THE TRANSITION STUDENT TO GRADUATE NURSE

McKenna, L., & Newton, J. M. (2009). After the graduate year: a phenomenological exploration of how new nurses develop their knowledge and skill over the first 18 months following graduation. Australian Journal of Advanced Nursing, 25. Retrieved from http://web.a.ebscohost.com.proxymu.wrlc.org/ehost/pdfviewer/pdfviewer?sid=57a243af-c0d3-4f81-addf-041456493db3%40sessionmgr4005&vid=1&hid=4206

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

It is imperative that the new graduate nurse cohort be given a full immersion into the organizational culture, a quality orientation program, and to feel welcomed into their departments to foster embeddedness early in the program (Reitz, 2014). To facilitate this, the program will begin with a welcoming gathering for their inauguration. This gathering will be designed to introduce the new graduates to organizational leaders, former graduates, and new graduates within their cohort in order to begin the building of relationships. Specific department leaders, supervisors, and team leaders will be invited to attend to support and welcome the new graduates, and to foster buy-in by department leaders.

In order to provide lasting solutions to the nursing shortage, we should determine whether actively recruiting mature new nurses is appropriate. Bedside nursing is an intellectually and physically demanding profession. The burnout rates and first year attrition are disturbingly high. A three year study of over three thousand American NGNs found that 37 percent intend to leave their jobs after one year (Kovner et al., 2007). Another review found that while there are many market variables, the average American NGN costs hospitals over $82,000. Thirty percent of these leave in the first year and 57 percent in the second (Twibell et al., 2012). Given the high barriers to entry, the statistics are surprising. Before we continue to invest in recruiting mature nursing students, we should determine if they are likely to persevere in practice.

Considering the progression of transition for Enrolled Nurses (ENs) to Bachelors of Nursing (BN), identifying their strategies and barriers to adapt to the university learning background is essential to grant support appropriately to enrich their learning and success. The author has selected an interpretivist and qualitative approach study that carried by Hutchison, Mitchell and St John, (2011) to analyse transition experience of ENs to BN in Australian universities. The following study has done a focus-group interview as a method of enquiry and has chosen 10 participants who are ENs transitioning to the BN in a Queensland University (Hutchinson, Mitchell, & St John, 2011).

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.

Nursing can be a demanding career, but the benefits far much outweigh the challenges. Most importantly, it’s the rewards it offers by allowing an opportunity to make a difference in another person’s life through the provision of care when they need it. Just as Patricia Benner theorized in her book “Novice to Expert,” nursing encompasses both educational knowledge and extensive clinical experience acquired throughout one’s career. This far, I continue to acquire knowledge and clinical knowhow which will promote proper and efficient care to patients. Since I began practicing one year ago in a long-term healthcare facility, I have interacted with patients, families, physicians and other members of the healthcare team to coordinate patient’s care which has enabled me to gain confidence in myself. While I cannot deny that it was difficult to transition from a student to a licensed nurse, I learnt to overcome these challenges and focus on my strengths. Practicing as an LPN has provided a platform to learn and gain experience even though the duties and responsibilities are limited by the scope of practice.

In addition to understaffing, health care professionals are also placed within a setting where they are overworked. According to a research study by Imai et, al. (2004), “Excessive work demands, particularly for emergency overtime work, and low job control for community psychiatric nurses appear to represent work environment factors contributing to burnout”. When institutions are understaffed, it often means that nurses are then over worked. When this occurs, they no longer have the ability to upkeep their self-emotional and physical health. According to an article by USA Today (2015), “A steady stream of studies link fatigue to errors, increased risk-taking, declines in short-term memory and a reduced ability to learn – with researchers likening the performance of someone awake for at least 17 hours to that of a drunk person”. A common work shift currently for nurses in these settings are at least 12 hours at a time. Fatigue can also increase if workers have 12 hour shifts, for multiple days in a row. When an individual reaches this level of fatigue, it can be difficult for them to then care for another individual to the best of their abilities.

According to Cappel, Hoak & Karo (2013), “nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression” (p. 22). This recommendation is one of the eight recommendations presented in “The Future of Nursing: Leading Change, Advancing Health” report in 2011. The research has shown that the Nurse Residency Programs (NRP) is often mistaken for “the new hire” orientation or an internship in a nursing specialty area. This concept was first noted in the literature review in the 1908s as a model for transition into practice for the new graduate nurses (Cappel et. al., 2013).

Role transition is a real change of thinking process as a nursing student from LPN to BSN. After taking this course, I have a new lens that I can look through intrapersonal, interpersonal and contextual levels of health and healing process of my patients.

According to Suzanne Gordon “ whether young or old, nurses are disillusioned because they believe that health care systems guided by bottom-line concerns simply don’t recognize the specificity of their work” (234). Nursing is more demanding than many other professions or occupations, due to the combination of difficult patients, exhausting schedules and arduous physical work (Gordon 235). It can take a significant emotional toll on many, hence the higher levels of burnout. Job dissatisfaction as a result of increased workloads and unreasonable demands, such as inappropriate nurse staffing levels, was cited as the number one reason that drives many experienced nurses to leave the profession (Sanford 38+). Studies have shown that such working conditions also affected the retention of new graduate nurses by leaving their first hospital jobs within two years of graduating (Sanford 38+).

In many if not all acute care hospitals, nurses work twelve hours shifts, three days a week, including mandated weekends and holidays. Many nurses report that there is a lack of control over days off with an inability or unwillingness by management to adapt work schedules in order to help meet employee obligations (Hill, 2009). Due to management’s lack of flexibility and the limited amount of leave allotted, many nurses may seek other jobs that provide a more life-work balance.

Nursing jobs provide emotionally and financially rewarding careers. The health care industry employs millions of nurses and the job outlook continues to improve each year. This paper explores two common types of degrees held by Registered Nurses (RN) and seeks to emphasize the primary differences between the two. An individual who has a Bachelor of Science in Nursing (BSN) or an Associate Degree in Nursing (ADN) can become an RN after passing the NCLEX-RN examination. However, there are certain advantages to having a BSN degree rather than an ADN. Although both degrees fulfill the educational requirement to become an RN, a BSN degree offers greater opportunity for career advancement and higher potential earnings. The paper discusses this through Chris Jensen, nurse manager of the child/adolescent psychiatric units at Kingswood Hospital. The leadership and management skills, educational background needed to be successful, as well as, responsibilities of the position are also discussed.

Nurses are especially vulnerable to several related effects of stress, such as burnout, job dissatisfaction, increased interpersonal problems, increased health complaints, disturbances in sleep patterns, as well as clinical depression and anxiety (Villani, Grassi, Cognetta, Toniolo, Cipresso, & Riva, 2013). The potential for stress can be reduced by resolving difficulties in the workplace promptly, addressing staff shortages, turnover and absenteeism, and developing clear objectives and plans (McIntosh, & Sheppy, 2013). Learning to manage and reduce stress by developing insight and coping strategies will help to maintain and promote nursing integrity and consistent patient care (McIntosh, & Sheppy, 2013).

Novice nurse attrition rates continue to haunt the profession of nursing, with rates as high as 30% leaving within the first year, and as high as 57% by the second year (Chandler, 2012; Laschinger, Grau, Finegan, & Wilk, 2012). These new graduate nurses who leave the profession commonly report reaching a state of burnout (Suzuki, Tagaya, Ota, Nagasawa, Matsuura, & Sato, 2010). Furthermore, with an aging nurse population, high attrition rates only compound the threat of an impending nursing shortage. While multiple studies identify and explore the independent stressors that may be contributing to the new graduate nurses’ intent to leave, little to no research exists that explains why, despite similar practice environments, some nurses engage