Benefits Of Working Closely With A More Seasoned Nurse

The second half of my preceptorship went well and I learned a lot. I felt comfortable giving medications, performing assessments, and caring for the patients. I was able to complete all of my objectives. We were in the ER for one day, and the rest of the time my preceptor was the Charge Nurse on the med-surg floor.

When most experienced registered nurses hear the word shock, they begin to use their critical thinking skills to determine the patient’s immediate need. However, new graduate nurses in the career field are faced with a different type of shock; they are faced with transitional shock. Transitional shock is a theory created by Judy Duchscher. Her theory is based on reality shock which is a term coined by Marlene Kramer. Reality shock is when new nurses recognize clinical practice and the classroom setting are two different worlds (Hentz and Gilmore, 2011, p.134). When new graduates transition to a registered nurse position, it does not happen with ease. Over the years, there has been a rise in concern with this transition. As new graduates move in the career field, they may feel anxious and uncertain about their new responsibilities. Unfortunately, when there is a high demand of nurses, new graduate nurses are expected to begin a new job at full speed, but they are not able to handle the fast pace position they are placed in. When new graduates are expected to accomplish task they are unprepared for, it sets them up for transitional shock. To minimize transition shock for new graduates, finding a mentor, preceptor, seeking an internship or residency program may help ease the transition.

This class was very challenging, interesting, and informative. First, students must push themselves to expand their knowledge and help themselves become more inquisitive, critical, reflective, and problem solve. As future professional nurse practitioner, we are striving for integrating clinical judgment skills. The knowledge gained in the textbook must be applied in the clinical settings without discrimination.

Over the course of this preceptorship, I have written a few different journals with the nursing process as my topic, the reason for this is because the nursing process is everywhere and has become a part of my day to day life, not just during my different clinicals over these past couple of years, it has spilled over into work, school work assignments, and home life, as well as. I now find myself assessing everything that needs to accomplish throughout my day and developing a plan of action, setting priorities to works towards their completion. Another topic that I feel is very important for a nurse is professionalism and important in developing a trust with the patients in your care, as well as, to earn the respect of your fellow nurses and other members of the hospital staff. Over these past couple years and I have seen that many of the patients and their families look to their

Healthcare systems and the way safe, quality health care is delivered are continually changing to better serve patients and communities. Professional nursing practice is a large component in the healthcare system today. Back in the 1960s, professional nursing leaders tried to adopt the bachelor degree programs as the only educational track to become a registered nurse (Creasia & Friberg, 2011). Due to nursing shortages and demands this motive did not hold fast. Individuals entering the nursing profession today must first decide which educational pathway to take to become a Registered Nurse (RN).

With an ever-increasing body of knowledge in the field of nursing, more education is being required to enter the field of nursing. Many healthcare institutions are raising the educational requirements in order to become employed or maintain employment in their facilities. Healthcare organizations are transitioning to hiring registered nurses (RN) who have a higher level of education, such as, a graduate from a Baccalaureate Degree Nursing (BSN) program. The goal of these institutions is to have nurses with a broader array of skills that can meet the growing demands of our patient population. BSN prepared nurses are recognized for their well-rounded skills in critical thinking, management, case management and health promotion versus Associate Degree nurses (ADN)/Diploma nurses that focus on direct patient care.

The literature supports that a formalized preceptorship program can be an effective means of bridging the gap between educational processes and entering the workplace for the new APRN (Barker, 2006). Moreover, several studies reported that preceptors felt more confident and comfortable, had enhanced satisfaction and professional development following formal preceptor preparation (Bradley et al., 2007; Henderson & Malko-Nyhan, 2006; Kaviani & Stillwell, 2000; Sandau,

My practice in nursing has been influenced by various elements within my career. I have come to embrace that nursing is a learning process and one should expect constructive criticism. When I began as a “novice,” I found myself nervous in some clinical situations but I managed to remain focused on

Across the United States, hospitals are experiencing a nursing shortage. Yet, according to the American Association of Colleges of Nursing, 63,857 students graduated from nursing school in 2015 alone and enrollment is increasing. It seems like a lot of new nurses to fill those vacancies, does it not? Studies show, however, that within a year, about thirty percent of those new graduates have voluntarily left their job (Hillman). Further studies have attributed the high turnover rate to new nurses’ lack of competency to handle conflict, make critical decisions, and function autonomously (Bratt). Many of the new graduates are disappointed with the hospital’s orientation, or lack thereof. Lack of knowledgeable preceptors and lack of nursing staffing in general has led to new nurses being thrown into autonomous function more quickly. Without proper training, these nurses must make sound clinical judgements and provide competent care to patients, which anyone can imagine is stressful. Today, Nurse Residency Programs (NRPs) are being instituted in numerous hospitals as a way to improve new graduate nursing skill, but research shows many other benefits to these programs. NRPs also reduce hospital spending costs, increase patient safety, and most importantly increase new nurse retention rates.

The beginning of a new graduate nurses career rarely begins easily, there seems to be a distinct disconnect between the fantasy of what it means to be a nurse and the reality of bedside nursing. Nursing school seems to feed into this disconnection, in that it does not prepare the new graduate registered nurse (NGRN) for their professional practice. What nursing school does is give the NGRN the basics, a peak into what is to come. The NGRN has to find out for themselves what the true meaning of being a nurse is and if it fits their preconceived ideas.

The check-offs would not reflect negative on their job status but provide a guide for further learning if needed. The assigned preceptor could educate that resident on their particular needs. Letourneau and Fater (2015) in their research found nurse residency programs increase recent nurse graduate retention and help with the transition from student to practicing registered nurse. The hope would be that using trained preceptors and encouraging the whole unit to be supportive to the nurse residents would increase the support felt by the new nurses therefore decreasing turnover and increasing morale for all nurses

A review of the literature was performed and yielded 26 articles relevant to precepting programs for novice nurses and advanced practice providers (APPs). For the sake of brevity, only the literature regarding novice APPs will be evaluated in this paper: six studies. Two had a date range exceeding 10 years, and were included in an attempt to fully explore the applicable literature. All of the articles reviewed can be found in Appendix A. The Johns Hopkins Evidenced-Based Practice Evidence Rating Scale was used to evaluate the literature (Newhouse, Dearholt, Poe, Pugh, & White, 2007).

According to Patricia Benner’s theory, I believe I am at the level of an “advanced beginner”. An advanced beginner is one who has had enough real life situations to understand the “aspects of the situation” (according to the Dreyfus model). The advanced beginner has the knowledge and the skills to perform adequately, but not enough in depth experience to be at the same level as a competent nurse. My recent experience during preceptorship has made me realize I am ready to be my own nurse. It has also made me realize, I have so much to learn. It will take time and experience to become competent. Each situation that arises is patient specific, therefore, a textbook can not tell you what to do. To advance towards becoming competent, time must elapse.

As Skar (2010) succinctly explained, knowledge, confidence and courage are potent factors when combined to empower nurses to perform autonomously in the workplace. All RNSE nurses scored highest in terms of mean score when it came to initiating nursing rounds regularly. The preceptorship experience could have instigated self-reflection in the RNSE nurses when it came to their nursing career and has further enhanced their awareness of their capacities, strengths and limitations, professional

Patricia Benner described the first stage as the novice nurse who is taught general rules to perform tasks without any, or very few, clinical experience. This rule-governed behavior is limited and inflexible (“From Novice to Expert”, 2013). Most nursing students are in the novice stage while they are completing their educational requirements (Cherry & Jacob, 2014). Although they have some exposure to clinical experience, it is limited and under the guidance of a nursing instructor rather than in a “real world” setting. According to Cherry & Jacob (2014), once the nursing student graduates, he or she will begin the progression into the advanced beginner stage (second stage). The advanced beginner nurse is able to make some judgment calls based on having experience in actual situations and performance is adequate. During this stage, the nurse begins to formulate principles to guide actions (“From Novice