Np Resilience Case Study

Transitioning from an licensed practical nurse to a registered nurse is of the hardest things I have ever done. Twelve years ago I took my boards and became a licensed practical nurse. Going to school to become an LPN was difficult, but I was not a mother and I did not work full time as I do now. Getting to know the students I attend school with has made me realize that each student’s role transition is different, with unique outlooks and emotional roller coasters. In the following paragraphs I will preview licensed practical nurse to registered nurse role comparisons, my change in

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.

Throughout this clinical semester, I have worked with several different registered nurses (RNs) and have been able to develop mentoring relationships with many of the staff on the unit. During our time together, I interviewed several of my nurse mentors and elicited information regarding their nursing experiences and the culture of the environment in which they work. The following conversations provide a summarization of my nurse mentors’ responses to the selected interview questions.

The new graduate nurses (NGN) are faced with various issues and challenges especially in their first year of nursing practice. The period of transition from a student to a graduate nurse is a demanding period that is filled with new experiences and there are several concerns and factors that can affect the transition process. The research into the issues has recommended some strategies that can be utilised to ease the transition process from being a student to a professional practicing nurse. Exhaustion, reality shock and time management are some of the factors and issues that the new graduate might encounter during their first year in their career.

Workload was described to be heavy, stressful, increase in intensity and overtime hours. As a result 25.8% consider resigning, 20.2% consider retiring and 25.6% consider leaving profession. Another problem that was observed at individual level was poor commitment to care. One of the factors that often limited nurses to provide therapeutic care was the change in nurse to patient ratio. As nurses assignments increase with the increase in the number of patients (i.e. 1 nurse to 6-8 patients) the quality of care provided decreases. Nurses’ ability to maintain safe environment became challenging. As part of caring, nurses also showed decreased amount of time spent with their patient. This eventually led to nurses being less satisfied with their current job. Self – efficacy was often low. Nurses felt that they did not have enough knowledge and skills required for professional practice (Newhouse, Hoffman, & Hairston, 2007). This often led into stressful transition and the ability to care for a patient even harder. New graduate nurses often had difficulty maintaining leadership role. They often felt that they did not have the ability to self advocate and raise their voice to be heard by others. They often feared that they would be over heard and that no one would listen to them (Mooney, 2007).

There have been several studies exploring the development, implementation and evaluation of preceptor programs for advanced practice nurses. Bahouth and Esposito-Herr (2009) described a formal, 12-week orientation program for newly graduated nurse practitioners that helped to integrate those providers into the clinical teams. One part of their program was the assignment of a NP preceptor for the new employee, which was found to be effective in reducing the new NPs feelings of isolation. In addition, Baumgartner and Williams (2014) developed and evaluated a mentoring pilot project, inclusive of a variety of advanced practice providers (APPs), which supported the program’s ability to improve inter- professional networks and system supports. Furthermore, Sorensen (2010) developed an orientation and mentoring program for APRNs and physician assistants.

The objective of this study is to examine the role transition from Licensed Practical Nurse (LPN) to Registered Nurse (RN).

The national shortage of Registered Nurses (RNs) has helped generate formidable interest in the nursing profession among people entering the workforce and those pursuing a career change. According to a report issued by the U.S. Department of Health and Human Service in 2002, the national population is continuing to grow and age and medical services continue to advance, so the need for nurses will continue to increase. They report from 2000 to 2020 the predicted shortage of nurses is expected to grow to 29 percent, compared to a 6 percent shortage in 2000. With the projected supply, demand, and shortage of registered nurses and nursing salaries ever-increasing, the nursing profession can offer countless opportunities. But first one must

The U.S. Bureau of Labor Statistics (USBLS) estimates the need for 439,300 registered nurses (RN) from 2014 to 2024, equating to a 16% increase in employment opportunities (USBLS, 2015). Approximately 30% of new RNs leave their first jobs with less than a year of hire and 525,000 nurses are expected to retire from 2012 to 2022- a demand totaled to around 1 million jobs by 2022. This increase is attributed to retiring baby boomers, turnovers, healthcare reform, and the increasing aging population (Kiel, 2012; USBLS, 2013). Control over the retirement of baby boomers is unrealistic, however, nursing turnover can be regulated.

For years now it has been well know and documented that there is a brutal disconnect between what school prepares NGRN for and the reality they find once they begin working.(Duchscher, 2009) This stark difference found between school and reality sets new graduates (NG) up for a hard fall and the disillusionment they are under when entering the professional practice can lead them to exit nursing altogether.(Duchscher, 2009) The problem then of course becomes recruitment and retention, and the cost of training new nurses back in 2007 was recorded to be as much as 82,000 to 88,000 each.(Ulrich et al., 2010)

The research problem in CS1 is the Insight in role transition that a nurse practitioner (NP) can help NP student’s transition into a new graduate and being able to take on the new responsibilities in an ever changing and highly demanding healthcare world. Within CS1 the aim is to use Meleis’s framework of transition to explore the role shift from student NP to graduate NP.

The article by Bally Jill (2007) identifies that nursing leadership can use mentoring culture to achieve professional and career development in nursing, and increase the quality of care given, especially for acute care nurses. This is because the article finds that nurses often have low morale, heavy workloads, high patient acuity, apathy towards professional collegial support, and reduced resources. The article identifies that mentoring in

Prior to deciding to return to school to obtain a NP degree, I had been considering this change for many years. The circumstances that motivated me to enroll in Indiana Wesleyan University centered around changes in my workplace. The atmosphere at work became progressively more fractured and I became unhappy and dreaded going to work. The efforts of the staff nurses to address an increasingly

The transition from student status to qualified practitioner can be a daunting and traumatic time for the majority of individuals. Feelings of inadequacy and the inability to cope with this change can prove extremely stressful for the newly registered nurse and place new, ill-prepared for demands on them. Kramer (1974) describes this as 'Reality Shock'. It could even result in a change of career for some people. Allanach and Jennings (1990) stated that 'by easing the transition into the professional practice role, preceptorships may be useful in mitigating negative affective states which, in turn may effectively reduce the premature exit of new nurses from the profession'. There could also be a damaging

Fig. 1 shows that the energy states and the LDOS of two hybridized MQPs are parity-correlated. Next, we considered whether this parity-correlated information can be manifested in transport properties. In previous studies, researchers mainly focused on the AR or CAR properties of MQPs. Those results are difficult to connect to parity. Recognizing that there is another ET process, an NSN model as shown in Fig. 1(a) was considered to investigate the interference information. Unlike the previous models, here the voltage is applied only on the left lead; the voltage on the right lead is set to zero. In this situation, the local Andreev reflection process cannot occur at the right lead; only the non-local transport process can occur. Fig. 2(a)