The Four Stages Of The Bridges Model Of Transition

A study was done at a 1,300 bed urban facility over a 13-week period. The purpose of the study was to describe the causes of inpatient falls in hospitals (Hitcho, et al., 2004). All falls were reported except falls in the psychiatry service and during physical therapy sessions. During the 13-week period, a total of 183 patients at an average age of 63.4 years old fell. Of the total number of falls 79% were unassisted, 85% happened in the patient room, 59% occurred during the evening or overnight shift, 19% were while walking, and 50% were elimination related (p. 732). In this study it was identified that many patients did not use their call bell before getting up because they did not believe they needed assistance. It was stated that, “perhaps patients need to be better educated on the effects that a new environment, decreased activity, medications, tests, and treatments can have on patients’ energy and ability to ambulate safely” (p. 737). The findings of this study showed that falls not only happen in the elderly, but in the younger population as well. Patients that fall in hospitals are often unaided and are due to elimination needs. To prevent falls and decrease injury rates, more studies need to be done.

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.

A number of emotions were felt during this experience, in regards to transitioning from a student nurse to the registered nurse role. Primarily, the transition in role from student nurse to registered nurse was similar to any clinical experience I have had at Midlands Technical College. I was placed in a medical-surgical rotation. I felt slighted that not only were we required to complete a data tool but we also participated in the teamwork model demonstrated in prior semesters. Personally, I did not feel a transition during this particular clinical experience.

On August 2015, I started the RN-BSN program with the Transition to Professional Nursing as my first course. I took one class at the time because I was working as a full time nurse at the same time. I did not take a break and started a new class each start date because I wanted to complete this program as soon as possible. The journey has been a long, hard road and the stress was constant and many times I felt that I could not complete it; it has been a difficult but very satisfying journey.

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.

In the healthcare facility there are many things that can benefit from change. Bedside rounding with the inclusion of the entire care team would be a beneficial change to any healthcare facility. By doing bedside rounding it promotes patient and family involvement in the exchange of information and planning of their care. This also allows for the interdisciplinary team to be completely involved rather than picking up bits and pieces of information throughout the day from multiple different people. This is also a great opportunity for the patient and their family to ask questions with the entire care team available for answers.

What has surprised you? I think the most surprising thing about my nursing school journey has been how much I have grown and changed as a person in the past two years. I have become a much more assertive and direct person. I have a greater appreciation for the monotonous moments in my life and have learned how to not over think things and just to appreciate every moment and day for itself. Part of this group come about from clinical and part of it developed through my work experience as a nurse tech in the Emergency Department at Seattle Children’s Hospital. I personally have grown and learned a lot from the kids that I have worked with and its taught me the importance of slowing down and living in the moment. It’s also taught me that happiness is something that only you can determine. I feel that throughout all my clincials I have learned important life lessons from the people from every age and stage of life. All of these lessons have helped to shape me into a more compassionate, understanding, and better therapeutic communicator with my patients and have shaped my personal nursing practice.

The Bridge's model of transition is made up of three stages known as the ending phase, the neutral phase and the new beginnings phase. The ending phase is characterized by the ability of an individual to let go of the old responsibilities. It consists of components such as disengagement, misidentification, disenchantment, and disorientation. In the second phase, the nurse begins to accept the new position and its responsibilities, accepting that most probably their relationships with former peers will change. The nurse works to proceed in the new job while at the new beginnings phase of transition through the maximum resistance of the temptation to go back to former position. In my

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.

Upon reflection of this assignment, I must refer to my personal journey as an RN to BSN student. Currently, there is an influx of nurses returning to school at the same time and none of us have graduated yet. During my journey as an RN to BSN I have learned that changes are not as easy to implement. In addition I have grown to appreciate that I can no longer make a statement, or ask why a change is being implemented. Furthermore I have developed a sense of appreciation to learning new policies and procedures. I have become more flexible. Prior to my RN to BSN program I had no desire to be apart of any nursing committees. Over time I have developed a sense of awareness as to time management and ways to decrease feelings of burnout.

Transition theory is one of the most applied theories in the nursing practice. In fact, whether or not nurses are aware of this theory, it is often used in the nursing practice because nursing is all about helping people that are going through changes, whether they are physical changes like an illness or developmental transitions like the birth of a child. Meleis reiterates this point as he states “Nurses often are the primary caregivers of clients and their families who are undergoing transition. They attend to the changes and demands that transitions bring into the daily lives of clients and their families” (2000, p. 13). Before going any further in exploring Transition theory, we must define transition. Meleis states that “Transitions are both a result of and result in change in lives, health, relationships, and environments” (2000, p. 13). Transitions are the times when a nurse can step in and act as a therapeutic medium and help the individual have a smooth transition from one semi stable state of being to another semi stable state of being (McEwen & Wills, 2014, p. 237). This is the essence of Transition Theory. It is the process that goes on between people undergoing some changes in their lives, and the nurse who is guiding care for a stable outcome.

Another barrier as described by the IOM is high turnover rates among newly graduated nurses and the need for better management of the transition from nursing school to professional practice. In 2002, the Joint Commission (JCAHO) recommended developing nurse residency programs to give nursing graduates some time to acquire knowledge and skills to practice confidently as clinicians (American Association of Colleges of Nursing, 2002). The American Association of Colleges of Nursing (AACN) release a publication in 1999 on how nursing schools can collaborate with health care programs and facilities to support student learning and faculty development. It identified clinical learning experiences needed to prepare nurses for basic and advance practice

The idea of returning to school to master new skills to compete in the workplace is an excellent goal for any working adult. However, it is important for the working adult to understand success is base upon the journey taken and the path chosen by someone. One must realize there will be many barriers and difficulties along the way; however, with dedication, ability to prioritize, and motivation to stay focus, I will succeed and graduate with my Master degree in Nursing in October 2017. For me to be successful in achieving this goal, there are different pathways that I must chose and followed. These are assessing my learning styles, finding ways to manage my time, money, and stress, and setting S.M.A.R.T goals.

Expectations are defined as something that you believe will happen to you. Before nursing school, I had several expectations. Some of these expectations have shown to be very true while adapting to this new lifestyle. Other expectations have fallen to the waist side and soon were forgotten. At the time, they seemed to be very real. I expected to study, study, and study some more. I wanted the program to be challenging and prepare me to be a nurse. I expected to struggle financially because of having to reduce my days off work. I thought this would give me extra study time and I would make all As on every assignment. I hoped to form study groups to ensure that I would excel in making those grades. But, my most important expectation of myself was to stay organized and ahead on all assignments. I expected this to get me through nursing school.