Introduction
Nurses have a long process of transition from the time they are undergraduate students in nursing schools to the time of being graduate nurses. This is a time when the graduate nurses face many challenges regarding their job. It is crucial for the nurses to develop ways of coping with these challenges, and the best way to do this is by coming up with relevant strategies to help them cope with these issues (Cowen &Moorhead, 2011 p. 612).This requires intense processes of socialization where they get to meet different people in the health profession who will have different demands from them. It is upon a newly-graduated nurse to identify ways of coping with the demands of each of them. The environment is also challenging; hence there is a need for the nurses to come up with ways of exerting power and control over the challenging work environment. Nurses participating in the professional development of self and others around them face numerous challenges especially during the initial days of their work life. The nurses have to strive to ensure that they cope with the challenges and demands of their professional development.
Challenges faced by midwives
Working in a challenging environment with many responsibilities means that a nurse will face many challenges. This is the case for nurses who just graduated and have to face the numerous challenges facing them in the health facilities (DeYoung, 2009 p.78).Their environment is so challenging, and they are not equipped with the necessary skills to deal with these challenges.
One of the key challenges faced by new nurses in the midwifery unit is the huge gap that exists between what they are taught in college and the reality of the nursing world. It is common to find students who have just graduated having a hard time relating what they have been learning during their years at school and applying them in the real workplace. Reality shock hits the students when they arrive at the work place, and they have to do things differently from what they were taught back in school. The procedures used by older nurses in the health facilities differ from the theories nurses learn in school. One comes out of school ready to apply the knowledge learnt, but once they get to their workstations, they realise that this is actually different from what they expected to find. One is then torn between adapting to practice roles or using the theories they learnt in school. This creates a loyalty conflict within the new nurse’s role in the health facility. He or she will be torn between sticking with the aspects of nursing they learnt in school and conforming to the professional work environment, and their way of doing things (Ellis & Hartley, 2012 p. 123).
The health care delivery system is designed in such a way that nurses have to work together to ensure that quality services are delivered to the patients (Auerhahn & Malone, 2010).This requires all the nurses to be on the same page when it comes to different issues facing the patients. This becomes an issue for the new nurses who have a lot to learn about the “real health care setting.” This is a huge challenge for new nurses as they try to fit in to the new routine and new teams. This may be due to the low experience they have with dealing with their fellow staff and dealing with clients. The lack of skills to deal with clients leads to frustration among the new graduates. They feel inadequate when they do not cope with the responsibilities accorded to them in time. This leads to frustrations and other emotional issues that may not be healthy for the nurses (Grady, 1987 p. 56).
Newly-registered nurses lack proper skills to set their priorities allocate time wisely and face the demands of the nursing career. This requires a lot of experience to help one identify how to do everything correctly and at the right time. The ambiguity of the job means that the nurses do not feel satisfied with their job. They lack the skills necessary to respond positively to the nursing roles. Speed is a key feature in nursing. This is a key challenge for the new nurses. Speed comes with time as one knows how to manage and apply different skills. For new nurses, this is a key issue. They do not have the speed to cope with the workload presented to them by the older nurses (Grady, 1987 p. 46).
Bullying by older nurses is also a key challenge faced by new nurses. Older nurses set high expectations for the new nurses placing them at a dilemma on what they have to d to please them. There is lack of a supportive and friendly work environment where the older nurses integrate nurses into the system. As a result the new nurses feel a lot of pressure from the other challenges regarding their duties, and the pressure coming from the older nurses. New nurses need time learn to do things the way other experienced nurses perform, and adapt to the changes in their life. This creates a lot of emotional and physical exhaustion for the new nurse until he or she learns to adapt to the new working environment. This comes from the huge difference that exists between the bureaucratic system of working and the professional way of doing things (Ellis & Hartley, 2012 p. 124).
The other challenge faced by new nurses is the exhaustion that arises due to the heavy workload new nurses has in the health facilities. It is common for new nurses to receive the most demanding patients who require a lot of attention. This may be seen as part of the orientation process where the new nurses learn from doing all the difficult tasks around the work environment. For the new nurses, this provides a huge challenge that takes up a lot of their time and energy. The allocation of all the high-dependency patients means that the new nurses have a lot of things to do when they are on duty. They are still new to the challenging work environment, and the work load is heavy (Ellis & Hartley, 2012 p. 124). This exhausts them on different levels as they try to cope with the numerous responsibilities that come from being a newly registered nurse. The other challenge that is linked to this is the lack of enough staff in the hospital to deal with the different duties in the hospital or health facility. It is difficult for the new nurses to have all the nurses to take in everything that comes with being a new nurse. The roles and responsibilities accorded to the nurses are numerous. This is highly exhausting for those who do not know how to balance everything.
The graduates have to focus on adapting to the new environment. The new graduates have to learn to adapt to the roles of a Registered nurse and the challenging hospital setting. As a registered nurse, one has numerous responsibilities. He or she not only has to take care of patients, but has to be on the lookout for welfare of other nurses in the facility. It is upon the RN to ensure that his or her actions do not hurt others. All these take up a lot of time and commitment. The hospital setting also places a lot of pressure to the new nurses. There are many new things they have to learn about the hospital setting. It is therefore, challenging for the registered nurse (Gallagher, 1991 p. 54) to integrate everything considering they lack the experience the older nurses have got over time.
Adapting and learning new things in order to build their capabilities and that of other nurses in the department provides a challenge to the nurses. They are faced with numerous problems regarding their transition to the health care setting. The nurses do not have time to focus on learning new ways of doing things and simplifying the work of others. This is a key issue that affect new nurses. They do not have time to focus on improving their abilities; hence they take time before they can improve their performance levels and help build that of others around them (Zerwekh & Garneau, 2011 p. 90).
Strategies that new graduates should apply
As discussed in the challenges provided above, nurses face the challenge of adapting to the professional world, which is different from the one they learnt in school. The two worlds apply different ways of operation. To the new nurses, this is a major challenge as they feel threatened when they cannot relate what they learnt in school to what they are actually experiencing in the real work place. It is therefore, important for the students to be open about everything that comes their way (Limon & Spencer, 1981 p. 121). This entails keeping an open mind to any change in procedure one may encounter in the workplace. The key strategy that should help eliminate this is the corporation between the high education sector and the different health agencies. This requires both parties to come up with a proper way of contributing to new ways of improving the experience of students and new nurses. They can do this by having clinical practices that make the transition process easy for the new nurses.
A key strategy to dealing with the challenges experienced by new nurses is the use of a positive preceptor relationship. The higher learning institutions and the health agencies can ensure that a positive preceptor relationship that will nurture the student exits. This is by coming up with proper programs that introduce the students to various aspects of the real nursing experience (Cowen & Moorhead 2011:90). This exposes the nurse to various issues that affect him or her Preceptor programs are one of the most effective ways of preparing and equipping the students with all the skills they will require fitting in and going on with the transition process smoothly.
Confidence and competency is an important skill and trait for the new nurses. They require these to fit in to the working environment as soon as they can. Through the preceptor programs, the students are able to gain all the skills and knowledge they require to fit in to the working environment. With the guidance of a preceptor registered nurse, the students gain all the information they need about working away from the theories they learn in a classroom setting. They get a feel of what they should expect once they graduate and go to work in a real hospital with real patients. The value of this program to the students is high; hence the need to adapt it during the last year of the students learning process. This will help expose the student to various work experience. As the nurse and the preceptor work together, the student learns how to care for the patient, and deal with other duties that nurses have to perform. This exposes the nurse to various issues, and helps him or her know how to deal with issues autonomously (Limon & Spencer, 1981 p. 123).
The other strategy to help nurses fit in to the work experience during their transition process is through provision of a mentor. Most of the time, nurses are taken through the orientation program that do not last for long. They do not get the chance to full understand what they need to do at particular times and situations. Everyone needs to find someone they can look up to and ask for advice when they are faced with different problems. This can be work-related or personal life. Having a more experienced person than you means that they can give you quality advice on what you should do when faced with an issue. This is the case with new graduates in nursing. They need to have someone they can look up to when they are down, and want someone to talk to about different issues (Limon & Spencer, 1981 p. 124). Mentors play a crucial role in making the transition process easy for the nurses. They can ask for advice when they do not know how to deal with issues relating to their work. It is upon the mentor to build a trusting relationship between him and her with the graduate nurse. This will build the abilities of the nurse to act in a positive way and help other staff deal with their issues. It is upon the nurses to help each other out when they are faced with various challenges. The same applies to the new nurses. They need someone to look up to in the health setting.
The health setting should also come up with a supportive environment for the new graduates. This entails coming up with a good induction program where the new nurses undergo a detailed orientation process. This should not be a one or two week orientation program as seen in many healthcare settings. It is vital to have an ongoing orientation process (Cowen & Moorhead, 2011 p. 90). The new nurses have many things to learn. It is not just about having them learn the health policies used in the health facility, and all the location of various units. It should entail a detailed plan where they are taken through various issues affecting the nurses. The nurses should also have someone who will help them with their duties for about three to six months. They will act as a reference point for the nurses when they have any issue with their work. The work environment should also promote incremental development of clinical skills. This also entails developing patient management skills that will help the nurse deal with issues regarding patients.
The structure of the workforce should also be in favour of the new nurses. There should be corporation between the experienced nurses and the new nurses. The health setting should be structured in such a manner that builds a trusting relationship between older nurses and the newly-graduated nurses. The older registered nurses should be ready and committed to assist the new nurses during their transition to the process. They should know that this is a lifelong process. New nurses will come, and they will also require guidance and assistance on how to deal with different roles and duties assigned to nurses (Benner, 2010 p. 122).
The older nurses, therefore have to minimize the amount of work given to the new nurses. This will offer the nurses a chance to appreciate and enjoy the success they make with the few patients they attend to during their initial time in the hospital. The nurses need to be friendly to the new nurses (Gallagher, 1991 p. 89). This will give the graduate nurses a positive feel of the career. They will also have the confidence to approach the older nurses and ask for advice when they feel the need. This requires a climate that promotes open communication between the nurses and other players in the health profession.
It is also crucial for the new nurses to have positive and timely feedback regarding nay issue facing them. New nurses are fragile especially due to the frustrations associated with the stress of fitting in to the professional world. The nurses need to have assurance of their performance. It is crucial for the nurse to do a self-review to determine how he or she is coping in the new working environment (National competency standards for the registered nurse, 2006 p. 3). However, giving him or her, a positive and timely feedback will boost their desire to work hard and achieve his or her goals.
It is crucial for the nurses to participate in personal strategies that will help them deal with the challenges facing them at the workplace. This may include various activities like doing regular exercises and taking part in recreational activities that will increase their physical strength. This will also go a long way in reducing their stress levels (Benner, 2010 p. 132).
The other strategy that can help nurses deal with the challenges faced during the transition process is preparing to handle all the challenges that will come their way. The nurses know that it is difficult to fit in to the challenging nursing roles. It is therefore, crucial for them to anticipate these challenges. This will prepare them psychologically and emotionally. They can also come up with different ways of coping with these challenges. Preparing to face challenges ensures that one is well-equipped to face them once they come across the various challenges. The nurses will also have an idea of what will happen once they go to work (Cowen & Moorhead, 2011 p. 76).
Conclusion
It is crucial for all nursing students to identify that there is a difference between what they have been learning in class to what they will see when they start working. It is therefore, important for them to know that culture shock will hit them when they go to work, and they are torn between the bureaucratic culture and the professional work. The challenges that will face them are numerous. They will range from personal issues, colleagues issues and the patients placed under their care. This will force the nurses to adapt strategies that will help them through the challenging experienced during the transition process. These strategies can be from personal initiatives or from the health facility. The health sector and the institutions for higher learning can do a lot to ensure that the transition process is smooth for both parties. They can do this by coming up with programs during the fourth year of training. This includes a preceptor program that exposes the students to various issues that will affect them. This also builds their confidence in their ability to solve issues (Clark, 2003 p. 134).
References
Auerhahn, C, & Malone, L 2010, Integrating gerontological content into advanced practice nursing education, New York: Springer Pub, Co..
Benner, P E 2010, Educating nurses: a call for radical transformation, San Francisco: Jossey-Bass.
Clark, C C 2003, Holistic assertiveness skills for nurses empower yourself and others, New York: Springer Pub..
Cowen, P S, & Moorhead, S 2011, Current issues in nursing (8th ed,), St, Louis, Mo,: Mosby Elsevier,
DeYoung, S 2009, Teaching strategies for nurse educators (2nd ed,), Upper Saddle River, N.J,: Prentice Hall.
Ellis, J R,& Hartley, C L 2012, Nursing in today's world: trends, issues & management (10th ed,), Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins,
Gallagher, R M 1991, Readings in transition: focus on professional nursing, St, Louis: Mosby Year Book.
National competency standards for the registered nurse, (2006). Nursing and Midwifery Board of Australia, Melbourne VIC
Grady, T 1987, Nursing finance: budgeting strategies for a new age, Rockville, Md,: Aspen Publishers
Limon, S,& Spencer, J B 1981, The school-to-work transition in nursing: an annotated bibliography, New York: National League for Nursing,
Zerwekh, J G, & Garneau, A Z 2011, Nursing today: transition and trends (7th ed,), St, Louis: Saunders.
