The Competencies That New Graduate Nurses Enter The Work Force

Dyess and Sherman (2009) explains in their journal The First Year of Practice: New Graduate Nurses Transition and Learning Needs, even though newly graduated nurses have achieved licensure to perform their job duties, many lack the clinical skills and critical thinking needed to provide safe patient care (Dyess & Sherman, 2009). In order to prepare for the influx of new nurses, The National Council of State Boards of Nursing’s (NCSBN) ideas led to a grant-supported Novice Nurse Leadership Institute (NNLI), a transition program used for researching and improving the transition of new nurses into practice. This model includes several significant novice nursing skill topics such as self-knowledge, leadership, procedural skill and ease, effective communication, clinical judgment, professionalism, knowledge of the health care environment, cultural diversity and sensitivity, safe practice, business skills, caring for self, and many others (Dyess & Sherman, 2009).

The rising rates of seasoned nurses have resulted in replacing the more experienced and skilled professionals by infusing fresh graduates who lack the required skill and experience needed to effectively adapt to a clinical environment. This is coupled by the booming level of workload witnessed by these graduates who many are unable to cope with. Adding fuel to fire the initial work experience is discouraging for many graduates who hence are exhausted .This results in numerous fresh graduates completely burning out in just 18 months of their introduction to professional medical environment (World Health Organization, 2006).

An ongoing debate for the requirements to become a Registered Nurse (RN) has been unsettled. Several different educational pathways lead to an RN licensure; however, the minimum educational requirements must be standardized at the baccalaureate level for several reasons. Spetz and Bates (2013) published that a growing number of hospitals prefer hiring nurses with a Bachelor Science in Nursing (BSN) as this increases the status of the nursing profession (p. 1). Associate Degree in Nursing (ADN), as well as a certificate on-the-job training Diploma are two other educational pathways to become an RN, which can be disadvantageous to the nursing profession in several ways (Tollick 2013; Spetz and Bates 2013). If entry-level nurses

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.

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.

Transitioning from nursing school to working in a hospital setting can be a challenging time for a new graduate. Due to the nursing shortage, new graduate nurses are being hired with little to no experience. This is overwhelming for new nurses, especially when they are not getting adequate support or training from the hospital. The amount of stress, pressure, and lack of training is leading to a high turnover rate for new graduate nurses. With patient acuity on the rise, new graduate nurses that are filling these vacancies in the hospitals, need to be competent nurses to provide proper and safe care to the patients.

In the traditional health care model, formal learning is not complete when a physician receives their medical degree and white coat at the end of their academic program. Medical school graduates are required to complete an accredited hospital residency program to become licensed to practice medicine, (Jolly, Erikson, & Garrison, 2013). However, acute care nurse practitioners (ACNPs) are not afforded, nor expected to complete, the same educational requirements. The current expectation that a new graduate ACNP learn their advanced nursing role “on-the-job” is unacceptable and leads to decreased job satisfaction and preparedness. In the every-changing climate of health care, the development of required residency programs for ACNPs should be maintained as a priority.

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

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.

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.

Some of the dilemmas associated with today’s nursing force are: Many are under-educated and task-oriented, unaware of their patient’s plan of care, medical histories, or pertinent results. Too many rely on clinical coordinators and team leaders, when it comes to critical thinking, therefore, miss out on the vital fundamentals, which make nursing such an honorable profession (Grietens, 2007, p. 10). In order to create a stronger, more knowledgeable nursing workforce, entry-level requirements for RNs, as well as APRNs, need to be uniform. In addition, research shows bachelors and masters prepared nurses, result in better patient outcomes. An example of a proposed solution includes:

Today more hospitals and employers are seeking to hire nurses who have a “broader knowledge base of patient care, quality standards, business acumen and other skills” (as cited in American Sentinel, 2013, para 1). Obtaining the Bachelor Degree of Science in Nursing would fulfill these requirements for healthcare industry. The further education will improve outcome of the patient’s health and develop a sense of personal accomplishment. I will discuss the advancement opportunities for BSN nursing, my interview with a BSN nurse and benefits of joining a professional organization. With the current trend, nurses are expected to continuously gain knowledge and improve skills within their profession.

Starting the Registered Nurse (RN) to Bachelorette of Science in Nursing (BSN) program at Jacksonville University in June 2015 was a simple transition for me. I had graduated an Associates Degree in Nursing (ADN) program in December 2014 and became a licensed RN in January 2015. I had just gotten hired for my first nursing position the month prior to the start of class and had not yet started working. I was very much still in student mode. While this makes it a bit easier to learn and process information in a classroom setting, I had no real world experience to help guide me. Through the knowledge I have gained as a student at Jacksonville University I have become a competent and well-rounded nurse. I am able to quickly problem solve and utilize critical thinking to identify and rectify issues. I have even put together, and will be presenting, and presentation about nursing practice for staff members at the facility where I work.

Being a new graduate with a bachelor degree in nursing is the most exciting thing everyone would need to have in life. As a new graduate, there are so many challenges as the nurse is try to familiarize themselves into the role and responsibilities of the clinical practice. These challenges include the many stressful demands of the profession which does not only involve the nursing practice and patient care but also the socialization of formal and informal hospital orders and their regulations. In addition to this, the new graduate lack of knowledge and clinical experience actually makes it overwhelming. Although the new graduate nurse has the qualification that requires them to practice as register nurses, they still feel much unprepared for the expectations and demands of their new role. In order to increase comfort and facilitate my socialization into this new profession, the method to do this includes making effort to learn and practice many skills now in school. Also having the confident to ask questions of what I do not understand from the seniors who have been there for a long time will help to make socialization into the new role as a graduate nurse easy (Feng &

There is no doubt that the health care system is constantly changing and working to improve its flaws, to the best of its ability. Whether nurses like it or not we are a part of the ever changing health care system. “With more than 3 million members, the nursing profession is the largest segment of the nation’s health care workforce” (Institute of Medicine [IOM], 2010, p. 1). The Institute of Medicine believes that nurses should be active in transforming the profession of nursing, along with the health care system. Regardless, of backgrounds, race, and age all nurses can contribute to the future of the nursing profession. The following paper will discuss the Institute of Medicine’s nursing expectations and recommendations, as well as the opportunity to becoming a clinical nurse instructor.