Essay on The Transition From Student to Practicing R.N.

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 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.

Nursing is a challenging profession and there are many qualities a person must have in order to be a successful nurse. Simply put, “nurses must have a reliable knowledge base for decision-making, clinical judgment, critical thinking, and lifelong learning” (Hamilton, 2011, p. 16). Likewise, it is well known that the demand for qualified nurses has increased, and with that so has the interest of students to enter this field has also increased. According to the AACN (2014), “RN enrollment has increased every year for the past 13 years, and the biggest limiting factor is instructors and clinical sites.” However, according to a study, “Although enrollments continue to grow the attrition rate nationwide hovers around 50%” (Beauvais, Stewart, Denisco, & Beauvais, 2013, p. 918). This is an alarming amount of students dropping out of their programs, and with it comes many burdens. When a student drops or fails out, the school loses money they would have generated and in addition, a demanded worker not provided. Additionally studies have shown that, “primary reported explanation for student attrition is admission of minimally qualified students to nursing programs who do not demonstrate adequate preparation to begin the rigorous curriculum” (Hamilton, 2011, p 27). In turn, with the national nursing shortage, it is essential we explore

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).

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:

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.

The shortage of nurses has gradually increased throughout the years. This shortage has taken a toll on patients, prospective nursing students, and faculty members. According to the American Association of Colleges of Nursing, “In 2012, United States nursing schools turned away 79,659 qualified applicants from baccalaureate and graduate nursing programs” (American Association of Colleges of Nursing [AACN], 2014, para. 5). Unfortunately, even though there is a high number of students wanting to enter the nursing field there are not enough instructors to educate and train the students properly due to the low pay incentive for nursing professors. According to Brown (2015), “Clinical settings offer higher salaries than

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.

Feng and Tsai (2012) examined the socialization experience of new graduate nurses transitioning to professional roles and noted that they face numerous challenges then moving to their new roles. Thus, they should be socialized into the nursing practice. Nurses should learn formal and informal regulations and rules of the healthcare facilities as they influence their behaviors. Most of the new graduate nurses have the competencies needed to become registered nurses, but feel they are unprepared for the expectation of the new roles. Scholars have expressed concerns regarding the difference between the values taught in nursing schools and the realities of the

Nurse turnover is defined as “the number of nurses changing jobs within an organization or leaving an organization within a given year” (Baumann 2010). Retaining nurses is one of the most important issues in health care as its effects range from challenges in human resource planning, to high costs in financial and organizational productivity (Beecroft et al, 2008), to workgroup processes and morale, to patient safety and quality of care (i.e. patient satisfaction, length of patient stay, patient falls, and medication errors) (Bae et al, 2010). Nursing Solutions Inc (NSI) reported the national average turnover rate for hospitals increased from 13.5% in 2012 to 14.7% last year. Nurses working in Med/Surg had more turnover

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+).

As of 2008, there were about 753,600 Licensed Practical Nurses and 2,618,700 Registered Nurses in the United States (U.S. Department of Labor, 2010-11). In the year 2018, the LPN employment percentage is expected to rise 21% while the RN rate should be approximately 22% (U.S. Department of Labor, 2010-11). This may not seem that high, but it is, when one considers that the expected employment rate for a Dentist is only expected to be 16% (U.S Department of Labor, 2010-11). Nursing is a highly respected and sought after career because every person that enters this profession is able to make a difference and is needed by the general population for his/her skills and contributions to the medical field. When a person is contemplating entering

The need for a continuing supply of new graduate nurses, and their retention in the workforce, is evident. However, while the national average of turnover for all nurses is 8.4%, the national average turnover rate for new graduates is 27.1%. CITE HARRISON Additionally, American nurse today reports new graduate turnover to be 30% within the first year of practice and as much as 57% in the second year, while other estimates of first year nursing turnover are as high as 60 to 75 percent CITE 1, CITE WELDING,

The general problem I am researching is that job discontent, burnout and workplace unfairness lead to high turnover among nurses globally. High turnover results in nursing shortage and lower productivity than in turn compromise patients’ perceptions of the quality of care they receive, and nurses’ job satisfaction, performance, and organizational commitment.

I once heard someone say, “Find something you love to do and you’ll always be successful.” If you want to be in a field where you are continually learning, nursing would be the top pick. This paper will reflect the journey I have taken from Registered Nurse (RN) to Bachelor of Science in Nursing (BSN) with the incorporation of my learning objectives from my clinical course.