This analysis seeks to outline the process of transition from graduate nurses to professional registered nurses as it is a challenging process. The transition from graduate nursing to professional nursing is often clouded with emotions. Some graduates tend to happy others will be anxious or fearful as they venture into the practical field of nursing (Hofler & Thomas, 2016). There are several factors that are considered in the transition to being registered nurses. The issues that change during this transition are; Gaps arising from the theory to practice change, caring for progressively composite patients with several medical disorders, managing their time, administration of medicine, the skills for assessing patients, documentation skills, insufficient expertise in managing and implementing practical skills, working and co-operating with colleagues, accountability, making informed decisions, working in shifts, development of competency in preparation and organization and giving priority to and handling unforeseen events (Kaihlanen , Lakanmaa, & Salminen, 2013).
Nurses should be aware of the duty of care owed to patients during this transition. The duty of care refers to being able to relieve pains of their pain and improving the quality of their health (Blais & Hayes, 2016). Clinical skills are defined as the ability to assess patients effectively and provide timely intervention and an example is being to manage a patient’s medication (Smith, 2016). Non-clinical skills refer to the skill that enable nurses to execute their duties successfully and includes clinical judgements (Bramhall, 2014).
A comprehensive understanding of the issues in new graduate practice enables nurses and midwives to transit to professional nursing smoothly and be able to put their theoretical knowledge of nursing into practice effectively.
There are numerous clinical and non-clinical skills that graduate nurses should be able to manage during the transition to professionalism. Communication and relational skills are basic skills acquired by graduates at the beginning of the transition (Kaihlanen, Lakanmaa, & Salminen, 2013). Graduate nurses tend to be very rich when it comes to communicating with patients, being accountable in the nursing profession and psychological assessment of patients since the knowledge of what is expected of them is still fresh. As the graduates grasp experience their nursing assessment and intervention skills are developed. The proficiency in making more informed decisions without involving an experienced doctor in enhanced.
The most important aspect of professionalism is the ability to make problem solving solutions. The decisions made by professional nurses are completely scientific and not just based on premonitions. When a nurse makes an informed decision concerning a patient situation, he/she is said to be very competent (Watkins, Whisman, & Booker, 2016). Understanding the patient situation even though the nurse cannot provide an immediate intervention is a form of professionalism. The nurses consistently monitor the patient’s situation and classify it as either improving or deteriorating (Smith, 2016). Experienced nurses tend to have a good grasp of the situation and highlight all the possibilities and solutions that are applicable (Blais & Hayes, 2016).
Being a professional nurse also requires one to abide by the ethical and legal principles and theories in nursing. These principles guide nurses in their daily medical practices. The Hippocratic Oath of doctors and nurses requires nurse to practice medicine ethically that is what competency entails. Nurses are also expected to provide high quality care to their patients and also act according to their professional knowledge when providing clinical care to patients (Kumar & McHugh, 2017). Nurses are also expected to seek a patient’s consent when it is required and not just assume that the patient will be contented with the intervention (Staunton & Chiarella, 2016).
Skilful nurses will also seek to do good to patients at all times and not cause harm to the patients neither physically or by leaking vital information to an outside party (King, 2017). Nursing intervention should always adhere to the laws guiding it. Issues like physician assisted suicide are legal in major parts of the world and should only be practised in areas where it is legal
In preparation for the professional nursing, I’ve been able to contain the fear of practice through constant revision of the knowledge of nursing as well as take part in internships in order to sharpen my practice skills.
Clinical and non-clinical skills help graduate nurses to effectively cope with stress and anxiety related to the transition to professional nursing. Administration of medication is an important but challenging skill during this transition. Knowing the drugs being prescribed well prevents the unnecessary misuse of drugs and reduce the risk factors associated. Learning from previous mistakes and errors in medication helps graduate nurses prevent recurrence of the same errors and improve their problem solving skills. However, graduate nurses lack this skill of medication administration since they have not put their knowledge into practice before the transition to professional nursing (Smith, 2016). Graduate nurses should have a good grasp of these professional skills in order to avoid making mistakes such as wrong administration of medicine, ineffective medical intervention and wrong diagnoses.
Clinical and medical judgements must be informed by scientific evidence and development of technology. The study of nursing practice is broad as it involves chemical, biological and psychological processes and medical trials at the end of a study. There are variations in the practice of nursing especially when dealing with a specific patient. Some of the variations might not be accounted for by science therefore the clinician must employ clinical reasoning skills in order to understand the situation of the patient. Clinical judgements and skills develop with time as the nurse consistently makes scientific decisions. Poor judgements are definitely inevitable at some point; however, nurses are able to make informed decisions as they learn from these mistakes (Bramhall, 2014). Nurses and other clinicians learn from bad judgements as they progress. Graduate nurses have poor clinical judgements since they possess a theoretical grasp of knowledge rather than the practical aspect.
According to Benner’s 5 steps of becoming a professional nurse and Dreyfus model of Skill Acquisition, one has to pass through the stages of novice, advanced beginner, competent, proficient and expert (Benner, 1984). In the novice stage, the nurse has no experience with the imminent situations except for weight, temperature and other basic nursing intakes. An advanced beginner puts up a performance that is acceptable marginally since he or she has coped up with sufficient real situations. In the competency stage, the nurse is typically said to have a 2 or 3 year experience and has a long-term plan of action. The nurse is conscious of the plan and advance situations are expected. Competency comes with experience and learning (Kohtz, Brown, Williams, & O’Conner, 2017). A proficient nurse is able to observe situations wholly and modify the plans for expected situations since he or she has enough experience. At the expert category, the nurse no longer needs to rely on guidelines in order to come up with an understanding of situations since he or she has a huge background of knowledge and experience. It would take graduate nurses some time before they accrue enough experience so as to reach the expert level.
There are several strategies, however, that can help graduate nurses in this transition. These are; mentoring and coordination programs and support by senior nurses, proper planning of their daily activities, the administration must be very competent, guidance and supervision by senior nurses and assistance when dealing with delicate patients so as to learn the proper way of intervening (Kavanagh & Szweda, 2017). These approaches will most likely improve the clinical reasoning skills of new graduates as well as help them settle comfortably in the professional practice of nursing. Graduate nurses should be able to contain their fear and anxiety in order to smoothly transit to professional nurses.
Clinical reasoning requires a lot of experience in the nursing profession. According to the Rolfe’s model of reflection, the initial stage of reflection is reflecting on what happened (Rolfe, Freshwater & Jasper, 2001). My clinical placement has improved my clinical reasoning skills. Being able to think critically, as required by standard one of the NMBA, helps me to solve the problems affecting the patient. Clinical reasoning skills will enable me make effective and appropriate decisions during the evaluation and assessment of patients (Kramer, et al., 2014). These skills enable me to assess, interpret, analyse and conclusively find out the patient’s disturbing condition. Apart from thinking, conducting research as well as working with other colleagues will help me make informed decisions as I seek to find an appropriate solution to a medical condition as required by standard six of the NMBA. As I aim to become proficient in my undertakings in the nursing profession, I have to be competent and always be ready to learn especially from previous experiences and mistakes that I make. Developments of problem solving skills and proficiency will be improved by consistent practice.
Transition from graduate nursing to professional nursing is not an easy task due to several barriers that graduates encounter during the process. However, there are also a number of strategies that can be implemented to facilitate smooth transition. The resources needed for the transition such as mentors and counsellors are also available to some graduates. The clinical skills appropriate to this transition should be carefully managed to avoid mistakes during the practical application of nursing knowledge. If all the necessary strategies are employed during this transition, then graduates will be able to avoid anxiety and fear while practising medicine and dealing with deteriorating patients (Hofler & Thomas, 2016). Therefore, it is necessary to look at all possible strategies and implement them in order to facilitate the transition of graduate nurses.
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