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Literature Review For The Newly Qualified Nurse

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Question:

What are the career opportunities available for the newly qualified Registered Nurse?

 

 

Answer:

Introduction

Nursing is a profession, which is dedicated towards the well being of society. Thus, to be qualified as a professional nurse, students need to gather and obtain several key skills and competencies, based on which they are selected for their respective profession. A student nurse, who is qualified as a registered nurse becomes able to work in variety of different specialized sectors, from paediatric department to mental health nurse. Therefore, there is a wide range of opportunities provided by the state and government, nationally and internationally. In this context, it can be said that nurses need to explore all of their opportunities throughout the health care sector. However, instead of several opportunities, it is not so easy to grab ad explore all the opportunities, because several previous literatures identified bitter experience of student nurses, while transitioning and attempted to establish themselves as a successful registered nurse. In this essay, the key focus is to review and investigate the career opportunity for the students available in national and international level.

Literature Review

Parker et al., (2014) identified a wide range of opportunities for newly graduate registered nurse, throughout a large number of domains in the health care industry. Different sectors, which are of key interest of newly graduate nurses include "Adult nurse, Health visitor, High intensity therapist, Children's nurse, Mental health nurse, Learning disability nurse, Paramedic, Midwife, Physician associate” and others. While exploring the opportunities of newly graduate registered nurses, it is also important to review their initial experience as the beginners in this field. In this context, the authors conducted a cross sectional design for gathering primary data from nurses through online survey and focus group. In this context, the quantitative data indicated that satisfaction with recruitment process, support for professional development, however, the level of job satisfaction was low. On the other hand, the qualitative data revealed several factors contributing in building the first year experiences of the newly graduate registered nurses, these are nature of workplace environment, level of support available for new entrants, nurse’s ability and willingness to learn, adapt in the new workplace environment and their expectations from the profession. Finally, authors concluded that a range of evidence based approaches for empowering nurses are needed to be placed for shaping the future of newly graduate nurses. In relation to the research question, the article revealed that there is significant opportunity to learn and develop the professional skills, if the nurse put her best efforts to practice.

 


Hofler and Thomas (2016) investigated the challenges experienced by the new graduate nurses during transition from a student to a RN workforce. The challenges, which are identified in this context, are the enhanced work pressure, lack of access to mentors, diversity in workforce and lack of motivation as well as bullying. Strategies identified by the author resolve these issues as well as provide scopes for professional development. Author introduced a three-phased mentorship program initiation phase, collaboration phase and autonomous phase, which provides the opportunity to improve communication skills, interpersonal relationship building and autonomous phase.

Bjerknes and Bjork (2012) conducted a study for investigating the opportunities and limitations experienced by the newly graduate nurses, during “transition from a student nurse to a RN”. Authors conducted an ethnographic study including observation, interview and document analysis, for understanding the daily work schedule from the perspective of the newly graduate nurses. In this context, 13 newly employed nurses were monitored throughout the first year of their work in the health care settings. The observation revealed neither respect nor nurturing attitude towards these newly entered nurses. On the other hand, these nurses entered the field with the urge to learn and empathy towards the patients. However, the experiences were negative, i.e. lack of supportive working environment, overwhelming responsibilities and absence of supporting role models. However, a significant opportunity for professional development has been reflected through the article, i.e. from the strict environment, the newly entered nurses learned to cope with professional hurdles in effective way, understood how to adjust the professional expectations. Author interpreted offering effective role model and comprehensive support would be effective for exploring their career opportunities.

Through the last decade, the reality shock has been acknowledged for the newly graduated nurses, however, the problem is becoming more serious and thus, initiatives for improving the situation are needed. For this the existing opportunities through the community are needed to be explored. In this context, Dyess and Sherman (2009) explored “transition from student to RN and learning needs from a community based novice nurse transition program. This article offers a continuing education initiative for newly graduate nurses, during the first year, which is comprehensive of the efforts extending more than clinical orientation and basic unit-specific preceptor programs. These kinds of educational programs showed the enhanced nursing competence of the newly graduate nurses, while offering development of nursing skills in diverse specialization fields of nursing.

 


Rush et al., (2013) conducted a review for identifying the best practices of formal new graduate nurse transition program. It would help to identify the opportunities in the educational and professional development for the newly graduate nurses, as well as the benefits of the formal transition program for the nurses. In this context, the literature review revealed the support provided beyond their traditional unit orientation period and the programs are providing several professional development and career improvement opportunities for the newly graduated nurses, these include mentorship, formal education and peer support opportunities, internship, residencies, extended preceptorship and generic programs. However, the lengths, type of education and support provided varies amongst different programs, overall information revealed significant benefits from these transition programs resulted in good retention and improved competency.

Pennbrant et al., (2013) identified the difficulties of transition from student to RN and developed a model describing the opportunities and the way of exploring those through professional development of newly graduate nurse during the first year of work. The study followed a qualitative design with the survey on 330 registered nurses, to identify embedded opportunities for professional development and career growth. The result revealed that mastering the professional role results from the ongoing process building on nurse’s experience and communication with the other professionals, clients and the surrounding environment. The process of mastering professional role include “developing professional self-efficacy, evaluating and re-evaluating educational experiences and developing clinical competence”, which are promoted by healthcare organization, social values and norms, co-workers,  management of new nurses, patients as well as nurse's own family and friends. To promote these opportunities, support from educators and employers are requires.

Similar to the previous study, Marks-Maran et al., (2013) also evaluated a program, i.e. preceptorship program exploring newly graduate nurse’s career opportunities and impact of the program. This mixed method study evaluated that “preceptee engagement in the program was high along with a highly valued perceptorship”, where preceptors played a significant role in alleviating stress. The program provided the opportunity to build communication skills, clinical skills along with advanced personal and professional development. Despite of acknowledging difficulties, perceptees revealed that the program provided them significant opportunity to improve their professional skills and sustaining their career growth.

 


Phillips et al., (2012) investigated a different domain to identify additional career opportunities for the newly graduate nurses in Australia, besides the core domain work. The author aimed to identify the link between the part time employments of undergraduate nursing students with the transition to practice. The study revealed four themes; these are “confidence and experience, financial independence and autonomy, ease of transition and future opportunity”. However, the study revealed diverse choices regarding employment choice and transition to practice. Nurses, who are working in the health settings, claimed that the paid employment gave them the opportunity towards availing best transition to RN practices, by maximizing their skills and competence as registered nurse. Some of them highlighted the opportunity to be strategic and disciplined associated with undergraduate employment. In addition, some of them revealed it provides the opportunity to be experts on specialized domains, enhancing their professional capabilities.       

Whitehead et al., (2013) conducted a review of literature similar to the work of Marks-Maran et al., (2013) that provided a systematic review on the development of preceptorship for supporting newly qualified nurses.  In this context, results revealed three themes, i.e. “‘Recruitment and Retention’; Managerial Support Framework’; and ‘Reflection and Critical Thinking in Action’” for maximizing their career opportunities and professional development. They concluded that structure preceptorship is a key opportunity to improve their professional skills.

Gordon et al., (2014) provided a discussion providing a prospective nursing workforce development and sustainability strategy, which is a “new graduate nurse transition to primary health care program”. The program is a key opportunity for the new graduate nurses in Australia for maximizing the efficiency of their transition. It would help to address the primary workforce shortage in future and would ensure the sustainability of the workforce through enhancing their satisfaction, improving their professional skills and providing wide ranges of career opportunities.

Lin et al., (2014) demonstrated the Nurse Residency programs and its impact upon the job satisfaction of new graduate nurses. In this literature review, 11 articles were reviewed, from where 7 domains were identified, which influenced new graduate nurse’s satisfaction during participation; these include scheduling,  extrinsic rewards, praise and recognition,  interactions and support, work environment,  professional opportunities and hospital system. Here, 5 studies indicated that professional opportunities are contributing in enhancing nurse’s job satisfaction. Professional opportunities include continuous professional development, training and referrals for better opportunities. Therefore, residency programs are providing significant career opportunities to new graduate nurses during transition.

 


Chappell and Richards (2015) conducted a systematic review for evaluating the relationship within the “new graduate nurse transition programs and clinical leadership skills”. Authors reported the impact of these nursing transition programs on improving the clinical leadership skills of new graduate nurses. In this context they revealed that “new graduate nurse transition program”, which were at least 24 weeks in length have a positive impact upon providing the opportunity to the new entrants for developing clinical nursing skills. For instance, the greatest impact was shown in transition programs, which used “University HealthSystem Consortium/American Association of Colleges of Nursing Nurse Residency curriculum”.

Pfaff et al., (2014) explored the newly graduated nurse’s confidence in terms of effective engagement in interprofessional collaboration. A cross-sectional collaborative study conducted for new graduate nurses in Ontario, Canada. Several factors were identified influencing confidence of new nurses, which are “availability and ease of access of educator, availability and ease of access of manager, number of different disciplines worked with daily and satisfaction with team and number of team strategies”. It also identified challenges. Therefore, team and organisational support provided new graduate nurse development the opportunity to develop collaborative and interprofesional working skills.

Cheng et al., (2014) conducted a longitudinal study for developing a pre-graduation clinical training program for nursing students to make their transition effective towards a registered nurse. Results shown improved competences of nursing students through the training, which will help them to cope strategies for dealing with stressed situation and improve their conflict handling and critical thinking skills, thereby promoting career growth.

Phillips, Esterman and Kenny (2015) provided a model for supporting the accommodation of new graduate nurses and providing the clinical opportunity to improve their experience and skills. The study revealed the organizational socialization provided several opportunities to the new graduate nurses       , which are achieving success in transition process easily, gaining a level of acuity commensurate with a beginning skill set to meet care needs and the opportunity to improve competence, shaping their career growth.

Conclusion

The critical review paper reviewed 15 academic articles for analyzing the opportunities for new graduate nurses. This key investigation has been done through analysing the transition of the student nurse to a registered nurse; it will help to identify the key opportunities existing along with the challenges experienced by this newly graduate registered nurse. Several opportunities has been identified, most of the article identified enhanced professional development and competency development as the key of shaping their future career.

 

References

Bjerknes, M. S., & Bjørk, I. T. (2012). Entry into nursing: an ethnographic study of newly qualified nurses taking on the nursing role in a hospital setting. Nursing research and practice, 2012.

Chappell, K. B., & Richards, K. C. (2015). New Graduate Nurses, New Graduate Nurse Transition Programs, and Clinical Leadership Skill: A Systematic Review. Journal for nurses in professional development, 31(3), 128-137.

Cheng, C. Y., Tsai, H. M., Chang, C. H., & Liou, S. R. (2014). New graduate nurses’ clinical competence, clinical stress, and intention to leave: A longitudinal study in Taiwan. The Scientific World Journal, 2014.

Dyess, S. M., & Sherman, R. O. (2009). The first year of practice: New graduate nurses’ transition and learning needs. The Journal of Continuing Education in Nursing, 40(9), 403-410.

Gordon, C. J., Aggar, C., Williams, A. M., Walker, L., Willcock, S. M., & Bloomfield, J. (2014). A transition program to primary health care for new graduate nurses: a strategy towards building a sustainable primary health care nurse workforce?. BMC nursing, 13(1), 34.

Hofler, L., & Thomas, K. (2016). Transition of new graduate nurses to the workforce challenges and solutions in the changing health care environment. North Carolina medical journal, 77(2), 133-136.

Lin, P. S., Viscardi, M. K., & McHugh, M. D. (2014). Factors influencing job satisfaction of new graduate nurses participating in nurse residency programs: a systematic review. The Journal of Continuing Education in Nursing, 45(10), 439-5.

Marks-Maran, D., Ooms, A., Tapping, J., Muir, J., Phillips, S., & Burke, L. (2013). A preceptorship programme for newly qualified nurses: a study of preceptees' perceptions. Nurse education today, 33(11), 1428-1434.

Parker, V., Giles, M., Lantry, G., & McMillan, M. (2014). New graduate nurses' experiences in their first year of practice. Nurse Education Today, 34(1), 150-156.

Pennbrant, S., Nilsson, M. S., Öhlén, J., & Rudman, A. (2013). Mastering the professional role as a newly graduated registered nurse. Nurse education today, 33(7), 739-745.

Pfaff, K. A., Baxter, P. E., Jack, S. M., & Ploeg, J. (2014). Exploring new graduate nurse confidence in interprofessional collaboration: A mixed methods study. International journal of nursing studies, 51(8), 1142-1152.

Phillips, C., Esterman, A., & Kenny, A. (2015). The theory of organisational socialisation and its potential for improving transition experiences for new graduate nurses. Nurse education today, 35(1), 118-124.

Phillips, C., Kenny, A., Smith, C., & Esterman, A. (2012). Pre-registration paid employment choice: the views of newly qualified nurses. Nurse Education Today, 32(1), 10-14.

Rush, K. L., Adamack, M., Gordon, J., Lilly, M., & Janke, R. (2013). Best practices of formal new graduate nurse transition programs: An integrative review. International Journal of Nursing Studies, 50(3), 345-356.

Whitehead, B., Owen, P., Holmes, D., Beddingham, E., Simmons, M., Henshaw, L., ... & Walker, C. (2013). Supporting newly qualified nurses in the UK: a systematic literature review. Nurse Education Today, 33(4), 370-377.

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