1.
Professional socialization is considered to be the driving force towards the development of one’s knowledge, values and skills that are necessary in building a professional career. The transition from the role of a licensed practical nurse (LPN) to a registered nurse (RN) carries with it the responsibility of maintaining the criteria for a high standard of profession in nursing. A profession carries with it the individual responsibility of practicing the proper knowledge necessary to meet the qualifications of a professional in order to enjoy the privilege of practicing the profession. The criteria of the nursing profession is achieved during the process of professional socialization through the acquisition of the norms, knowledge, skills, culture and ethical standards that are learned through the reciprocal interaction of nurses with one another (Cherie, Mekonen, and Shimelse, 2005). As nurses begin to interact with fellow nurses and other healthcare professionals, they learn to develop their own occupation identity and become a functioning participant in providing the high standard of health care services within the workplace. Through professional socialization, one learns to assume new roles through the acquired training or skills taught to them or based on their observation. The process may involve a direct or formal learning by attending classes and professional training involving nurse care plan and how to perform physical examination, for instance. Informal learning may also be involved, such as socialization with fellow nurses and learning how they interact with patients or by observing the values and practices of nurses and absorbing their behavior.
The four stages of professional socialization involve the unilateral dependence, independence, dependence and interdependence. The unilateral dependence involves some uncertainties on the individual’s capacity to perform a particular task on his own without the confidence of the acquired knowledge. The independence stage provides the person the capacity to exhibit a behavior of confidence in his ability to perform a particular task based on his knowledge and skills. The dependence stage allows the individual to identify that he needs the help of others as his skills and knowledge may not be sufficient and he needs guidance from others to perform his tasks better. Lastly, the person in the interdependence stage knows that he has the capability and knowledge, but he needs other resources for further improvement in his nursing career.
I am currently experiencing the fourth stage of my nursing career. It is at this stage where I have already acquired the basic knowledge and skills that are required from nurses, but require supplemental learning based on mentoring and further actual experience in the clinical settings. Dinmohammadi (2013) indicated that the nursing learning experience and self awareness involves a complex process of professional socialization with the attributes of competent role models, comprehensive educational training, an adequate field or clinical experience. Among the barriers that can interfere with my ability to accomplish the fourth stage (interdependence) include the lack of professional collaboration skills with the other health care professionals and conflicting cultural values and norms, such as adapting to the actual clinical settings and nature of work. With respect to the first barrier of a difficult collaborative process, the potential sources that can help me overcome such difficulty would be to learn how to improve my communication skill. Beyond the learning experience inside the four corners of the classrooms is the clinical environment that involves professional socialization of nurses with the other healthcare providers that also serves as a learning ground for nurses. Physicians and fellow nurses are potential sources of helping me learn about the expectations from my nursing performance. Discussing with them the expected outcomes required from the patient and working with collaborative efforts together with other healthcare providers will help me learn about the various aspects in the delivery of comprehensive and quality nursing care. Maintaining a good camaraderie and working relationship can help me develop the various aspects of exercising my profession, such as the different nursing care techniques, assessing clinical outcomes, dealing with patients and their family members and observing the proper behavior in the every unique clinical setting. Professional socialization is a good resource and means for me in taking the initiative of keeping myself associated to the clinical setting and to actively involve myself in the learning process on dealing with the patient unique condition and in the exercise of a more thorough process of assessing patients based on observation on the other healthcare provider practice in patient treatment and management.
Cultural values and norms can often cause conflicting issues in the effort of building an interdependence relationship in the healthcare setting. This issue may arise from the nature of work of a nurse or when they are confronted with difficult tasks to perform, something that may be the first time to encounter and unexpectedly assigned to them. In resolving conflicting cultural values and norms, I usually learn to keep an open mind about the various perspectives involved in the clinical setting. A good means of resolving issues is to learn discussing various points involving the nature of work that I need to perform and ask for clarification about the doctor’s orders. According to Stacey, et. al. (2011), nurses often already established their own person-centered values on how to perform their job responsibilities. Learning how to discuss certain conditions in the clinical setting helps nurses learn how to adapt to the traditional norms and standards within their workplace. Getting support from colleagues will also help me learn how to adjust to the current healthcare practice. Asking for their advice is a good source of learning, especially during the transition process of a nurse’s role. Professional advice is an effective guide in order to help me learn how to overcome the barriers involving culture shock and discovering coping strategies. Learning the appropriate coping strategy is essential in helping me learn to adapt to the norms and values in the healthcare setting to improve my competence and ability to meet the high standards of care required within the working environment. There are instances when the educational learning experience is already espoused with one’s own norms and values and conflicting issues arise from it. As a nurse, I could use a more adaptive approach in helping me overcome the diversity of norms and values present in the work setting. While I have already established my own personal values as a nurse, harmonizing my own values with that of the current healthcare environment where I work is the best way to cope with this barrier. Through professional socialization, it is possible to learn new things and perspectives in the nursing practice. With collaborative effort, I can adapt to these new values in order to promote quality healthcare service standards and meet the level of care required within the healthcare setting. Professional healthcare providers always share a common goal, which is to promote the general welfare of the patients. With a cooperative attitude, I can possibly overcome the conflicting norms and values existing between me and the workplace in order to satisfy the need of delivering quality patient care.
2.
There are three differences between the roles of an LPN and RN that can affect the ability of the RN to perform their role in providing safe and effective patient care. These are nursing care and planning, educational preparation and assessment skills. As the LPN role transitions into RN, more serious responsibility rests upon the registered nurse in terms of providing quality nursing care and planning. RNs utilize problem solving skills in contrast to the role of an LPN in identifying patient problems and helping patients to achieve positive treatment outcomes (Claywell, 2009). Registered nurses are required to perform a higher standard of patient care and planning, unlike the practical nurses. More thorough nursing processes are observed by RNs in order to ensure the administration of safe patient care. RNs need to exercise analytic skills in diagnosing and defining treatment outcomes. LPNs do not exercise critical analysis and judgment. They do not interpret clinical data for diagnosis or define a treatment plan of care. The role of RNs is more unique and carries with it more serious responsibilities in the clinical setting. While LPNs assists in helping identify the medical problem of patients, but it is the RN who formulates the treatment plan and carries its implementation and management. RNs, however, need to communicate the treatment plan and the expected outcomes to the LPNs in order to implement a more collaborative effort in attaining the desired patient outcomes. RNs have a greater responsibility in terms of designing and planning treatment care for patients, as well as in evaluating the effectiveness of the implemented nursing care plan.
In terms of the educational preparation, RNs are trained to evaluate patient condition, understand the why in their clinical condition and to exercise critical analysis in planning for the appropriate nursing care plan and management. The nursing programs for registered nursing are different from that of the practical nurse. They are required to render longer clinical hours to practice their role as an RN more efficiently and they are more exposed in the management of complicated medical conditions. Their educational training is more rigid and clinical exposure more thorough. LPN education takes only two years while the RNs spend four years of educational training. The education trainings of RNs are not limited to the clinical setting. They practice their profession in nursing homes, clinics, health care facilities and hospitals. Their knowledge in clinical nursing is broader and they are competent in practicing their skills and educational training in a more structured medical environment. RNs need to obtain the appropriate educational background and training in order to perform their role more efficiently in diagnosing patient condition and define the most viable nursing care plan for them. To make them more effective in delivering safe and quality patient care, RNs need to complete their education and comply with the licensure requirement in order to practice their profession. They also need to learn the holistic care in treating their patients in order to meet the various aspects of their needs for faster recovery and optimize their response to treatment. LPNs are usually under the supervision of the RNs because they are usually exposed to the same clinical settings as the registered nurse. RNs are also required to learn nursing leadership in supervising LPNs better to attain their common goals. They are the managers of patient care and nursing leadership is usually taught for registered nursing to learn during their educational training. This is required for RNs to learn because of the independent role that they perform as a healthcare provider (Hill and Howlett, 2013) and most of the time LPNs report to RNs.
The assessment skills required from RNs is different from that of the LPNs. The ability of registered nurses in assessing the patient condition is broader and their responsibilities involve initiating, updating and completing the assessment, as well as to manage LPNs in the safe administration of patient treatment. In certain extent, the LPNs may exercise assessment on the patient condition, but it is usually limited to taking the medical history of the patient and data collection. RNs take the assessment process further after the collection of data where they apply critical analysis and professional clinical judgment regarding the patient’s condition based on the data collected. The validating process and the clustering of data as part of the assessment procedure are considered by Nunnery (2010) as very critical for RNs to make an accurate diagnosis on the patient condition and in the planning of the appropriate nursing intervention to give. In order for RNs to deliver quality assessment to their patients, it is necessary to focus on the unique condition of the patient, including individual factors, their health condition, environment and responses. These are the crucial roles that RNs need to perform in order to ensure that they are properly defining an appropriate nursing care plan and treatment management for patients. It is also incumbent for registered nurses to practice their ability in performing a comprehensive and focused assessment. By comprehensive assessment, RNs are able to see the whole picture regarding the patient condition. Focused assessment involves the determination of the patient condition and response to treatment solely based on specific signs and symptoms. This makes RNs more competent in ensuring the delivery of effective and safe patient care because they are focused on both the general well-being of the patient and on their specific health status to ensure that adequate and targeted treatment is given.
In conclusion, the role transition in nursing from LPN and RN is significant because of the differences in the competency areas that RNs are required to exercise. Registered nurses are expected to perform higher standards of patient care and are engaged in the exercise of critical analysis, clinical judgment, and supervision of LPNs. In order to optimize the performance of a registered nurse on their independent role as healthcare providers, professional socialization is necessary to enhance their learning experience and knowledge in their field of profession. Professional socialization is achieved through the improvement of communication skills, the observance and adaption of professional behavior and values of senior healthcare providers, collaborating efforts with other healthcare providers and consistent interaction with those under their supervision like LPNs for the efficient monitoring of patient outcomes.
References:
Cherie, A., Mekonen, A.H. and Shimelse, T. (2005). Introduction to Professional Nursing and Ethics. Retrieved from http://www.cartercenter.org/resources/pdfs/health/ephti/library/lecture_notes/nursing_students/LN_Intro_Prof_Nsg_final.pdf.
Claywell, L. (2009). LPN to RN Transitions. 2nd Ed., St. Louis, MO: Elsevier.
Dinmohammadi, M. (2013). Concept Analysis of Professional Socialization in Nursing. Nursing Forum. 48(1):26-34.
Hill, S.S. and Howlett, H.S. (2013). Success in Practical/Vocational Nursing: From Student to Leader. 7th Edition. Missouri: Elsevier.
Nunnery, R.K. (2010). Making the Transition from LPN to RN. USA: F.A. Davis Publishing.
Stacey, G. et. al. (2011). How Do Nurses Cope When Values and Practice Conflict? Nursing Times. 107(5): 20-23.
