Transitions and their effects
A transition is the passage from one stable state to another stable state and is triggered by a change. Transitions may involve dynamic changes, turning points, milestones and challenges.
The nursing practice is deeply interwoven with different types of transitions. Depending on the background, transitions may be classified into several types. A situational transition is the one triggered by a change in the situation and involves the transformation in the educational and professional roles. For example, transition of an RPN to an RN is situational transition.
A nurse may face several challenges during the transition from an RPN to an RN. These challenges may either be intrapersonal or interpersonal and affect the performance of the nurse. Some of these challenges are communication issues, role conflict, time crunch, financial issues, and excessive workload because of multiple roles as a student, nurse and a family member (Meleis, 2010).
The challenges and the hiccups
I always wanted to make my career in the healthcare field. Considering my nature to help people, I chose nursing, and it was like a dream come true when I got my RPN licence. It has been six years for me working as an RPN. At my work place, my manager and administer encouraged me to go for RN since I have the potential to grow. I had started the RN program with lots of positive energy; however, as I am proceeding further, I can see certain obstacles and challenges in the transition phase from an RPN to an RN with new roles and responsibilities. I am finding it challenging to transform myself from a care-provider supervised by the RN into a manager of care.
Going back to school. Initially, the idea of going back to the nursing school gave me instant energy and enthusiasm. However, as the ‘Honeymoon phase’ of the school ended, I found myself in an inner conflict. I had heard and read about this conflict; however, I never thought that I will face a similar situation. Once we are into a job for a long time, we forget to learn theoretically. In a nursing field, we become habitual of evidence-based practice, and we seldom open our books for reference. However, nursing school is a place where we have to learn it theoretically and then understand the practical aspects. Therefore, going back to school and learning the nursing practices & techniques is a big challenge for me.
The communication issues. I feel that I do not have the confidence to talk openly to express my concerns, needs, desires, thoughts or feelings. It happens to me so many times where I know what to do or say in my nursing practice but I tend to be quiet. Since the role of an RN assumes the person to be an excellent communicator, this is another challenge that is facing me currently.
Challenges in the setting-type and time management issues. I am currently working as RPN or LPN in a long-term care facility. Long-term care does not have much as patients are stable and so time is easily managed with the same assignment every day, same routine, etc. However, in acute care setting, patient status changes, new admissions, discharges, etc. So, too much work load is there that needs very good time management skills. I want to work in an acute-care setting after my RN graduation, but I am afraid to face the reality of this fast paced setting.
Role conflicts. Sometimes, I feel that I have already spent six long years in the nursing practice. I consider myself an efficient, knowledgeable and well-trained nurse and question myself that how is my nursing practice going to change with the new RN role. After all, passing a medication will remain the same. My dealing with the patients and their families is not going to change. These feelings and doubts lead to a very personal conflict and internal challenge daunting my evolution as an RN.
Multiple responsibilities leading to stress. As an RPN, I was balancing my professional life and family efficiently. The new role of a nursing student has brought a vast array of stressing factors. Now, I need to manage my own education along with work and family. Sometimes, I feel frustrated with the bundles of assignments, classes and schedules that I have to attend to and it becomes challenging to balance (Meleis, 2010; Duncun & Depew, 2011; Nunnery-Kearney, 2010).
Strategies to overcome the challenges
My transition from an RPN to an RN is challenging as well as fulfilling. All the obstacles and challenges faced by an RPN while transitioning to an RN can be addressed by a strong sense of self-efficacy. This sense is often associated with enhanced cognitive processing, high performance and achievement. People with high self-efficacy meet the challenges head-on and do not try to avoid them. As a primary strategy to face the challenges of my transition, I will use the four pillars of high self-efficacy viz. performance accomplishment, vicarious experience, verbal persuasion and physiological cues. In my new school, I will gain the knowledge through theory instructions and clinical experience leading to a sense of personal accomplishment. Coaching and feedbacks from my peers help enhance my emotional quotient and intelligence. I will obtain vicarious experience while observing the other nurses and instructors perform the procedures. My dialogue with my instructors will serve as verbal persuasion and will enhance my efficacy further. Finally, the high levels of self-efficacy will be projected in terms of my physiological cues and will advocate my successful transition to RN (Zulkosky, 2009).
In addition to development of high self-efficacy, I will have to implement certain specific strategies to address my day-to-day challenges. In the present scenario when I have joined back the nursing school, learning has become a potential challenge for me. I am trying to discover my learning style to maximize my own learning. As the scope of learning is broadened by understanding how learning occurs, having an insight of my own behavior including learning styles, decision making and social styles may help me adapt better in the new environment.
Another strategy for an effective transition from an RPN to an RN is the development of efficient time management skills. I will prioritize and organize my activities in a set time-frame. I will try to control the time by learning to manage multiple tasks using written schedule or visual reminders. Therefore, I am preparing myself to multi-task without being overwhelmed. A useful tip that I have received from my peers is that of breaking the monthly calendar into weekly or daily calendars. This may help me in preventing a crisis and will also reduce the physical and emotional stress. I feel that there is no clear cut strategy to resolve the role conflicts between an RPN and an RN. An RN is expected to perform same clinical tasks as that of an RPN but with refined critical thinking. The expectations of performance are much higher for the RNs as compared to the RPNs. They may have similar ‘on the floor’ duties, but the RN has more medical responsibilities than an RPN. I order to be a successful RN; I will need to resocialize myself as an RN. With the advancements in my educational profile, I will try to advance my nursing roles and identify myself as an RN and leave the ‘mental tag’ of RPN behind. I clearly understand that I am not the first RPN of the world who is going back to nursing school to become an RN. When I am at my low, I remind myself that if others can do it, I can also accomplish it. I will develop new skills to cope with the problems faced during this transition. Apart for this, I am also developing my sense of humor to lighten the work pressure. I will try to maintain a positive attitude and continuously renew myself in body and the spirit by regular exercise, well-balanced diet and spiritual renewal.
Transitioning from an RPN to an RN can be a challenging and stressful change for any nurse. This change is more demanding if the nurse has been in the job for quite some time. My own transition from RPN to the RN has been taxing in terms of the communication obstacle, role conflict, student- and family-life balance, etc. Researchers have developed concrete strategies to minimize the hindrance in this transition. The application and worth of each of the strategies may vary from person to person. I have applied the concept of self-efficacy to increase my confidence and productivity. Other strategies working best in my case are polishing the communication skills, learning to multi-task and re-socialization as an RN. Overall, I am taking this transition as the challenging opportunity that will help me grow mentally and emotionally and will prepare me for the future growth process. I would like to say, “I want it; I am committed to it and I will pursue it.”
References
Duncun, G. & Depew, R. (2011). Transitioning from LPN/VN to RN: Moving ahead in your career, Second Edition. New York: Delmar.
Meleis, A. (2010). Transitions Theory: Middle range and situation specific theories in nursing research and practice. New York: Springer.
Nunnery-Kearney, R. (2010). Making the transition from LPN to RN. Philadelphia: F.A. Davis Company.
Zulkosky, K. (2009). Self-efficacy: A concept analysis. Nursing Forum, 44(2), 93-102.
