mosby items and derived items copyright © 2002 by mosby, inc. making the transition from student to...
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Mosby items and derived items copyright © 2002 by Mosby, Inc.
Making the Transition from Student to Professional Nurse
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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
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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
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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
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Phases of Reality Shock
• Honeymoon• Shock or Rejection• Recovery• Resolution
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Honeymoon Phase
• Everything in the work world is just as the new graduate imagined
• Most often occurs during the orientation period
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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?”
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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 outContinued…
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• 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”
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Appropriate Response to Shock
• Change agent– Welfare of patient is foremost– Care enough to elicit change
• May be called a troublemaker
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Recovery Phase
• Novice nurse begins to understand the new culture
• Novice nurse experiences less anxiety and healing begins
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Resolution Phase
• Novice nurse adjusts to the new environment• Work expectations are more easily met• The nurse has developed the ability to elicit
change
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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
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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
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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 calls
aspects, based on prior experience
• Stage 3: competent nurses; able to foresee long range goals & master new skills
some mastery and coping ability, not speed
Continued…
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• Stage 4: proficient nurses; holistic view; able to develop effective solutions
sees whole, not aspectsspeed
• Stage 5: expert nurses; intuition & decision making instantaneous
does not rely on rules or aspectsquickly zero in on problem
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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
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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…
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• 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
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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
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Meeting Special Needs of the Novice Nurse
• Organizational skills• Clinical skills• Interpersonal skills• Delegation skills• Priority setting skills• Balance with personal life
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Improve Organizational Skills
• Use report sheets• Contact former nursing instructors to discuss
challenges• Learn to delegate appropriately
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Improve Clinical Skills
• Observe experienced nurses• Provide mentor with list of skills needing
refinement• Use policy & procedure book
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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
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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
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Improve Prioritization Skills
• What are the patient needs?• How much time is required for a task?• What tasks can be delegated?
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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!
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