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Transition to Nursing

Introduction

The transition of newly graduate nurses to the mainstream practice has always been a conflicting issue addressed by the academicians and researchers. Over the time, the interest surrounding this issue is continuously increasing and exposing several areas of conflict within the subject. The transition of newly graduate nurses in the practical framework as Registered Nurse is not an easy way. In most of the cases, the graduates find it extremely stressful to consolidate their learning and understanding of this issue to their practical practice and gain the deserved recognition in their working field at the initial stage of their work. The newly graduates are required to fit in the working environment instantly and start working under the shift-based system. Moreover, the instant adjustments related to teamwork, new skills and knowledge acquisition and catering to serious responsibilities generate a significant amount of stress in the new graduates.

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In the case of Australian health care setting, the situation is almost the same for the newly registered nurses. The following discussion will take a leap on those challenges faced by the newly registered nurses in Australia as they are expected to be fully equipped to handle every responsibility that comes their way as soon as their start their career in the professional field. The discussion will further present a qualitative study on the gaps that are quite visible between the university lectures regarding health care and that of the practical experiences encountered by Australian nursing practitioners in the health care setting.

Discussion

There are various views contributed by the academicians in this context that has raised conflicts. On the other hand, the supportive arguments and positive feedbacks suggest that there are plenty of opportunities regarding this that suggest there are several influential factors that motivate these fresh graduates to combat the challenges and proceed with sheer confidence. In this context, it is quite evident that there are plenty of opportunities for the graduates using which the nurses can successively improve the initial experience and derive encouragement for staying in the health care sector, contributing their best efforts (Dolphin, 2013). The newly graduates require immense support from the registered nurse appointed in the health care settings. It felicitates the graduates with a significant amount of support that enhances their employment and encourages them to stay within the complex framework despite the difficulties.

Over the time, it has been a proven theory that the more the new graduates in Australia is exposed to the clinical experiences, the more their development as a professional nurse will be assured. In various health care settings around Australia, the newly graduated registered nurses are provided with proper training and support programmes as they start their professional work (Parker et al. 2014). However, arguments have suggested that students who go through different training programmes in Australia do not get the privilege of understanding the responsibilities of a registered nurse (Phillips, Esterman & Kenny, 2015). Although, the supportive graduate programmes aim to equip the graduates with enough knowledge to proceed with, but despite the efforts, graduates around the rural sectors of Australia still faces the same challenge while they start working as a professional registered nurse.

The basic challenge the newly graduates face after completion of their nursing degree programme is sure regarding the selection of their working venue. There is a common perception regarding this idea that the venue the graduates select for carrying out their work as a professional nurse can leave a severe impact on their upcoming career. In Australia, the empirical evidence and surveys have established the idea that the graduates who start working as a registered nurse in the private sectors have both positive and negative experiences (Benner et al. 2009). However, it has become quite evident from the researches and surveys that the nurses working in the public health care sector have plenty of negative experiences.

The current situation is Australian healthcare is essential in this context, as the number of Australian nurses is declining in a rapid force. Whereas the increase of the aged population is continuously elevating in Australia, the shortage in the number of nurses is becoming a grave issue (Scully, 2011). The study of Health Workforce Australia has suggested that by the year 2025, the shortage in the number of nurses will reach up to 110,000. On the other hand, in Queensland, the shortage rate is also quite high and by 2020, the expansion in the health care setting will create almost 14,000 vacant positions (Salt, Cummings & Profetto-McGrath, 2008). Evidently, the problem is there regarding the employee retention in the health care sector of Australia that is not addressed properly. Considering this significant statistical factors, the Australian healthcare authority is trying its best to enrol the nurses in several training courses. The gap is yet to be filled, as there are several obligations the new registered nurses face during clinical practices that are not being addressed in their training programmes. However, various studies regarding this issue have tried to resolve the problems, but those have barely met the objectives. As a result, the transition for the graduate nurses in Australia is still quite problematic and poses a valid challenge for the health care industry (Cleary et al. 2011).

In the Australian health care settings, the newly graduated registered nurses often declare negative comment upon their career choice claiming that their expectations to perform exceptionally well in the professional field have diminished over the time (Pellico, Brewer & Kovner, 2009). At the initial stage, the major problem for new registered nurse occurs because of their continuous rotation to the different wards within the healthcare setting. The challenges are quite visible in the primary level of joining as a registered nurse that is also considered as the developmental phase. ‘Reality shocks’ is a very common term that is used for this stage of learning of the nurses. In their first encounter of the clinical experiences, the newly graduate registered nurses encounter several incidents that shock them, as they do not experience those in their training period (Evans, Boxer & Sanber, 2008).

Lack of confidence and fear are the two transitional challenges that grab the nurses because of encountering reality shocks within the health care setting. However, arguments have revealed that the fear is somehow generated from the excitement of entering a completely new area of professional practice and if not, fear can be abolished over the time through the extended support from the people within the healthcare setting (Hartigan et al. 2010). Lack of proper communication within the setting is another barrier faced by new graduates as they find it difficult to communicate with the physicians as well as the team members. Various experiences of novice registered nurses confirm that while communicating with the physicians over the telephone regarding a critical health condition of a patient, they experienced negative approaches from the senior physicians (Wu et al. 2012). Such rejection from the physicians often leads the newly graduated registered nurse to become clueless. In order to diminish this issue, health care authorities need to initiate in-depth interpersonal communication-based training programmes to address such conflicts on a serious note.

A major challenge faced by the newly emerged professionals of the health care setting is the sense of being unprepared to face the work challenges. The suppressing workload and immense responsibilities of the registered nurse make them feel out of place in the health care setting as they start as the beginners. Despite being equipped with sufficient knowledge of the activities of the healthcare setting, the newly graduated registered nurse feel to be less prepared for carrying out their duties effectively (Jacob, McKenna & D’Amore, 2014). As a result, they fail to put their best efforts in their work and left with utter disappointment about their career choice at the early stage. Apparently, the lack of proper training is considered as the prime reason in this case, but arguments have suggested that various graduate nurses also lack efforts to address the issues and resolve them as because of their anxiety.

The unrealistic expectations of the hospital staffs along with the patients often lead them to face severe challenges within the healthcare setting. Moreover, the already experienced nurses also try to impose dominance over the newly graduated registered nurses and compel them to fulfil the expectations (Dolphin, 2013). Such a condition regarding over expectation generates a significant amount of guilt and inadequacy among the graduates as they fail to cater to the expectation levels. Arguably, in the positive work environments, the graduates successfully catered to the expectation levels because of the more realistic approach to their workload allocation process (Parker et al. 2014). As a result, the nurses felt confident and encouraged them to work more independently.

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Assimilation anxiety, more explicitly, the need of adjusting with the team in the fastest possible way is another challenge faced by the new graduates. Every ward within the health care settings of Australia possesses a different culture and it becomes difficult to fit in within the complexities (Phillips, Esterman & Kenny, 2015). Moreover, as the newly enrolled registered nurses encounter frequent shifting and rotations within the wards, it becomes immensely difficult for them to make the adjustments fast. The lack of proper time management skills along with personal accountability also lead them to feel stressed out as they start their role as a beginner. Moreover, the newly appointed registered nurses evolve a nature of comparing themselves with the existing experienced nurses of the healthcare settings (Benner et al. 2009). Such a practice makes them feel more under confident and inadequate.

Proper time management at the initial stage becomes a major issue for the newly enrolled registered nurses in Australian healthcare settings, as they need to perform faster and combat the time. Lack of proper time management skills in the primary stage creates an immense amount of stress among the nurses and leaves them with unfinished works (Jacob, McKenna & D’Amore, 2014). Most of them even try to outperform beyond their shifting time with the fear of losing the competition with the other newly enrolled registered nurses. The challenge of the role that is the legal and ethical responsibility of handling others lives also generate a certain amount of stress among the new graduates that they never felt during their training period. As per the experiences shared by various nurses, it became quite evident that they remain afraid of certain situations that their care initiatives may leave a negative impact on the patients and their condition may get worse (Wu et al. 2012).

Along with these challenges, the challenge of consolidating all the learning, understanding and knowledge in performing the works, handling the pressure of negative feedbacks and unsupportive work environment are the other major barriers that every newly graduated registered nurse face in current time. Experiences regarding the horizontal violence or bad conduct from the experienced staffs, professional isolation and exchange of contradictory information within the workplace make it difficult for the nurses to adjust in the complex environment at the initial stages. Moreover, adapting with all the technical skills and making the clients happy and satisfied by delivering high quality of care often appear to be challenging for the newly enrolled registered nurses.

Conclusion

Based on the above discussion, it is quite apparent that Australia requires filling the gap and shortage of nursing by improvising innovative strategies in the training methods. It has been quite evident from the discussion that the challenges, demands and expectations are posing a barrier for the newly graduated registered nurses to achieve the job satisfaction. The growing dissatisfaction and fear of failure is directly influencing the professional commitment of the nurses leading them to alter their profession. Considering these facts, it can be stated that health care organisations should not restrict themselves in providing training to the newly registered nurses, but also put focus on amending the environment of the health care setting so that it can fulfil the requirements of the new generation of registered nurses adequately.

Reference

  • Benner, P., Sutphen, M., Leonard, V., & Day, L. (2009). Educating nurses: A call for radical transformation. New York: John Wiley & Sons.
  • Cleary, M., Horsfall, J., Mannix, J., O'HaraAarons, M., & Jackson, D. (2011). Valuing teamwork: Insights from newlyregistered nurses working in specialist mental health services. International journal of mental health nursing, 20(6), 454-459.
  • Dolphin, S. (2013). How nursing students can be empowered by reflective practice, Mental Health Practice, 16(9), 20-23.
  • Evans, J., Boxer, E., & Sanber, S. (2008). The strengths and weaknesses of transitional support programs for newly registered nurses. Australian Journal of Advanced Nursing, The, 25(4), 16-25.
  • Hartigan, I., Murphy, S., Flynn, A. V., & Walshe, N. (2010). Acute nursing episodes which challenge graduate’s competence: Perceptions of registered nurses. Nurse Education in Practice, 10(5), 291-297.
  • Jacob, E. R., McKenna, L., & D’Amore, A. (2014). Senior nurse role expectations of graduate registered and enrolled nurses on commencement to practice. Australian Health Review, 38(4), 432-439.
  • Parker, V., Giles, M., Lantry, G., & McMillan, M. (2014). New graduate nurses' experiences in their first year of practice. Nurse Education Today, 34(1), 150-156.
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