The transition from a nursing student to a registered nurse is a critical career turning point among the nursing trainees. It is a point in which student nurses experience both exciting and challenging moments as they struggle to adapt to their professions. As such, they require mentors to encourage and guide them through their career development. During this transition point, student nurses need adequate time to adapt to the work environment, roles, responsibilities, and the underlying change of identities. Of great importance is their ability to switch from protected training institution to the authentic world that underpins their careers. However, the duration that nursing students take to adjust and adapt to the demanding professional roles varies from one trainee to another. In most countries, the transition period is the first twelve months after graduation upon which the student is recognised as a qualified nursing professional.
Several studies in the literature review are in consensus that the nursing trainees encounter numerous challenges during the transition period. In some instances, the new professionals quit their jobs if there are no role models to guide them. The occurrence of such incidences explains the rise of nurses’ turnover, especially in the developing countries. According toWong et al., (2018, p.30) stress and work dissatisfaction are criticalelements that are challenging to the nursing trainees during the transition. Hong Kong is one of the cities that records the highest number of nursing students that quit their jobs at the early stagetransition. In this case, the authors noted that the rate steadily increased from 6% in 2011 to 14.5% in 2013. The situation suggests that there is a need for immediate intervention to enable the stakeholders to effectively manage the challenges that the fresh nursing professionals face during a transition.
The change of working environment and roles is the primary challenges that the nursing graduates face during the first month of transition (Edwards et al., 2015, p. 1257). Their stress, in this case, is directly associated with insufficient preparation for the work environment during the study. It is also attributed to the past failures during clinical placements besides little study while in the training institutions. Hofler and Thomas (2016, p. 133) corroborate that excessive workload in the ward is another factor that explains why the nursing students find it difficult to adapt to the nursing field, the underlying practices and responsibilities. The researchers further assert that the graduate nurses placed in surgical wardshave high levels of stress compared to their counterparts in other units of the healthcare facility. Missen, McKenna, L. and Beauchamp (2014, p. 4422) argue that inadequate support from the practising nurses and workload in the health facility are the primary drivers for the trainee resignation.
The process of managing the transition from a student nurse to registered nursing professionals entails a critical analysis of the potential challenges and their solutions. However, such strategies vary from one nursing student to another and for this reason, require appropriate and appropriate tailored to meet individual needs. One of strategies to enhance the effective management of the transition is the formulation of an effective preceptor and mentoring programs. According to Kaihlanen, Lakanmaa, and Salminen, L., (2014, p. 422), preceptor programs play critical roles since it reduces culture shocks among the fresh nursing professionals in transition. It is therefore arguably from this perspective that the preceptor programs foster the attainment of positive outcomes besides integrating theory and practice among the nursing students. The strategy, in this case, supports the graduate nurse to cope with the working culture by incorporating them with the experienced and registered professionals in the healthcare facility. Consequently, trainee nurses will enhance their professional competence, confidence and most importantly the gaining of autonomy when handling patients (Banister, Bowen-Brady & Winfrey, 2014, p. 321).
Self-care is another essential strategy that enables graduate nurses to have exciting experiences during the transition period. In this case, it is an aspect that requires both the registered and the trainee nurses to care for one another as a strategy. The objective is to foster mutual understanding and cordial relationships during the transition. One of the approaches is assigning the trainee professionals thoughtful work as they grow their careers (Kajander-Unkuri et al., 2014, p. 798). They also consider the need to establish a balance between the lifestyle and the roles that they assign the fresh graduates during the initial phases of their transition. The primary objective is to enhance better experiences among nursing students and thus allow them to adapt to the new working environment gradually. That said, the experienced colleagues ought to monitor the skills of their trainee counterparts during eth transition. The key aspects in this context are whether the nursing students are growing both personally and professionally (Phillips et al., 2014, p. 105; Whitehead et al., 2016, p. 64). The self-care programs also enable the registered nurses to monitor anxiety and feelings of exhaustion and thereby adjust the underlying workload besides acting as the caretakers of the trainees in their respective departments of the healthcare system.
A significant proportion of nursing students experience difficulties to interact with the registered nurses. As such, they develop an attitude that they are excluded by their colleagues and thus explain their challenges. Kumaran and Carney (2014, p. 604)argue that fresh nursing professionals have a notion that supportive colleagues play critical roles that enable them to adapt to their roles in the healthcare delivery system. Such trainees also have high expectations that they can quickly grasp nursing roles practices. Accordingly, they get frustrated if they do not meet their aspirations during the first stage of transition. Mellor and Greenhill (2014, p. 54) corroborate that fresh nursing professionals are further stressed when they find significant variation between theoretical knowledge and the actual clinical contexts. The ultimate consequence that underpins their challenges is poor clinical performance and even resignation from the healthcare facility. The authors assert that a close working relationship with the experienced nurses is essential to the trainees. It this case, it enables them to bridge the requisite skills and knowledge that is critical for their career development.
The establishment of a supportive environment in the healthcare delivery system is essential in the process of managing transition among nursing students. It involves promoting a culture that considers the needs of the trainee nurses and allowing them to utilise the available opportunities to enhance their career development. The strategy entails assisting the trainee nurses to overcome anxiety through programs that enable them to breach the gap between nursing theory and the actual practices that are required of any registered nurse (Chen & Lou, 2014, p. 434). As such, the experienced nurses ought to assign nursing roles and monitor how their trainee counterparts are gaining patient management and clinical skills. The critical aspect is the monitoring of the nursing trainee ability to adjust to the working environment and the competence in undertaking their usual roles. Of great importance of a supportive environment is creating a culture that encourages fresh nursing students to feel comfortable when raising their concerns (Pennbran et al., 2013, p. 741; Freeling& Parker, 2015, p. 42). The strategy, in this case, is critical in managing stress and anxiety that adversely affect eth experiences of the trainee nursing professionals.
The healthcare management and the experienced nurses ought to create awareness among their counterparts in transition on the need to identify challenges and communicate accordingly. Through proper planning, the nursing students can conclusively determine the potential difficulties that they will likely encounter and thereby seek guidance. The strategy psychologically prepares them on the common challenges during the transition period and thus formulates the necessary approach. As such, it promotes the development of positive experiences besides its role in eliminating culture shock. The Nursing and Midwifery Council standards on student supervision and assessment require the nursing professionals to monitor the trainees while in the practice environment strictly (NMC, 2019). Both the academic and practice assessors play critical roles that promote trainees’ career development.
Arguably, the training institutions should create an awareness that students play essential roles in developing their professional proficiency. As such, nursing students are supposed to communicate all the challenges that they encounter during the transition for an immediate solution. They should also have positive attitudes towards the problems that they face while in transition since it is part of the learning process that equips them with the requisite clinical and patient management skills. It is apparent from this situation that the nursing students experience challenges that hinder their transition to registered nurses. As a result, the future NMC standardsshould incorporate the provisions that potentially address these difficulties. For instance, an outline of the workload as the nursing trainees progress from one step of their transition to another.
Preceptorship in the UK refers to the process by which newly qualified nurses (NQNs) are often supported throughout the transition from being a basic student to being a fully registered nurse (RN) (Beddingham& Simmons, 2016). Support, as well as acceptance of newly registered nurses mainly by the senior colleagues, helps to ensure that they develop positively.
The initial stages of nursing profession right after qualification can be very challenging, and if the newly qualified nurses are not supported effectively, they tend to leave the nursing profession earlier, thereby making them less beneficial to the members of the general society. Preceptors in a nursing context refer to a practice-based trainer. According to Duchscher (2017), the main functions of the preceptor include refining the skills of the newly qualified nurses which they had mainly gained in their academic training, refining their values and behaviors so that they become valuable members of the nursing community as well as motivating them to continue with their learning process throughout their lives so that they can be able to hone their skills and competencies even more.
Importance of Preceptorship to Newly Qualified Nurses
There are many benefits that the students reap from being engaged in preceptorship programs and that help them to become better nurses after registration. To start with, preceptorship helps to introduce newly qualified nurses into a clinical setting. There is a great difference between the school and clinical nursing, and such newly qualified nurses may find challenges trying to adapt to the new settings (Schumacher &Meleis, 2015). Changes in a setting often precede a change in behavior, and it attracts new roles and responsibilities. Newly qualified nurses are exposed to preceptorship to enhance a swift and a less challenging transition of settings by helping them to adopt the new roles and responsibilities, as well as helping them to familiarize and adopt the various changes as they may be found in any clinical setting (Hardacre& Hayes, 2016). The preceptors help the trainees on the best use of various facilities found in the clinical setting as well as guiding them through safety measures and precautions that they are supposed to observe. The change from their school setting often exposes them to a new set of threats and risks and preceptorship ensures that the students are well informed about the various ways that they can improve their safety and avoid the risks that may be associated with the new environment (Kaihlanen, Lakanmaa&Salminen, 2015). As a result, the students are kept away from any accidents and injuries, and their wellbeing is maintained.
Besides, preceptorship exposes and introduces the newly qualified nurses into the real daily life of nurses, and it helps them to transit easily from their previous schedules and fit themselves to the newly acquired schedules. There is a great difference between a nursing student and a real nurse in that their normal daily lives are completely different ranging from their working and operating schedules to the actual activities that are handled by each of them (Walsh, 2015). To facilitate an easy transition from a newly qualified nurse to a registered nurse, the subjects need to be introduced into the real world of nursing where they are exposed to the typical daily schedules of nurses thereby giving them the insight to help them become convenient professionals (Edwards et al., 2015). Nursing is a very dedicated professional and any individuals aspiring to register as qualified nurses need to be ready to undertake all the challenges that are likely to be found in the line of transition. Besides, the students need to be given insights on how to handle different situations and events as they may come to meet along their profession. Some of the great lessons that preceptors teach newly qualified nurses include flexibility and commitment. A professional nurse needs to be highly flexible to enable their ability to respond to the various events as they may arise.
Through preceptorship, knowledge is integrated into practice. The newly qualified nurses are equipped with great knowledge that they gather from the school, but they lack the practical experience to handle and apply the various skills and knowledge that they gather from the various academic institutions in which they may have trained. To start with, the students need to be brought to the realization that they will be dealing with real humans and therefore, greater care is required when carrying out the various operations so that life can be saved (Watson, 2017). They need to be taught the various repercussions that may be contributed by negligence, and they are also made aware on the various safety tips that they should always remember in their daily engagements (Missen, McKenna & Beauchamp, 2014). Theories are very different from real practical knowledge, and the students require to be exposed to the actual application of the vast theoretical knowledge into practical work (Thomas, Bertram & Allen, 2016). Without being exposed to such a period of mentorship as preceptorship, the newly qualified nurse are likely to lead to many accidents that may, in turn, lead to the loss of lives.
The preceptors also provide consistent feedback on the progress of the newly qualified nurses. In most cases, the new nurses are anxious, and they undertake the various duties assigned to them with fear since they are not fully sure about how they should undertake them (Holland, 2016). They are afraid of taking new responsibilities since they lack enough confidence. However, preceptorship helps to take away the anxiety of the students on builds on their confidence by ensuring that they get consistent feedback from the preceptors (Watson, 2017). Whenever they undertake a successful task, they are appreciated and also they are corrected when they do any slight wrongs. That does not only help them to perfect in their skills, but it also helps to motivate them to keep growing and undertaking more tasks and duties in the future (Omer, Suliman, Moola, 2016). Without such an acknowledgment, it becomes very hard for new nurses to monitor their progress, which is a great component in motivating growth.
Qualities of a Preceptor
Considering the great importance that is associated with the entire process of managing the transition from nursing student to a registered nurse, it is very crucial to monitor the qualities and values of the nurses who fit to become preceptors. Nursing students are more likely to emulate the behavior and qualities of their receptors and it, therefore, becomes essential to make sure that such preceptors have valuable and quality qualities and values (Mohide et al., 2018). There are a variety of positive qualities that preceptors are supposed to possess so that they can pass them down to the nursing students who they interact with to improve the quality of the nursing care which would, in turn, promote quality lives among the members of the society.
To start with, good preceptors are supposed to be able to assess the learning needs of the new nurses since they assume the responsibilities of their trainers and mentors. Even though the nursing students may have a significant amount of quality knowledge from their previous nursing schools, they still require a lot of technical learning to assist them to apply the specific knowledge they acquired from school (Blevins, 2016). As a result, any good preceptor should be in a position to identify the various weaknesses as displayed by the students and help them to improve on them (Mohide et al., 2018). Without such qualities, a preceptor would be of less importance to the learners. Since the main purpose of the entire preceptorship entails helping the new nurses to become qualified and better professionals, any individual who qualifies to be a preceptor must be able to identify the various weaknesses that may be posed by their new nurses and help them to improve and build on their profession.
Besides, a good preceptor must be inspiring and motivating enough. The process of transiting from a nursing student to a nursing professional is quite challenging, and without enough support, many individuals are normally likely to give up on the profession. Other than ensuring that the new nurses adapt to their new operating setting, roles, and responsibilities, the preceptor still has the role of building the interest of the students by highlighting on the positives and benefits that are associated with the profession (Whitehead et al., 2016). Preceptors should inspire the students to take up the various duties assigned to them willingly and also to help each other and embrace teamwork (Shinners&Franqueiro, 2015). They should also encourage them to improve themselves through further training and enrollment in education programs. The success of any nurse is highly dependent on the preceptor they interact with during their transition from nursing students to professionals.
Good preceptors should also be able to give valuable and constructive feedback to the newly qualified nurses. Feedback is one of the important elements that promote growth in almost every department. When quality and honest feedback is provided, it acts as a tool for motivation. It may also assist to initiate correction where an individual identifies that they have been doing the wrong thing. Good preceptors provide essential honest and quality feedback to their perceptions (Whitehead et al., 2016). They command them on the various positive attributes they may possess and also helps them to improve on their weaknesses by advising them accordingly (Bengtsson& Carlson, 2015). They also understand the correct use of language when they are expressing their feedback. When feedback is expressed negatively, it may lead to greater harm by discouraging its recipient, thereby destroying them rather than building them. The ability to give honest feedback constructively is one of the traits that every preceptor should possess.
The period of transition from a nursing student to a nursing professional is very critical, and it requires quality support from trained quality nurses called preceptors. While the preceptors mainly help the newly trained nurses to adapt to their new environments and take over their new responsibilities, preceptors also carry out essential functions of teaching them and improving them through such ways as providing constructive feedback to them (Welyczko, 2018). The preceptors are, therefore, required to possess quality traits such as the ability to motivate, assess learning needs and other essential and beneficial qualities that would help to build quality professionals for the betterment of healthcare.
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