For new graduate nurses, transitioning into clinical practice is not an easy ordeal. The final year of school is more so characterized by the endless anxiety of what to expect upon entry into clinical practice. Many are the times' student confess that they are engulfed in a feeling of emptiness. Feelings of lack of sufficient knowledge on how to face encounters of real-life clinical problems is another issue (Chang & Daly, 2015). Newly registered health professional have a stinging role to undertake as they have to develop confidence and adapt to the new requirements of the workplace they find themselves in. confidence emerges to be the key theme characterizing the first year of clinical practice. In many scenarios, it is not that newly registered nurses have no relevant skills to tackle prevailing situations; it is only that they have no confidence even in their own abilities, a factor greatly culminated by lack of experience and shift into a new environment. Due to a huge load of responsibility and accountability of actions, new nurses are faced with extreme feelings of fear. To gain proficiency and efficiency, there is a wide range of skills, both clinical and non-clinical, that new graduate nurses transitioning into clinical practice should embrace and emulate. Discussed henceforth in details are a variety of such skills that aids a smooth transition into clinical practice.
Upon entry into clinical practice, there are a wide variety of both clinical and non-clinical skills that nurses should be well acquitted with. First, clinical skills will be discussed comprehensively and then followed by various non-clinical skills that have a significant impact on the overall development of experience by new nurses. Newly registered nurses should possess the skill to measure and record blood pressure. It goes beyond measuring and recording as the nurse must be well aware of the optimum blood pressure and the critical levels that call for immediate action to avoid lethal impacts (Moore & Cunningham, 2016). The ability to take good care of the skin is another clinical skill of great significance. Skin-related disorders or injuries are quite common in a clinical setting and a nurse should be well acquitted with relevant knowledge on how to handle and treat them efficiently. Bathing skill is another skill that new nurses should be well conversant with. There are many situations in which a nurse will be required to bath their patients. Nurses should also be aware that bathing is categorized into two; complete and partial. Deficiency of this skill could cause adverse effects more so when bathing newborn children; a common exercise especially for nurses in the midwifery department.
Nurses should also possess the skill to assist various clients with feeding. There are many situations when nurses will encounter patients in critical conditions to the extent that they cannot feed themselves (Bayes, Sally-Ann, & Maude, 2018). It is upon nurses therefore to know the right type of food that is the best fit for a certain patient and develop the right method to feed such a patient. This skill will be of much help to patients as they will receive food, a crucial basic need compulsory for survival. Lastly, on clinical skills, a nurse should be fully aware of how to make a bed. There are situations when nurses will be required to make a bed that is occupied by a patient and other times, to make an unoccupied bed (Delves-Yates, 2015). Clinical skills perfectly employed by a nurse contribute to delivery of quality care to patients in an organization.
There is also a variety of skills that are not directly related to clinical setting but are crucial for the survival of a new nurse who has just transitioned to clinical practice. These skills are known as non-clinical skills. First, efficient communication in the workplace is a vital skill that nurses should possess. They should be able to develop the right communication channels to pass and receive information basically from patients and other clinical staff present in the workplace (Riley, 2015). Critical decision making skill is also a vital skill for nurses entering into clinical practice. There are many situations when nurses will find themselves entangled in situations requiring quick and critical decision making. At times, they will be required to make a decision choosing from two alternatives that put them in a dilemma. Ability to work in teams is another vital skill for new nurses. In clinical settings, there are many situations that will require nurses to join hands and work together for the sake of the patients. It can therefore be concluded that non-clinical skills are essential for prevalence of quality care in an organization and should therefore be effectively managed.
According to Benner, there are five stages of achieving clinical competence. Stage one is known as Novice. Here, a beginner is in a total deficit of experience on how to face the situations expected to prevail, in their line of work. It is at this stage that they are oriented to rules that will help them perform in clinical settings (Masters, 2018). Typically, they will rely on rules that are context-free to arrive at conclusions by basing on objective data of the situation at hand. The second stage is the advanced beginner. This is a typical graduate nurse transitioning to clinical practice. At this stage, the nurses have already gained experienced and acquired skills to handle prevailing situations and therefore have an acceptable performance level. They, however, rely heavily on orders and external standards to gain direction on what to do to provide nursing care.
At stage 3, the nurses have now become competent. This stage is usually achieved after one and a half to two years of placement into a particular unit. The nurse can now recognize some of the patterns that he/she have already experienced in the past. They are also able to perform procedures with little or no supervision or directions from the older nurses. The fourth stage is referred to as proficient. Here nurses have acquired the perceptual ability and relational skills. Their responses are no longer focused on rules but rather focused on the prevailing situation while simultaneously displaying the increased use of intuition. Lastly, Benner describe the climax of it all as the expert level. A nurse at this stage displays high vigilant monitoring and no conscious effort is required to realize relevant aspects of situations or change (Masters, 2018).
Dreyfus model of skill development is also similar to Benner's five-stage process of professional development. It recognizes the stages as novice, competent, proficiency and expert. This model is however based on four binary qualities. The qualities are; recollection recognition, decision, and awareness (Sudak, et al., 2015). A learner at the first stage, novice stage, usually adhere rigidly to plans and tough rules. His recollection skill is non-situational, recognition decomposed, decision making is analytical while their awareness mental function involves a lot of monitoring. At the advanced beginner stage, Dreyfus acknowledged that a nurse here will guided by previous experiences to take action in similar situation. They will not adhere too much on rules. As such, their recollection mental skill will be situational. Their recognition skill is still decomposed, decision making analytical and awareness based on intense monitoring. Further on, a nurse graduates to the competent stage. Here they have a significant amount of experience and can cope with issues such as crowdedness (Chang & Daly, 2015). They have also developed partial view of actions into development of longer-term goals. As such, their recognition mental function is now holistic. Deliberate planning is now evident due to their increased consciousness. Most of the procedures they now undertake have become a routine and standardized.
Further on, Dreyfus documented that a nurse then progresses into the proficient stage. Here, they have developed a holistic view of situations rather than by aspects. They are therefore able to distinguish what is crucial in situations and adjust accordingly to the same. Also, they are able to decide the right deviation from the normal wok pattern depending on prevailing patients’ situations. Their decision making skill level has therefore advanced to intuitive. The last st6age of Dreyfus decision making model is Expert. The nurse no longer relies on maxims, guidelines or rules (Masters, 2018). They have deep understanding of tactics which enables them to grasp situations intuitively. They have also developed visions of what is possible and what to expect in various patient situations and conditions.
In my quest to become an expert nurse, I have realized that there is a wide range of skills that I ought to equip myself with. There are a variety of these skills that I have been able to learn in my school work during practical lessons. My clinical placement also played a significant role in imparting me with a huge load of clinical skills that will help me greatly during the transition into clinical practice. There are also several non-clinical skills that I have developed with time due to interactions with various parties that will also be of help during clinical practice. When I achieve expertise in my field, I will be able to operate in line with standard three of NMBA which require me to be accountable and responsible for my own actions. I will also work obeying the seventh standard which requires me to communicate and use documentation to inform and report care.
In conclusion, it has been identified that new graduate nurses experience a lot of struggle while trying to get accustomed to the clinical environment upon during transition. They have to develop the confidence to put their already acquired skills and knowledge into practice. The various skills required for successful transition into clinical practice have been identified. Discussed in details are the various clinical and non-clinical skill necessary for successful transition. Benner's five-stage model of clinical competence has also been discussed. Dreyfus' model of skill acquisition has also been discussed comprehensively. Lastly, a concise reflection of personal skills and future professional development have been reported.
Bayes, S., Sally-Ann, d.-V. S., & Maude, R. (2018). Skills for Midwifery Practice Australia & New Zealand edition. Elsevier Health Sciences.
Chang, E., & Daly, J. (2015). Transitions in Nursing: Preparing for Professional Practice. Elsevier Health Sciences.
Delves-Yates, C. (2015). Essential Clinical Skills for Nurses: Step by Step. SAGE.
Masters, K. (2018). Role Development Professional Nursing Practice (5 ed.). Jones & Bartlett Learning.
Moore, T., & Cunningham, S. (2016). Clinical Skills for Nursing Practice. Taylor & Francis.
Riley, J. B. (2015). Communication in Nursing. Elsevier Health Sciences.
Sudak, D. M., Codd, R. T., Ludgate, J. W., Fox, M. G., Sokol, L., Reiser, R. P., & Milne, D. L. (2015). Teaching and Supervising Cognitive Behavioral Therapy (reprint ed.). John Wiley & Sons.