A nurse’s transition to practice can be an emotional journey.
In the beginning there is excitement, anticipation and an enthusiasm for the nursing profession. New graduate nurses are spurred on by their desire to make a positive contribution to a patient’s life.
However, while a Bachelor of Nursing is designed to equip student nurses with the practical skills and theoretical knowledge required to become a capable nurse, often this is not enough to truly prepare them for professional practice.
After a few shifts the initial excitement may be accompanied by feelings of incompetence, insecurity, exhaustion and anxiety. A new graduate nurse may begin to question their decision-making and may feel overwhelmed by the demands of the role.
Nurse educators are perfectly positioned to support graduate nurses to ensure their transition to professional practice is smooth and ultimately successful.
But first, educators must consider the hidden influences that affect the transition of a newly licensed nurse before working with them to develop a professional learning plan.
Hidden Influences that Effect Transition to Professional Practice
There are a number of hidden influences that are exerted on graduate nurses (Kumran and Carney, 2014). Nurse educators can work to minimise the effect of these influences in order to support nurses in their transition to professional practice.
Unclear Role Expectations
Having a clear understanding of your role and position is very important to a successful transition.
Uncertainty around what is expected in a new job could lead to confusion and misunderstandings, as well as feelings of disappointment and dissatisfaction.
Clearly establishing the requirements and expectations of the role can provide graduate nurses with valuable guidance around scheduling and prioritisation of tasks.
Demands of the Job
Student nurses experience the clinical setting very differently from graduate nurses.
On placement, student nurses will often be accompanied by an experienced, qualified nurse which makes the hospital routine appear more controlled.
While an experienced nurse is able to calmly and smoothly deal with unexpected or stressful situations, these situations may initially be confronting for a new graduate nurse.
Nurse educators should be aware of this disconnect while supporting graduate nurses.
A nurse’s personality and character will affect how they approach stressful or difficult situations.
Does the nurse have a tendency to be confrontational and defensive? Or are they passive, and not able or unwilling to provide constructive solutions or suggestions?
An understanding of this provides information around supporting strategies that nurse educators could develop in order to support the new registered nurse.
Personal issues or struggles of a newly licensed nurse could impact performance, attention span and concentration levels at work.
It could also lead to absenteeism and negatively impact their continuing professional development.
How Nurse Educators Can Support Transition to Practice
There are many different ways in which nurse educators can assist with the transition to professional practice, and support newly licensed nurses in their role.
Developing an understanding of the graduate nurse’s goals will enable nurse educators to more clearly provide structure through the transition period.
Once goals have been established and communicated, the educator can then collaborate with the newly registered nurse to plan and implement strategies with a view to achieve these professional goals.
Understand Learning Styles
Having an understanding of your graduate nurses’ learning styles will contribute to a much smoother transition to practice.
This will also ensure that they are better supported in the commencement of lifelong learning and continuing professional development (CPD).
For the nurse educator, this understanding will provide a better framework within which they can design a supportive development program and transition to practice toolkit for the newly registered nurse.
Create a Supportive Professional Environment
Creating a supportive professional environment within which new nurses can practice is key to a smooth transition to practice.
Nurse educators can facilitate this in several ways:
Provide reassurance to new nurses as they embark on their new role;
Schedule times for follow-up support throughout the duration of the nurse’s transition;
Ensure your initial communication with graduate nurses is inviting, welcoming and approachable;
Be available to answer questions and to meet face-to-face.
Having regular contact with a nurse through the duration of their transition to practice is key for the nurse educator. This enables the nurse to inform the educator of their progress and areas of limitation, which will then inform the educational opportunities they should pursue.
Provide Constructive and Timely Feedback
Giving feedback is an important part of the nurse educator’s role. It is also key to ensuring an effective transition.
Feedback should be delivered in a timely and constructive manner. If the nurse educator is not present to observe how the nurse is performing on the ward, feedback from peers is also encouraged.
Preceptor Programs and Buddy Shifts
Preceptorship is a proven method to aid in a graduate nurse’s transition to practice.
Having an experienced nurse working alongside and guiding the graduate nurse on the ward can have a very positive impact on confidence and capability.
After identifying an appropriate preceptor, the nurse educator should have a discussion with both the preceptor and the graduate nurse to speak about strengths and limitations and strategise ways to improve on these.
Introduce the Nurse to the Multidisciplinary Team
The nurse educator should take steps to making the newly registered nurse feel a part of the wider multidisciplinary team at the workplace.
This will ensure the nurse feels comfortable to approach the team for clarification or questions that they may have around the correct management of patients.
Further, the multidisciplinary team will also then be aware that the nurse may need extra support through their transition period.
Encourage and Develop Coping Strategies
Transitioning from student nurse to registered nurse can be an emotionally straining process.
Nurse educators should seek to discuss coping strategies with graduate nurses and encourage them to seek help when needed. Ensure that the nurse is aware of support provided by the employer through counselling and provide contact details.
If you know of a colleague experiencing difficulty, encourage them to contact Nurse & Midwife Support, a 24/7 national support service for nurses and midwives providing access to confidential advice and referral.
Kumaran, S., Carney, M., 2014, Role transition from student nurse to staff nurse: Facilitating the transition period. Nurse Education in Practice, Volume 14, Issue 6, 605 – 611DOI: https://doi.org/10.1016/j.nepr.2014.06.002