EASING THE TRANSITION FROM STUDENTS TO NURSES

INTRODUCTION

School is a world of “black & white”

The transition from nursing student to RN is called “transition shock” or “reality shock”.

Movie clip: The New Nurse

LEADERSHIP AND PRECEPTORSHIP

Preceptorship emerged as the "reality shock" that students were experiencing at the transition phase from a student to a professional nurse, became the focus of concern for the profession (Kramer, 1974, McGrath & Koewing, 1978).

Preceptorship was adopted as a way for preparing clinically competent graduates who would be able to assume full patient care as soon as they are employed (Myrick, 1988).

LEADERSHIP AND PRECEPTORSHIP

In education preceptorship is usually defined as an individualized one to one learning and teaching interchange between a student and a staff nurse who supervises the student and acts as a role model and a resource person who is available any time during the clinical instruction

 MAKING THE TRANSITION FROM STUDENT TO NURSE

There are 3 distinct aspects of any given role:

Ideal role image: society’s expectations of what a nurse should be.

Includes obligations and responsibilities, rights, privileges.

CLEAR image of what is expected.Often unrealistic. Perceived role image:an individual’s own

definition of nurse’s role. Often more realistic than the ideal role, but not be

realistic, either. This is usually the role with which the nursing

student usually graduates. Performed role image:what the nurse actually

does. 

MAKING THE TRANSITION FROM STUDENT TO NURSE

Reality shock occurs when the ideal or perceived role comes into conflict with this performed role image.

Cognitive dissonance may occur in new graduate nurses:they know what they should do but their circumstances won’t allow them to do it.

Unresolved role conflict may result in high levels of anxiety and eventually, physical and emotional symptoms.(burnout)

WAYS TO DECREASE REALITY SHOCK IN NEW GRADUATES

preceptored clinical experiences during the last semester of nursing school. - this can produce a type of anticipatory socialization into the role of registered nurse.

internships for nursing students after their junior year in nursing school - such experiences offer experience in skills and help the student become socialized into the professional role.

EMPLOYMENT IN TODAY’S MARKET

Employers want graduates who can:

Function independently Require little orientation or re-

training Can supervise a variety of less

educated and unlicensed personnel

EMPLOYMENT IN TODAY’S MARKET

Ways to increase the likelihood of being hired:

Take advantage of internships, and extern or precepted experiences

Try to obtain clinical experiences in the hospital where one wants to be hired

Do your best in clinical and make a good impression!

EMPLOYMENT IN TODAY’S MARKET

Resumes An institution’s first impression of a job

candidate… has a substantial effect on the hiring process

A neat, thorough, professional-looking resume is well worth the time and effort.

Interviews An interview allows the institution to

obtain a first-hand look at the applicant, as well as an opportunity for the applicant to obtain important information about the institution and position requirements.

EMPLOYMENT IN TODAY’S MARKET

 First impressions are important. Be sure to do the

following at your interview: Wear clean, neat, well pressed and conservative

business clothes Hair should be conservatively styled and

clean.Jewelry and makeup should be tasteful No smoking, biting fingernails, chewing gum or

tobacco, or nervous pacing Arrive a few minutes early Carry a copy of your resume, cover letter,

references, and information about the hospital.Also bring a pen and something to take a few notes on. Bring your business card if you have one.

EMPLOYMENT IN TODAY’S MARKET

Be prepared!!! Know something about the institution where

you’re applying.  Expect questions about your past jobs,

education, unusual activities outside the employment setting

Answer questions honestly but briefly

EMPLOYMENT IN TODAY’S MARKET

At the end of the interview, applicants may be asked if they have any questions. At this time you should bring up questions about:

responsibilities of the position other staff in the area where you’re

applying client-to-staff ratios requirements for floating, weekends, etc. opportunities for CE, clinical ladder,

advancements, etc policies for employee health and safety

ISSUES AFTER EMPLOYMENT Indeed, nurses are leaving the field at a

record pace. A recent study conducted by Julie Sochalski, RN, PhD, of the University of Pennsylvania reveals that new nurses are abandoning the profession at much faster rates than they did just 10 years ago. Four percent of new female nurses drop out within four years of earning their RN licensure; for males, the figure is almost double (7.5%).

ISSUES AFTER EMPLOYMENT

Burnout Burnout syndrome has been recognized as a

problem that can be reduced or even prevented.

Burnout:a state of emotional exhaustion that results from the accumulative stress of an individual’s life, including work, personal, and family responsibilities.

ISSUES AFTER EMPLOYMENT

People most likely to experience burnout tend to be:

above average intelligence hard-working idealistic perfectionistic

ISSUES AFTER EMPLOYMENT

Jobs which tend to produce a high incidence of burnout have:

demand for consistently high performance

unclear or unrealistic expectations little control over the work situation financial rewards are inadequate very demanding and stressful little recognition or appreciation  constant contact with people Most of these elements are present in

NURSING!!

ISSUES AFTER EMPLOYMENT

Symptoms of burnout include: extreme fatigue, exhaustion, frequent

illness, overeating, headaches, sleeping problems, physical complaints, alcohol abuse, mood swings, emotional displays, anxiety, poor-quality work, anger, guilt, depression.

ISSUES AFTER EMPLOYMENT

Symptoms of burnout include: extreme fatigue, exhaustion, frequent

illness, overeating, headaches, sleeping problems, physical complaints, alcohol abuse, mood swings, emotional displays, anxiety, poor-quality work, anger, guilt, depression.

may lead to feelings of helplessness, powerlessness, purposelessness, and guilt.

ISSUES AFTER EMPLOYMENT

There are ways to prevent burnout and to deal with the stress that leads to burnout:

Recognize early symptoms of burnout Manage stress and time. Set personal goals

(short term: 6 months- 2 years; and long term: 10 years).Goals should be flexible.

Identify problems that are producing the stress. Time management is one important technique to decrease work stress. The most important aspect of time management is SETTING PRIORITIES!!

Take care of yourself. Take time after work for “decompression”, to release the tension of the work day. Relaxing activities, solitude, prayer, etc. can all be effective.

PRACTICE MAKES PERFECT

"Assertiveness ties in with self-confidence and it comes with more experience," "Be assertive when seeking opportunities to develop strong clinical skills. Seek those out. Don't be passive and wait on people to bring those opportunities to you."

“You may feel like you’re not quite ready for it. But midway through, you will start gaining confidence and thinking 'maybe I can do this.' By the end, you are sure you can. You will be able to see your own competence and realize you know far more than they think you do.”