Discuss about the Transition Nursing Practice for Bachelor of Nursing.
This assignment aims to reflect on a challenging position that I have experienced, utilizing a standard reflective model and supporting it with appropriate scholarly literature. The reflective model, which is selected for this assignment, is Driscoll reflective model or framework (Coleman and Willis 2015).
A transition phase appears in the lives of undergraduate nursing students, when they step further to become a registered nurse (Teoh et al. 2013). This phase presents a collection of experiences including the several opportunities as well as challenges. It is concerned with a personal experience, which can often be hectic as well as confronting (Mellor and Gregoric 2016). A study conducted by Chang and Daly (2015) revealed that several registered nurses in the beginning level feel that they are not fully prepared for practice and also felt besieged with the accountability. Besides this, some of them felt abandoned. When I started my practice, I too had these kinds of feelings in the first few months of practicing as a registered nurse. An additional phenomenon will also be discussed in this piece of assessment is the socialization of the graduate nurses. In professionalism, socialization is concerned with the learning of new aspects, which are necessary for the role of nursing like skills, knowledge and conduct. Professional socialization involves workplace adaptation (Doody et al. 2012). The experience of socialization of an individual can play a fundamental role in job satisfaction, performance of work and retention in the profession of nursing effectively (Spector et al. 2015).
I would like to share a personal experience, which I have encountered in the initial two months of my transition to practice on a mental health facility. I was assigned with the task of addressing a 50-year-old- female named Julia who was experiencing mood disorder after the death of her husband Peter in a car accident one month ago. Julia entered into the mental health facility at 1200 hours. Her sister Carol, who stated her symptoms, accompanied her. According to her, she was suffering from anxiety and depression. After the death of her husband, Julia was all alone, as she did not have children. She was living in a rented house and her landlord told her to shift to a new place as she was not able to pay the rent of the house after the death of her husband. This concerned her more as she had no one except a sister, carol. Carol was not financially strong as her husband was a laborer and used to get small amount of wages. They had two children, who used to study in the school. Therefore, there was no one, who could help Julia to overcome her grief and depression. She started to live in an old-age home and her sister carol used to visit her once in a week.
I informed the doctor and the nurse who was given the charge. However, I started collecting the information from Julia and continued with the process of admission, for which I was accountable at that time. Julia cooperated with me in the process but she appeared guarded and avoided eye contact, and when I was about to end my nursing assessments, she admitted that after the death of her husband, she was not able to overcome her grief and depression. It was quickly ascertained that presently she did not had a dwelling place as she was a widow now and was living in the old-age home. I provided her with something to eat and arranged a social worker to see her. After that, I went to the in-charge nurse and asked her to give me some advice regarding what should be done now. I was told by her to discharge the patient and instruct her to visit a social worker somewhere else. She clearly affirmed that ‘this is a mental health facility and we don’t deal with such types of patients here” The nurse manager agreed with the nurse in-charge. I evidently remember one of my colleague, who once said, “I can make out that you think we are being harsh but as time will pass by, you will do the same like us what we did today”.
After this incident passed by, I felt disturbed and upset. I was surprised by this incident and it made me emotional and strong-minded to assist my patient and get an established plan so that he can have accommodation, food and water at the time when he left my care. This incident made me asked different questions like ‘who am I?’ and what role do I have?’ Being a registered nurse, I reflected on my journey in the field of nursing. When I was an undergraduate, I used to focus on my clinical development and I never in reality considered the ‘hidden curriculum’, which can be described as the influences that helps in shaping a person at the level of organization (Bull et al. 2015). It involves the learning of professionals from the environment of their place of work, which lies exterior to the intended objectives of learning in a complex process of socialization (Kumaran and Carney 2014).
In my opinion, I reacted in this way due to the reason that I was in a dilemma that whether I should listen to the words of my colleague or should follow my own belief regarding my responsibility of caring. Duty of care involves legal obligation for promoting and protecting the concerns of the individuals who receive care (Kramer et al. 2013). In the code of professional conduct for nurses in Australia, the conduct statement four outlines that the nurses must give respect to the self-respect, values, ethnicity, beliefs and culture of the individuals who are receiving care by them (Flinkman et al. 2013). The nurses must also take suitable actions for ensuring the quality of care and safety of the patients. I was in a state of pressure and had doubt on myself being a new registered nurse. Certainly, being a new nursing having less than six years of experience, it was not possible for me to supersede the suggestions of the manager and the in-charge nurse.
It is common for a new registered nurse to encounter confronting and hectic situations in the transition phase that is generally known as ‘transition shock’ (Chang and Daly 2015). This particular situation opened my eye and helped me in highlighting the differences between the reality and expectations to work being a registered nurse. In addition, the hidden curriculum, in which a wider process of socialization was taking place, was also highlighted by my response. Being a new registered nurse, the guidance and instruction of my seniors is essential for my development. It is well recognized that the nursing culture or organizational culture possess a direct impact on the well-being of nurses along with the quality of patient care. I had a lack of experience and due to this, I felt overwhelmed. I questioned myself regarding my capability and making decision as a responsible nurse.
After this episode, I was not sure regarding what I should have done at that time. Julia stated to me that she wanted to converse with the social worker and desired to stay until an arrangement could be done.
As the time passed, I made a decision to approach another senior member of the staff in the mental health facility, whose name was Paul and he was my mentor in several shifts. I took help from him regarding my personal thoughts. Paul helped me in establishing a plan. He gave me instruction to inform the doctor regarding the intention of the nurse manager of discharging Julia. I was instructed by the doctor to keep Julia in the mental health facility until the social worker assesses her.
My thinking was challenged by this response as I started to recognize that I could make utilize my strength by means of this experience in building self-confidence and always consider what is appropriate for the patients. Therefore, I can say that this transition phase allowed me to grow in a personal and professional manner. Now, I can accept the challenges confidently and I can continue my practice efficiently.
In this section, a senior registered nurse has been interviewed. The questions along with their answers are provided in this section.
In this situation, your frustration can be understood and I can make out how you might have given sympathy to the patient and handled the situation. Being nurses, we deal with individuals who possess genuine lives and have their individual needs. As this was complex situation, in my opinion, getting assistance from a social worker would have been suitable. It leaves the complex issue for analyzing where do we need to apply the duty of care.
Though we tackled the particular situation mutually, I considered the only thing which we could have done in a better way was to be focused with our intent of keeping the patient in the mental health facility, as long she wished, until she was seen by the social worker. The factors of risk for Julia returning to her existing situations of living were excessively high lacking an arrangement of accommodation along with food and water.
This episode has provided you with an apparent insight regarding the term ‘Duty of care’, and you will possibly refer back to this episode for the future practices. In your learning practice, you have had personal experience of transition shock and role stress. However, these terms generally have a negative implication related with them. You need to use them to your benefit to develop and learn from your experiences in your nursing profession.
Therefore, from a Registered nurse, the undergraduate nurses who are stepping forward to become registered nurses can learn to manage their work, handling pressure, and dealing with the complex situations in the nursing practices.
References
Bull, R., Shearer, T., Phillips, M. and Fallon, A., 2015. Supporting graduate nurse transition: collaboration between practice and university. The Journal of Continuing Education in Nursing, 46(9), pp.409-415.
Chang, E. and Daly, J., 2015. Transitions in nursing: preparing for professional practice. Elsevier Health Sciences.
Coleman, D. and Willis, D.S., 2015. Reflective writing: The student nurse’s perspective on reflective writing and poetry writing. Nurse education today,35(7), pp.906-911.
Doody, O., Tuohy, D. and Deasy, C., 2012. Final-year student nurses’ perceptions of role transition.
Flinkman, M., Isopahkala-Bouret, U. and Salanterä, S., 2013. Young registered nurses’ intention to leave the profession and professional turnover in early career: a qualitative case study. ISRN nursing, 2013.
Kaihlanen, A.M., Lakanmaa, R.L. and Salminen, L., 2013. The transition from nursing student to registered nurse: The mentor’s possibilities to act as a supporter. Nurse education in practice, 13(5), pp.418-422.
Kramer, M., Maguire, P., Halfer, D., Brewer, B. and Schmalenberg, C., 2013. Impact of residency programs on professional socialization of newly licensed registered nurses. Western journal of nursing research, 35(4), pp.459-496.
Kumaran, S. and Carney, M., 2014. Role transition from student nurse to staff nurse: Facilitating the transition period. Nurse education in practice,14(6), pp.605-611.
Mellor, P. and Gregoric, C., 2016. Ways of Being: Preparing Nursing Students for Transition to Professional Practice. The Journal of Continuing Education in Nursing, 47(7), pp.330-340.
Spector, N., Blegen, M.A., Silvestre, J., Barnsteiner, J., Lynn, M.R., Ulrich, B., Fogg, L. and Alexander, M., 2015. Transition to practice study in hospital settings. Journal of Nursing Regulation, 5(4), pp.24-38.
Teoh, Y.T.E., Pua, L.H. and Chan, M.F., 2013. Lost in transition—A review of qualitative literature of newly qualified Registered Nurses’ experiences in their transition to practice journey. Nurse Education Today, 33(2), pp.143-147.
Whitehead, B., Owen, P., Henshaw, L., Beddingham, E. and Simmons, M., 2016. Supporting newly qualified nurse transition: a case study in a UK hospital. Nurse education today, 36, pp.58-63.
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