the communication skill of the nurse in the team is not up to the mark it can cause a fatal result (AdibHajbaghery & RezaeiShahsavarloo,  2014). Nevertheless through proper communication training verbal and non-verbal communication can be developed.  There is a huge amount of workload in the nursing care setting that should be properly distributed by the top management (Jalal et al., 2014). However, the top management has to take the initiative to develop the communication skills of the nurses through a proper capacity building program.

In the transition phase, proper capacity building training should be provided to the nurses for holistic development of the clinical and non-clinical skills. During the first few months of the transition period, additional support should be given to the nurse (Negarandeh, 2014). The experienced and professional nurses should be train the new nurses so that they can develop the clinical and non-clinical skills.

The nurses and midwifery require developing their interpersonal skills to cop up with the transition problems in their initial years of nursing practices. As per Benner’s theory nurses need to pass five clinical levels with potential (Stutz, 2013). The five potential stages are a novice, advanced beginner, competent, proficient and expert.

It is a situation where the nurses or the midwives have no practical nursing experiences. They remain incapable to manage the clinical challenges and transition problems (Coxon, Bisits& Sandall, 2015). The nursing staffs generally remain less confident. Moreover, nursing staffs remain ignorant to characterize the safe practices. this is the stage when the nurses and midwives require clinical advice from their senior members. They require a constant verbal and physical response form, their senior to understand the clinical issues.

Advance beginner is a stage when the nursing care staffs become a little clinically potential to handle the clinical issues. The level of nursing performance gets better at this stage. The nurses start getting prior experiences in critical clinical situations (Dyer & Latendresse, 2016).  They become potential enough to handle the practice area with effective nursing skills. However, the nurses and midwives still require verbal and physical assistance from the senior nursing members but lesser than the novice stage. This is a knowledge developing stage for the nursing staffs.

Discussion

Competence signifies the potential existence of nurse’s in particular clinical practices for two or more years.  The nurses become more proactive trot heir clinical approach due to the existence of their clinical experiences (Coxon, Bisits & Sandall, 2015). The nurses become potential enough to describe their efficiency focusing on the key competency level. The clinical actions of the nursing staffs become more matured. They require the least assistance from their senior clinical staffs for clinical advice. The nurses become capable of demonstrating the several clinical plans based on their analytical skills and ethical clinical consciousness. Several clinical plans enhance the nursing capabilities of the nursing staffs to provide quality care to the patients with suitable intervention procedure.

The proficient nurses are capable enough to understand all the clinical issues. They become efficient in managing the situations wholly rather than partly. The proficiency helps then uses to develop their capability to set long terms intervention goals. The proficient nurses have a wide range of experiences and they can plan for any clinical situation (Dyer & Latendresse, 2016). They have the efficiency to provide quality care to the patient with a professional outlook. This stage enables the nursing staffs to attain the clinical decision-making process and capable to handle the pressure situation.

The expert stage is the final stage for the nursing staffs and midwives. The nurses become potential enough to tackle the clinical issue, involve in the decision-making process, a situational analysis of the clinical condition of the patient and provide quality care (Miah, 2013). Here, the nurses develop their transition level into the expert level. The wide ranges of experiences have been beneficial for them to provide flexible care practices with professionalism. Additionally, they become proficient in developing ethical consideration overcoming the transition level.

The transition theory of nursing can be segregated into three stages doing, being and knowing.

The nurses have no experience in this stage. This is the first three and four months of the nursing stage.  They are unable to resolve clinical problems (Schmied& Bick, 2014).  The nurses are hired for temporary basis but a full-time job. None of the nurses has registered the nursing certificate in this stage. They try to learn new sets of clinical issues and responsibilities. this stage can be segregated into learning, performing, concealing, adjusting and accommodating.

This is the initial learning stage for the nurses and the midwives. This stage enables the nursing staffs to understand the recurrent features of clinical experiences (Miah, 2013). This stage is 5 to 8 months of the initial nursing stage. The nurses and midwiferies start developing their nursing capabilities and clinical skills. This stage can be segregated into five steps; searching, examining, doubting, questioning and revealing.

The proficient stage is the advanced experienced stage for nursing caregivers. They develop their potential capability to handle the clinical issues (Berardo, 2017). This is the final phase of the graduate nursing learning process. The new nursing graduates start continuing two recovers the second phase of the nursing learning process. Additionally, the nursing staffs experience a supportive relationship with their friends, family and colleagues. This is a stage when the nurses and midwives are ready to provide quality care at any time (Schmied& Bick, 2014). This is a little-stressed stage when they feel a little problem in coming up the new clinical environment. However, the situation gets easy through experiences. This stage can be segregated into five sub-stages separating, recovering, exploring, critiquing and accepting.

I think it is essential to develop the clinical and non-clinical skills for the holistic development of the nurses. (Cook, 2016). According to the Rolfe model, the main content of the case is described. I think the lack of clinical and non-clinical knowledge is the main problems of the Transitional nurses.

According to the Rolfe model, the consequences of the problems are analyzed. However, it is natural to be in a state of shock for the transitional nurses. Thorough proper support and capacity building training the transitional nurses can develop proper clinical and non-clinical skills. In my opinion, to combat the fear anxiety and shock of the transition nurses, it is very much important to make proper capacity building training program. Nevertheless in my opinion excessive workload is another prime problem for transitional nurses. Workload should be distributed properly among transitional nurses through systematic management.

According to Rolfe reflection model, the final phase is the analysis of the present scenario. I think that if the proper implementation of the support and capacity building training program is done it will have a positive impact on the transition nurses. On the other hand, it is essential to manage the workload of the nurses in a proper way so that holistic development of the nurses in the transition phase can be possible. I think it will enhance the quality of service in the nursing care setting.

Conclusion

The study has focused on the issues that the nursing care staffs and midwives use to face in their clinical practices. The transitory issue is the biggest issue that the nursing staffs use to face during their care plans. In order to develop the care plans to cop up with the transitory period, the study has discussed two clinical and non-clinical skills. Moreover, Dreyfus and Banner's model are used to analyze the developmental stage of the nursing care staffs from the transition period.  The effective maintenance of Dreyfus's model and Banner's model can be beneficial for the nursing staffs for a healthy outcome.

References

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