Challenges Faced By Newly Graduated Nurses During Medication Management

Challenges in Medication Management

Question:

Discuss about the Graduate Nurses To The Workforce.

A graduated nurse like me face several challenges when we make a transition from a university student to a clinical practitioner. Among all the challenges that a nurse faces, medication management is the vital and the most important area where a nurse needs to develop to deliver quality clinical care and medication management effectively (Sulosaari et al. 2012). Medication management is a methodological management of medicines that patients take and it is the duty and responsibility of the nurse to look whether the patients is complying with the prescribed medication. The medication is especially important for the patients that take multiple medicines for the treatment of chronic illness and different diseases. Accordingly, effective management of medicines, and monitoring the patients are the several challenges that a newly graduated nurse faces. Although the role of the newly graduated nurses is clearly depicted, often due to mistakes and errors on the part of the novice nurses causes more complication compared to the experienced registered nurses. The lack of experiences of the novice nurses, stress, the issues of unacceptability when assigned to a new team and the inability to communicate effectively with the other staffs and nurses are identified as the vital reasons for errors in the newly graduated nurses. During the transition of the newly graduated nurses to the role of practitioner, the medication related errors occurs the most in the Australian Hospitals which has serious health implication on to the patients (Weidman 2013).

I as a newly graduated nurse have selected medication management as the focal point for the essay because, I have determined the problems related to medication management as vital issue for newly graduated nurses through my practical and theoretical experiences. There are several areas where I have difficulties which include the medicine delivery and handling, storage, proper administration of drugs, proper recognition and intervention of the side effects, adverse events related to improper medication and complications. Upon reflection, I found that the problems that I am experiencing is vital for me because my understanding and practicing gap can lead to serious health implications (Cherry and Jacob 2016). Although I have proper theoretical knowledge, the lack of practical exposure is leading to several errors during practicing. The environment provided in the classroom environment do not match with the environment during the practicing because, during practicing there is an added effect of the rush, stress and work load. These factors negate and nullify the knowledge gained during the training. I especially being a novice and newly graduated nurse face difficulties in intravenous (IV) medication because I lack the lack the confidence in formulating the right dosage. Because formulating the right dosage depends on patient’s several physical parameters (Nursingmidwiferyboard.gov.au, 2017).

Competencies and Confidence in Nursing

According to Hofler and Thomas (2017), other than the challenges in the medication management, there are other challenges ranging from the increasing number of patients which leads to increased complexities and work load, the less number of experienced coaches and mentors, workforce having staffs of different age group, anxiety related issues, and bullying. The worst part is that these issues often occur simultaneously. It is a known fact that during transition from graduate nurse to practitioner, nurses feel stressed and fatigued. For a nurse, she has to manage different kinds of patients, manage proper relationships with the family members of the patients and provide guidance to the inter-professional team. Often the novice nurse had to deal with the complex patients which make the novice nurses like me exhausted and overwhelmed, thus we suffer from anxiety resulting into attrition (Washington 2012). Proper addressing of fatigue is important because role ambiguity related issues contribute to a large extent to burnout among the novice nurses. studies have revealed that when professional nurses find the reason for their burnout, they often get detached from the team in their workplace, which causes more anxiety and stress of that nurse. The performance of the stressed and fatigued nurses drops which results in to the compromise of patient’s health conditions and safety. According to Moura, Orgambídez-Ramos and Gonçalves (2014), role ambiguity occurs when clear information is not communicated to the newly appointed nurses. The lack of the clarity of information often results into mistakes and errors which both affects the patient’s safety and nurse’s mental state. Role ambiguities result into role strain which negatively impacts the working efficiencies of the novice nurses and even further deteriorates when more than one demands are put onto the novice nurse. The reason for such deterioration in the work quality are the uncertainties associated with the role, which leads to increase in levels of stress, over burden of the work and a state of confusion among the novice nurses. This factors reduce the productivity of the nurses and it directly affects the quality of care delivered to the patients. Thus, a probable medical safety issue arises.

Competencies and confidence are the both sides of the same coin because nurses like me who is currently going through a transition phase, I need to be competent enough to perform my tasks confidently. According to (Nurseeducationtoday.com 2017) the concept behind competence are the skills at the core, more specifically the clinical skills, which are essential for the best practices. Studies reveal that technical skills are the most desired skills whereas empathy and humanity comes second. Hence, these are the skills that make a registered nurse competent. There are many skills that are required in the modern day nursing. Certain skills like the personal hygiene of the patients, hand hygiene, aseptic dressing technique, drug administration, are the most desired skills that a registered nurse must possess to be competent. This skill sets help in the personal management and effective care and medication delivery. Also there are certain skills that are often neglected and not taught during the training are the ways to break the bad news to the relatives of a patient. These competencies cannot be termed as the most important and ultimate skills, while the employers want the newly qualified nurses like us to have certain advanced skills. The advanced skills include electrocardiography, intravenous cannulation, defibrillation and the usage of the syringe drivers carefully (Masters 2015). In addition to the competencies there are instances where I lack the confidence in my ability to deliver the task competently. The prime for such lack of confidence is the lack of understanding of the assigned task. Studies revealed that confidence is an important aspect of nursing. Intravenous cannulation especially helps to deliver the intravenous medication through a cannula. Thus, donning this skill can help in effective delivery of IV medications.

Preservation of Self through Reflective Practices

Preservation of self through reflective practices is important for newly graduated nurses like me because, reflection allows the newly graduated registered nurses to understand patients in a much better way through the application of the reflective practice and reflective writing in a clinical perspective (Wallace 2016). Reflective writing helps to me to comprehend and generate a clear perception of a situation, develop clear thinking and problem solving capabilities. The possibilities of the reflective practice are many which even includes to have a clear demarcated goals, adopt a collaborative nursing style, express feelings effectively. Furthermore, reflective practice helps me to increases the learning competencies and thus will help me to achieve clinical competencies and will help in effective medication management (Oelofsen 2012).

I feel that being a novice registered nurse, time management and setting the priorities play a major role in our effective medication management. According to Hemsley, Balandin and Worrall (2012), transitioning to a registered nurse is although a rewarding experience but it does come with a hectic schedule. If I do not schedule my tasks beforehand it becomes hectic and tiring to cope the ever increasing tasks that come piling later on. Thus scheduling the daily tasks and how much time each task will take and planning accordingly can yield better results. Prioritizing the task helps me to manage the tasks effectively and prevents me from forgetting any vital task (Nunes, Rego and Nunes 2014). Prioritizing the works helps to place the important tasks above the less important ones, thus I can say that this is an effective plan which minimizes and reduces distractions, keeps the tasks organized (Mayor, Bangerter and Aribot 2012)

I as a new graduated nurse making a transition from to practitioner faced several challenges while becoming a part of the team. One of them is that as a new graduate nurse, we are not viewed as a permanent nurse and due to our rotating nature of shifts we are often subjected to bullying (Farrell and Shafiei 2012). According to Ajan.com.au (2017), hospitals must implement and develop practical and realistic ways to remove bullying in the workplace. I felt that the issue of becoming a part of the team often becomes cumbersome and depressing because effective teamwork helps to cope up with the tough situations, it helps to effectively manage the work pressure. Moreover, communicating effectively in a team helps in effective medication management (O’hagan et al. 2014). The effectiveness increases depending how the senior team members helps and guides the new graduated nurses and thus creates a cooperative work environment.

Time Management and Prioritization

Therefore, to conclude from the above disclosure, the best practice of medication management includes the traditional 6 R’s (Lewis, Strachan and Smith, 2012). The medication given to the right person, at right time, in right form, through right route and right dose and right documentation. The student experiencing a transition from a student to practitioner faces several hurdles and challenges (Barlem et al. 2013). While I found medication management as the biggest challenge during my transition. Getting adapted to the new environment, getting into a new team, work pressure due to mismanagement of time and lacking the confidence due to role ambiguity during work hours are the other hurdles that I need to overcome during my transition. I hope to bring the best out of me through practical learning, and gaining confidence to deliver the medication management competently.

References

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