Introduction
Nursing education prepares learners to become experts in providing skilled, high-quality patient care. In the present day, the global community is caught up in a crisis where there is rising demand for healthcare services amid a declining workforce. In particular, organizations are also finding it increasingly difficult to recruit and retain adequate nurses. The prevailing situation makes new nursing graduates a critical addition to the nursing community. Fresh graduates are well-considered for injecting new evidence-based theories to enhance service delivery.
However, transitioning from the learning environment into practice has numerous challenges. Nursing graduates struggle to meet work and work-life balance expectations and encounter stressful moments that impact their psychological wellbeing. The challenges further threaten to reduce the nursing staff, which is already characterized by high turnover rates and increasing intentions to leave. The vulnerable newcomers need support from the school and the working environment. Practice-based training experiences, supervision, orientation, and transition programs are essential strategies to ensure graduate nurses overcome the initial challenges and contribute to the attainment of better healthcare outcomes.
Challenges
High-Expectations at Work
The moment nursing students complete their studies, they are expected to transition theory into practice and, at the same time, provide safe and quality care. However, the reality is that shifting theoretical knowledge (“knowing that”) into practical knowledge (“knowing how”) is not easy (Dudley et al., 2020). Supervisors and colleagues at work expect the new nurses to fit seamlessly into their new roles and deliver on their mandate like those who are more experienced. The practical application of knowledge and development of expertise is facilitated through the gradual acquisition of experience and exposure to clinical problems.
GRNs find that they have a low level of experience, which, when coupled with limited confidence, increases levels of fear and anxiety when confronted with expectations and commitments not previously encountered (Zhang et al., 2019). These become feelings of bafflement, doubt, disillusion, and inadequacy, leading to clinical deterioration. GRNs also feel intimidated and may need to communicate more effectively with experienced nurses or other medical staff. This can translate into an environment characterized by the potential for decreased quality of patient outcomes.
Adjusting to Work Environment
Nurses may find a huge difference between their idealistic view regarding nursing and the actual professional practice. Nurses’ responsibilities as nursing students and what is required of a GRN are different. Calleja et al. (2019) state that while learning, nursing students follow a strict academic calendar instead of the work environment where they are tasked with constantly changing positions based on patient and organizational needs.
Nurses struggle with managing different components in their new and higher levels of commitment. They must handle higher caseloads, make critical decisions, perform managerial duties, and ensure patient acuity. The challenge is further compounded by the expectation that they can do all of the above by themselves. They may face further conflicts with their families as they discover that the demands at work may make it quite hard to meet their roles at home, which can invoke feelings of inadequacy, insecurity, vulnerability, and incompetence.
Psychological Wellbeing
The transition from nursing student to GRN can be psychologically challenging. The students will likely encounter stressful moments as they have to shoulder huge responsibilities in attending to critically ill patients, which may be a real shock. According to Halloran et al. (2020), stress is associated with negative feelings of isolation, frustration, and feeling overworked and undervalued. Nurses can suffer further psychological harm as they transition due to exposure to negative public opinions. Nursing is sensitive, and a person may be accused of being irresponsible to the extent that they can consider leaving the profession. Nurses have a high social image and may sometimes have to question their career choice and continue serving patients.
Appropriate Strategies
Practice-Based Learning and Experience and Transition Programs
Nursing students can be supported in many ways to ensure that the transition to GRN is smooth and amounts to a comfortable experience. Preparing for actual nursing practice should commence in the final years of study, practice-based learning, and experience. Practice-based experiences enable nursing learners to use their academic proficiency and obtain a great and comprehensive understanding of the study content (Wiersma et al., 2020). The experience will make them ready to start their professional careers with more confidence.
Such an approach enables the students to overcome fear during their first days at work. Practice-based learning occurs in an experimental stage where mentors and preceptors guide one. Nursing students can learn how to handle themselves as they assume higher responsibilities that may involve high levels of stress, constant communication, time management, and peer support.
In addition, nursing students can be supported through transition programs so that they develop critical skills. GRNs are expected to show competency in organizational skills, critical thinking, clinical decision-making, patient care prioritization, collaboration, teamwork, communication, and leadership. Transition programs can help ensure that the students get tested and that their behavior is observed using patient-simulated assessments (Wiersma et al., 2020).
Transition programs can also be structured to support nursing students in improving their level of competence. The programs can be administered through stretched periods to ensure the learners have adequate time to enhance their competency. Self-reporting should be encouraged so that the nurses feel more confident and competent. For instance, a six-month transition program would be more effective in helping the students transition into GRNs than a two-month transition program.
Effective Supervision
Supervision is a critical factor during the transition of nursing students into GRNs as it enhances the capability of the learners to connect their acquired skills to practice. Adequate supervision should be provided by an experienced nursing professional who can provide vital support, criticism, and feedback and facilitate a successful transition. Murray et al. (2019) indicate that the supervisor can help define the nursing student’s perceived success in their career. The act helps equip new practitioners with capabilities suitable to their professional practice in healthcare. In particular, nursing students can attain a higher level of self-confidence, increase their clinical skills, and better understand competence. In the end, effective supervision will help enhance service quality to patients and clients.
Advisory Meetings and Orientation
Advisory meetings are best held during the final year of the nursing teaching program. The institution can prepare the student to transition to GRNs by holding discussions on work soon after graduation. Nursing educators best facilitate helping learners understand that they must ensure they are ready to work in healthcare organizations as they transition into practice. Wiersma et al. (2020) argue that there is increasing support and proof of the need for transition to practice. The institutions can guide the nursing students on where to seek employment based on their preferences as well as the credibility of healthcare organizations that can provide further support as they transition.
Orientation is handy when nursing students get attached to a specific working environment. It helps the students to get accustomed to the clinical work environment. Orientation includes clearly understanding the nursing policies, standards, and practices, as well as the hospital regulations. It enables nursing students to attain a higher level of self-appreciation by providing critical support as they transition into GRNs (Zhang et al., 2019). Nursing students can feel more qualified and ready to start their new careers. It can involve working with colleagues, who play a vital role in guaranteeing a victorious transition by providing advice and information.
Organizational and Family Support
The healthcare organization should support new nurses and facilitate their transition to GRNs. There are many ways of providing support, including facilitating access to educational and training opportunities, such as nursing seminars and workshops. The organization can further provide opportunities for continued professional development to enable the nurses to enhance their personal and professional capabilities. Such opportunities allow the students to improve their mastery of the profession alongside social, clinical, and personal competencies after graduation.
The nurses should also be supported in ensuring that their vision and values align with the organization’s goals for easy transitioning. Support from the family is equally important, especially during the transition from student nurse to GRN. The family can provide invaluable encouragement and help the students to remain in the profession instead of leaving despite a few challenging moments.
Conclusion
Nurses are caught up in a problematic situation characterized by high turnover, leading to staff shortages amid rising demand for nursing services from the public. Some nurses choose to leave due to the challenges encountered as they transition from students into GRNs. They may need help to meet the high expectations at the place of work or to adjust to their new work environment. These factors may contribute to stressful encounters that result in adverse psychological damage to graduate nurses. However, transitioning from nursing student to GRN is essential in defining their long-term commitment to nursing. They can be supported during transition through numerous strategies, including practice-based learning and experience, transition programs, effective supervision, advisory meetings and orientation, and organizational and family support.
References
Calleja, P., Adonteng-Kissi, B., & Romero, B. (2019). Transition support for new graduate nurses to rural and remote practice: A scoping review. Nurse Education Today, 76, 8–20. Web.
Dudley, M., Khaw, D., Botti, M., & Hutchinson, A. F. (2020). The relationship between the undergraduate clinical learning environment and work readiness in new graduate nurses: A pre-post survey study. Nurse Education Today, 94. Web.
Hallaran, A. J., Edge, D. S., Almost, J., & Tregunno, D. (2020). New registered nurse transition to the workforce and intention to leave: Testing a theoretical model. Canadian Journal of Nursing Research, 53(4). Web.
Murray, M., Sundin, D., & Cope, V. (2019). Benner’s model and Duchscher’s theory: Providing the framework for understanding new graduate nurses’ transition to practice. Nurse Education in Practice, 34(1), 199–203. Web.
Wiersma, G., Pintz, C., & Fraser Wyche, K. (2020). Transition to practice experiences of new graduate nurses from an accelerated bachelor of science in nursing program: Implications for academic and clinical partners. The Journal of Continuing Education in Nursing, 51(9), 433–440. Web.
Zhang, Y., Huang, X., Xu, S., Xu, C., Feng, X., & Jin, J. (2019). Can a one-on-one mentorship program reduce the turnover rate of new graduate nurses in China? A longitudinal study. Nurse Education in Practice, 40. Web.