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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 • 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 • 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 • 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 • Honeymoon • Shock or Rejection • Recovery • Resolution
Honeymoon Phase • Everything in the work world is just as the new graduate imagined • Most often occurs during the orientation period
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 • 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 Continued…
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 • Change agent • Welfare of patient is foremost • Care enough to elicit change • May be called a troublemaker
Recovery Phase • Novice nurse begins to understand the new culture • Novice nurse experiences less anxiety and healing begins
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 • 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 • 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) • 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 Continued…
Stage 4: proficient nurses; holistic view; able to develop effective solutionssees whole, not aspects speed • Stage 5: expert nurses; intuition & decision making instantaneousdoes not rely on rules or aspects quickly zero in on problem
Strategies to Ease Transition • 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 • 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 Continued…
Set goals and mark them off when complete • Maintain a positive attitude • Become active in professional organizations • Offer to mentor students • Keep personal and professional life in balance
Keys to Survival • 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 • Organizational skills • Clinical skills • Interpersonal skills • Delegation skills • Priority setting skills • Balance with personal life
Improve Organizational Skills • Use report sheets • Contact former nursing instructors to discuss challenges • Learn to delegate appropriately
Improve Clinical Skills • Observe experienced nurses • Provide mentor with list of skills needing refinement • Use policy & procedure book
Improve Interpersonal Skills • 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 • 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 • What are the patient needs? • How much time is required for a task? • What tasks can be delegated?
Improve Your Social Life • Reintroduce yourself to spouse, family & friends • Participate in children’s activities • Read a novel • Try new recipes • Participate in exercise • Enjoy the nursing profession!