The phase of transition from a student nurse to a registered nurse is a new experience for the nursing students; hence a multitude of issues may occur during this period (Kensington et al., 2016). Hence, it is important for a student nurse to remain aware of this crucial phase and understand their professional role to improve their professional values. According to Hayes (2018), it is important to build in-depth understanding regarding essential clinical and non-clinical skills to facilitate the transition to a professional nurse. For example, a student nurse needs to focus on the process of analyzing vital signs as a clinical skill to identify the impairment in vital signs (McCutcheon et al., 2015). On the other hand, the non-clinical skill such as communication is another important skill that a student needs to focus in order to become a successful registered nurse in future (Kourkouta & Papathanasiou, 2014). The purpose of this essay is to explore the different factors that need to be considered while preparing for transition to professional practice. This paper will critically analyze various nursing skills, nursing theories and reflect on own preparedness for becoming a graduate nurse. This essay aims to prove the thesis that it is important to have in depth understanding regarding various clinical issues and nursing skills for new graduate nurse to access adequate support for the transition to professional nurse.
As mentioned earlier the phase of transition to new graduate registered nurse is a new experience for the nursing students and they may face various difficulties in order to settle in the new clinical settings. This is mainly due to the new clinical environment which is completely different from their academic environment (Kensington et al., 2016). The common problems that a student nurse faces during this periods include the theory to practice gap, time management, communication issue, accountability, decision making and collaborating with the wider medical team (Duane & Satre, 2014). According to Kensington et al., (2016) due to the surrounding of experienced nurses the new graduate nurse sometimes experiences the supernumerary situation, hence, feels unprepared, inexperienced and incapable in their professional field. As opined by Hayes, (2018), beside such issues there are certain benefits of this transition phase that lead to the development of nursing skills, for example, the opportunity to interact with patients and improve communication skill, improve accountability for their own practice and learning various psychosocial assessments. Walton et al., (2018) have argued that the critical phase of transition helps the new graduate nurse to become more confident due to their experience in clinical practice and it helps them to develop their various nursing skills that are required to provide quality service and achieve positive outcomes.
In order to cope up with the issues faced by the new graduate nurse during their transition to professional nurse it is important to have in-depth knowledge regarding the various clinical and non-clinical skills which could help them to establish themselves in the new clinical environment (Hutchinson et al., 2016). As per Duane & Satre, (2014) the basic knowledge about clinical skills such as assessment of vital signs, administering IV injections and others. The adequate academic knowledge regarding such clinical skills would help the new graduate nurse to understand the application of academic knowledge in the practical field to provide quality service and avoid malpractice. In spite of such clinical or technical skills the nurse should contain essential non-clinical skills such as effective communication. It would help them to interact with patients to understand their concern and communicate with peers to avail adequate collaboration (Kourkouta & Papathanasiou, 2014). McCutcheon et al., (2015) have recommended that the skill of decision making and critical thinking is also important which enables the nurses to analyze clinical situation and introduce intervention that is best for managing particular situation. As per the argument of Hutchinson et al., (2016) such understanding about the nursing skills would help the new nurses to adjust with the new environment and develop knowledge and experience to become successful nursing professional.
There are various nursing theories which could help to shape the perception of a student nurse in order to become a registered nurse. Such theories could help to understand the different aspects that are required to consider during the phase of transition from student nurse to professional nurse in order to facilitate the transition phase. In this regards, the contribution of the Benner’s stages of clinical competence is considered as most valuable. According to this theory of nursing, it is important for a nurse to go through the five levels of proficiency such as, novice, advanced beginner, competent, proficient, and expert. In the stage of novice a nurse lack experience and confidence to manage the given clinical situation, hence requires physical and verbal cues in order to perform their duty effectively. In advanced beginner stage, a nurse becomes skilful and efficient to perform clinical tasks due to the experience of working in practical field. However, supportive cues are required occasionally to develop core knowledge. The third stage known as competent is appropriate for a nurse who has engaged in a task or similar situation for more than two years. In this period a nurse becomes competent to provide deliberate planning and discretionary judgment without any supporting cues. The stage of proficient is associated with the nurse that are able to represent holistic understanding regarding a clinical situation and implement appropriate interventions in order to manage the situation in an effective manner. Finally, the stage of expert enables a nurse to acquire intuitive grasp regarding each situation and perform the clinical task with flexibility and high proficiency Benner, (2004). Each stage of Benner’s stage of clinical competence allows the nurse to improve their nursing skills to convert them from beginner to an expert nurse during their clinical practice.
Another important theory which could guide student nurses during their transition to registered nurse is Dreyfus’ model of skill acquisition. This model is associated with four binary qualities such as recollection, recognition, decision and awareness. Such binary qualities are linked with the stages of transition from novice to expert. The model is used in order to support the development of nursing skills and assessment of level of competency of the nurse. The quality of recollection is considered as non-situational during novice period and it develops to situational through the stages of advanced beginner to expert. Through the stages decomposed recognition becomes holistic one and a nurse starts to make intuitive decisions. It is important for a nurse to monitor the clinical practice throughout the stages from novice to expert in order to develop awareness. According to Benner, (2004) he stage of expert does not indicate end of development, even the experts need to evaluate their practice to update it with new evidence accordingly.
Reflect on the preparedness for new registered nurse is important as it helps to identify the mistakes and learn from them to develop skills and improve clinical practice. As per the description of Rolfe, Jasper & Freshwater, (2011) the first stage of reflection includes reflecting on what happened. As I reflect on the preparedness of transition from student nurse to registered nurse, I trust that my academic knowledge and clinical placement has prepared me effectively to communicate information appropriately. I have used effective communication in order to access collaboration from the peers and interact with the patient. My strength of communication accurately aligns with the guidelines of Nursing and Midwifery Board of Australia. According to the standard 2 of NMBA it is required to use effective communication in order to establish therapeutic and professional relationship during clinical practice (nursingmidwiferyboard.gov.au, 2018). In addition, I use adequate skill of clinical reasoning and problem solving in order to make appropriate decision regarding a situation. In this regards I have always remained engage in nursing research to improve my nursing skills and keep myself up-to-date with the new evidence. As per the NMBA standard 1, it is important to analyze a clinical situation with the help of best available evidence; hence I can say that my clinical reasoning, research and problem solving skill also align with the guidelines of NMBA (2018). Furthermore, my strength of effective communication and decision making has enabled me to contribute in the team work efficiently. Now, I realize that, currently I am at the orbit of so what stage of Rolfe’s reflection model. As I have grasped the required nursing skills I believe that I could cope up with the issues that a new registered nurse faces during transition phase. Such skills would help me to collaborate with the experienced staffs, gain knowledge from their performance and improve my practice. In order to link with the now what stage of Rolfe’s reflection model I can say that I need to utilize my skills and knowledge in the practical field, follow the instruction of the senior staffs and keep on evaluating my practice to achieve the status of an expert nurse.
Conclusion
In conclusion, it can be said that the phase of transition from student nurse to registered nurse is crucial and comes up with various challenges. Hence, it is important for the new graduate nurse to focus on the essential nursing skills and grasp them in order to reduce the difficulties during the transition phase and adjust with the new clinical environment. In this regards the nursing theories such as Benner’s stages of clinical competence and Dreyfus’ model of skill acquisition could help the new graduate student to understand the importance of utilising each stage and plan accordingly for the preparedness of new graduate nurse. In addition, it is also required to reflect on the preparedness in order to identify the mistakes and resolve them to achieve desired outcomes. Hence, the new graduate nurse needs to evaluate own practice and learn from the performance of senior staffs in order to reach to the position of expert nurse in future.
References:
Benner, P. (2004). Using the Dreyfus Model of Skill Acquisition to Describe and Interpret Skill Acquisition and Clinical Judgment in Nursing Practice and Education. Bulletin of Science, Technology & Society, 24(3), 188–199. https://doi.org/10.1177/0270467604265061
Duane, B. T., & Satre, M. E. (2014). Utilizing constructivism learning theory in collaborative testing as a creative strategy to promote essential nursing skills. Nurse Education Today, 34(1), 31-34. Retrieved from https://doi.org/10.1016/j.nedt.2013.03.005
Hayes, C. (2018). Simulation: Smoothing the transition from undergraduate to new graduate. Journal of Nursing Management, 26(5), 495-497. doi: 10.1111/jonm.12676
Hutchinson, M., Higson, M., Cleary, M., & Jackson, D. (2016). Nursing expertise: A course of ambiguity and evolution in a concept. Nursing Inquiry, 23(4), 290-304. Retrieved from https://doi-org.ezproxy.uws.edu.au/10.1111/nin.12142
Kensington, M., Campbell, N., Gray, E., Dixon, L., Tumilty, E., Pairman, S., … & Lennox, S. (2016). New Zealand’s midwifery profession: Embracing graduate midwives’ transition to practice. New Zealand College of Midwives Journal, 52,20-25. Retrieved from https://dx.doi.org.ezproxy.uws.edu.au/10.12784/nzcomjnl52.2016.3.20-25
Kourkouta, L., & Papathanasiou, I. V. (2014). Communication in Nursing Practice. Materia Socio-Medica, 26(1), 65-67. Retrieved from https://dx.doi.org.ezproxy.uws.edu.au/10.5455/msm.2014.26.65-67
McCutcheon, K., Lohan, M., Traynor, M., & Martin, D. (2015). A systematic review evaluating the impact of online or blended learning vs. face?to?face learning of clinical skills in undergraduate nurse education. Journal of Advanced Nursing, 71(2), 255-270. Retrieved from https://doi-org.ezproxy.uws.edu.au/10.1111/jan.12509
Nursing and Midwifery Board of Australia. (2018). Registered nurse standards for practice. Retrieved from October 22nd, 2018, from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/registered-nurse-standards-for-practice.aspx
Rolfe, G., Jasper, M., & Freshwater, D. (2011). Critical reflection in practice: Generating knowledge for care (2nd ed.). Basingstoke: Palgrave Macmillan. Retrieved from https://trove.nla.gov.au/work/38439355?q&versionId=50950950
Walton, J. A., Lindsay, N., Hales, C., & Rook, H. (2018). Glimpses into the transition world: New graduate nurses’ written reflections. Nurse education today, 60, 62-66. Retrieved from https://doi.org/10.1016/j.nedt.2017.09.022
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