Making the transition from student to professional nurse
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Making the Transition from Student to Professional Nurse. Key Concepts. Phases of reality shock Differences between the novice nurse and the expert professional nurse Strategies to ease the transition from novice to professional nurse. Overview.

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Key concepts
Key Concepts

  • Phases of reality shock

  • Differences between the novice nurse and the expert professional nurse

  • Strategies to ease the transition from novice to professional nurse


  • Inconsistency between the expectations as a student and those of the profession creates conflict for the new nurse

  • Transition, often referred to as reality shock, is a complicated process that can be overwhelming for the new nurse

Reality shock
Reality Shock

  • Inconsistency between the academic world and the work world

  • Occurs in novice nurses when they discover a work environment for which they have prepared for several years and suddenly feel that they are not prepared

Phases of reality shock
Phases of Reality Shock

  • Honeymoon

  • Shock or Rejection

  • Recovery

  • Resolution

Honeymoon phase
Honeymoon Phase

  • Everything in the work world is just as the new graduate imagined

  • Most often occurs during the orientation period

Shock rejection phase
Shock (Rejection) Phase

  • Realization of conflicting viewpoints and different ways of performing skills

  • Lack of an expert available as a resource

  • Common questions:

    • “What must I do to become the kind of nurse I want to be?”

    • “What must I do so that my nursing contributes to humankind and society?”

Inappropriate reactions to the shock phase
Inappropriate Reactions to the Shock Phase

  • Native

    • Adopts ways of least resistance; mimics other nurses

  • Run away

    • Leave nursing; return to graduate school

  • Rutter

    • Bottles up conflict and becomes burned out


Making the transition from student to professional nurse

  • Loners

    • Adopts the attitude just do the job and “keep your mouth shut”

  • New nurse on the block

    • Change jobs frequently; use the excuse: “I am new here”

Appropriate response to shock
Appropriate Response to Shock

  • Change agent

    • Welfare of patient is foremost

    • Care enough to elicit change

  • May be called a troublemaker

Recovery phase
Recovery Phase

  • Novice nurse begins to understand the new culture

  • Novice nurse experiences less anxiety and healing begins

Resolution phase
Resolution Phase

  • Novice nurse adjusts to the new environment

  • Work expectations are more easily met

  • The nurse has developed the ability to elicit change

Degree of reality shock
Degree of Reality Shock

  • Less for graduates who begin their career in the same institution where clinical rotations were performed

  • Higher for graduates who choose to work in institutions in which they did not train

  • Reality shock inventory will be helpful to assess oneself and the situation

Causes of reality shock
Causes of Reality Shock

  • Culture shock

    • Work culture is different and unfamiliar

    • Providing “wholistic care” may not be reality

  • Methods of evaluation

    • Work world evaluates on quantity of care

    • Academic world evaluates on correct steps

  • Incongruent school and work values

From novice to expert benner 1984
From Novice to Expert (Benner, 1984)

  • Stage 1: few clinical experiences; skills learned by roterule governed behavior

  • Stage 2: advanced beginners; able to perform adequately; make some judgment callsaspects, based on prior experience

  • Stage 3: competent nurses; able to foresee long range goals & master new skillssome mastery and coping ability, not speed


Making the transition from student to professional nurse

Strategies to ease transition
Strategies to Ease Transition effective solutions

  • Participate in orientation programs

    • Biculturalism

    • Role models and mentors

    • Preceptorships

    • Self mentoring

  • Improve self-confidence and self-esteem

  • Know keys to survival

Ways to build self esteem
Ways to Build Self-Esteem effective solutions

  • Become future-oriented; do not focus on mistakes

  • List areas in which to improve

  • List personal qualities that you like about yourself

  • Take time to treat yourself

  • Engage in positive self-talk


Making the transition from student to professional nurse

  • Set goals and mark them off when complete effective solutions

  • Maintain a positive attitude

  • Become active in professional organizations

  • Offer to mentor students

  • Keep personal and professional life in balance

Keys to survival
Keys to Survival effective solutions

  • Never fail to ask for help

  • Use available facility resources

  • Re-energize with professional associations

  • Stay in contact with friends

  • Evaluate your growth realistically

  • Stay focused on your goals

Meeting special needs of the novice nurse
Meeting Special Needs of the Novice Nurse effective solutions

  • Organizational skills

  • Clinical skills

  • Interpersonal skills

  • Delegation skills

  • Priority setting skills

  • Balance with personal life

Improve organizational skills
Improve Organizational Skills effective solutions

  • Use report sheets

  • Contact former nursing instructors to discuss challenges

  • Learn to delegate appropriately

Improve clinical skills
Improve Clinical Skills effective solutions

  • Observe experienced nurses

  • Provide mentor with list of skills needing refinement

  • Use policy & procedure book

Improve interpersonal skills
Improve Interpersonal Skills effective solutions

  • Attend unit meetings

  • Volunteer for committees

  • Take an active interest in the nursing unit

  • Participate in professional organizations

  • Make rounds with physicians

  • Assist with procedures

Improve delegation skills
Improve Delegation Skills effective solutions

  • Communicate face to face; be aware of body language

  • Follow-up by putting tasks in writing

  • Be pleasant and open to suggestions

  • Offer help

  • Provide sincere, positive reinforcement

Improve prioritization skills
Improve Prioritization Skills effective solutions

  • What are the patient needs?

  • How much time is required for a task?

  • What tasks can be delegated?

Improve your social life
Improve Your Social Life effective solutions

  • Reintroduce yourself to spouse, family & friends

  • Participate in children’s activities

  • Read a novel

  • Try new recipes

  • Participate in exercise

  • Enjoy the nursing profession!