Description:
Aims: This research explores the challenges that new nursing graduates experience whilst adapting to their new role in their first year of practice. These challenges are presented from the perspectives of Graduate Nurse Program Coordinators in the state of Victoria, Australia, previously not described in the literature. Background: Each year, thousands of new nursing graduates join the workforce in Australia, with many suffering major stressors and dissatisfaction in their first year of practice. Much has been written about challenges faced by this group from their own perspectives, yet nothing has been heard from the perspectives of those who support them; that is, the coordinators of year-long graduate nurse transition programs. Methods: This descriptive qualitative study used individual, semi-structured interviews to access information and perceptions from sixteen Graduate Nurse Program Coordinators about the challenges experienced by nursing graduates in their first year of practice. Transcripts were thematically analysed to reveal reoccurring themes and sub-themes. Results: The interviews provided an insight into various challenges that nursing graduates experience in relation to role adaptation in their first year of practice. Nursing graduates found difficulties with reality shock, work-life balancing and having unrealistic assumptions in their capacity to work, assuming they should be at a higher level despite being a beginner practitioner. Conclusions: This study reinforces the need for education providers to maintain currency in their undergraduate nursing programs and to work closely with health care services in providing a quality clinical experience to all nursing students. It also provides evidence that graduate transition programs are essential, with Graduate Nurse Program Coordinators performing a crucial role in providing appropriately planned strategies to support graduates through this vulnerable time.
Description:
Aims: This research explores the challenges that new nursing graduates experience whilst adapting to their new role in their first year of practice. These challenges are presented from the perspectives of Graduate Nurse Program Coordinators in the state of Victoria, Australia, previously not described in the literature. Background: Each year, thousands of new nursing graduates join the workforce in Australia, with many suffering major stressors and dissatisfaction in their first year of practice. Much has been written about challenges faced by this group from their own perspectives, yet nothing has been heard from the perspectives of those who support them; that is, the coordinators of year-long graduate nurse transition programs. Methods: This descriptive qualitative study used individual, semi-structured interviews to access information and perceptions from sixteen Graduate Nurse Program Coordinators about the challenges experienced by nursing graduates in their first year of practice. Transcripts were thematically analysed to reveal reoccurring themes and sub-themes. Results: The interviews provided an insight into various challenges that nursing graduates experience in relation to role adaptation in their first year of practice. Nursing graduates found difficulties with reality shock, work-life balancing and having unrealistic assumptions in their capacity to work, assuming they should be at a higher level despite being a beginner practitioner. Conclusions: This study reinforces the need for education providers to maintain currency in their undergraduate nursing programs and to work closely with health care services in providing a quality clinical experience to all nursing students. It also provides evidence that graduate transition programs are essential, with Graduate Nurse Program Coordinators performing a crucial role in providing appropriately planned strategies to support graduates through this vulnerable time.
Description:
Background: Evidence from the literature and anecdotally from clinical settings suggests that newly graduated nurses are not fully prepared to be independent practitioners in healthcare settings. Aims and Objectives: The aim of this studywas to explore perceptions of qualified nurses in relation to the practice readiness of newly registered nursing graduates and determine whether these views differ according to specific demographic characteristics, clinical settings, and geographical locations. Design: A descriptive quantitative design was used. Methods: An online survey tool was used to assess how qualified nurses (n = 201) in Victoria, Australia, rated newly graduated nurses' abilities on 51 individual clinical skills/competencies in eight key skill areas. A composite score was calculated for each skill area and a comparative analysis was undertaken on the various cohorts of participants according to their demographic and clinical characteristics using one-way ANOVA and post hoc tests. Results: Newly graduated nurses were found to be lacking competence in two key skill areas and were rated as performing adequately in the remaining six skill areas assessed. Significant differences (p ≤ 0.05) in performance were found according to the age of the nurse, number of years registered, the educational setting in which they undertook their nurse education, their role, and the clinical area inwhich theyworked. There were no significant differences according to whether the nurse worked in the private or public healthcare sector. Few differences were found between nurses working in a metropolitan vs. regional/rural healthcare setting. Conclusion: This is the first study to quantify the scale of this problem. Our findings serve as a reference for both nurse education providers and healthcare settings in better preparing nursing graduates to be competent, safe practitioners in all clinical areas.
Description:
AIMS: To investigate job satisfaction and confidence levels of graduate nurses during their first year of employment and the impact various training programmes have on these factors. BACKGROUND: The transition from nursing student to practising nurse can be a challenging and stressful time for new nurses. Healthcare organizations provide transition programmes to support nurses through this vulnerable time and to assist in increasing graduates' job satisfaction and retention rates. However, no systematic review of transition programme outcomes has been undertaken to determine the impact of these programmes on improving satisfaction levels and on easing the challenges faced by nursing graduates in their new roles as Registered Nurses. DESIGN: Systematic review of effect using narrative synthesis. DATA SOURCES: Quantitative studies published between 2000-December 2012 were identified using electronic databases and reference lists and by searching 'grey literature'. Primary search terms were 'new graduate nurse' and 'transitional programmes'. REVIEW METHODS: The three authors, guided by standardized procedures, performed independent, blinded data extraction and quality assessment. RESULTS: From 338 studies initially identified, eleven studies were included in this review. These studies used a variety of study designs including quasi-experimental and pre- and posttesting. CONCLUSION: Evidence suggests that transition programmes are necessary in creating working environments that support new nurses in the clinical environment and this is demonstrated by increased job satisfaction and retention rates. However, optimum programme length and structure are unclear.
Description:
Background: Nursing work often occurs in complex and potentially hazardous settings. Awareness of patient and practice environments is an imperative for nurses in practice. Objectives: To explore nursing students' situation awareness while engaging in simulated patient deterioration scenarios. Design: The educational process of FIRST2ACT was the model for the nurse intervention. Situation awareness was measured quantitatively using the Situation Awareness Global Assessment tool. Four domains were measured: physiological perception (patient parameters), global perception (surroundings), comprehension (interpretation of information), and projection (forecasting outcomes). Settings: Clinical laboratories at each of three participating universities. Participants: Ninety-seven nursing students from three Australian universities. Methods: Between March and July 2012, students participated in three video-recorded simulation events, in which a trained actor played patient roles and groups of three students worked as teams. To measure situation awareness, following the simulation each team leader was taken to a separate room and asked to report on a question set regarding the patient's vital signs, bedside setting and medical diagnosis. Results and Conclusions: Overall, situation awareness was low (41%). Of the four domains, physiological perceptions scored the lowest (26%) and projection the highest (59%).Final year nursing students may not have well developed situation awareness skills, especially when dealing with these types of scenarios. Education providers need to consider ways to assist students to fully develop this attribute. Findings suggest that this is an aspect of undergraduate nursing education that requires significant consideration by curriculum developers.
Description:
Objective: To describe Australian midwifery academics' perceptions of the current barriers and enablers for simulation in midwifery education in Australia and the potential and resources required for simulation to be increased. Design: A series of 11 focus groups/interviews were held in all states and territories of Australia with 46 participating academics nominated by their heads of discipline from universities across the country. Findings: Three themes were identified relating to barriers to the extension of the use of simulated learning environments (SLEs) ('there are things that you can't simulate'; 'not having the appropriate resources'; and professional accreditation requirements) and three themes were identified to facilitate SLE use ('for the bits that you're not likely to see very often in clinical'; ['for students] to figure something out before [they] get to go out there and do it on the real person'; and good resources and support). Key conclusion: Although barriers exist to the adoption and spread of simulated learning in midwifery, there is a long history of simulation and a great willingness to enhance its use among midwifery academics in Australia. Implications for practice: While some aspects of midwifery practice may be impossible to simulate, more collaboration and sharing in the development and use of simulation scenarios, equipment, space and other physical and personnel resources would make the uptake of simulation in midwifery education more widespread. Students would therefore be exposed to the best available preparation for clinical practice contributing to the safety and quality of midwifery care.
Description:
Background This paper reports on one aspect of a larger doctoral project which investigated the perceptions of qualified nurses on the abilities of newly registered nursing graduates. Aims To explore qualified nurses’ perceptions on national examinations for registration in Australia.
Description:
Nursing students are required to develop clinical knowledge, skills and attitudes for professional practice. However, objectivity and parity of students' clinical assessments has been questioned. In the last decade, more objective techniques have been developed, with increased use of Objective Structured Clinical Examinations. We reviewed objective clinical assessment measures used in preregistration nursing courses to determine utilization and the validity and reliability of assessment techniques. A systematic search was made of quantitative research publications between 2000 and May 2011, identifying 16 studies that were subsequently reviewed. The validity and reliability of studies varied, with six studies judged as high quality, using various methodologies. This paper describes methods of instrument development and reports on their application in preregistration nursing programs.
Description:
Australian registered and enrolled nurses: Is there a difference? There are two categories of nurse registered to practise in Australia, the degreeâ€educated registered nurse and the certificate/diploma trained enrolled nurse (EN). While it is argued that the roles of the two categories of nurse in Australia are different, recent changes to the educational preparation and supervision requirements of ENs have narrowed these differences. This paper examines the existing literature to determine the perceived differences and similarities between registered and ENs in Australia. Differences identified included registration requirements, educational preparation, supervisory requirements and role expectation. Further research needs to be undertaken to examine the educational preparation of registered and ENs in order to obtain a greater understanding of role expectations on graduation. Supervision processes also require reviewing to demonstrate differences between indirect supervision and independent practice for ENs.
Description:
Background: The transition from nursing student to graduate remains problematic internationally with issues arising concerning graduates’ work readiness upon commencing employment. Aim: This exploratory study specifically investigated perceptions of graduate nurse program coordinators on the work readiness of nursing graduates, with the aims of identifying strengths, weaknesses and challenges that exist. Design: Qualitative descriptive design. Methods: Sixteen graduate nurse program coordinators were interviewed from various healthcare services in the state of Victoria, Australia. Interviews were audio-recorded and transcribed verbatim and thematic analysis was used to disclose reoccurring themes and sub-themes. Findings: This paper reports on one theme, preparation readiness, and three sub-themes associated with this theme; clinical skills deficits, communication issues and transitioning as an enrolled nurse to a registered nurse. Conclusions: There are several areas of weaknesses and challenges for nursing graduates in their preparation for practice. As a poorly understood area, evidence from this study will inform curriculum development and transition programs, not only in Australia, but also internationally.
Description:
Aims and objectives: The aim of this study was to explore perceptions of qualified nurses on the abilities of newly registered nursing graduates to perform a variety of clinical skills. Background: Evidence from the literature suggests that undergraduate nursing programmes do not adequately prepare nursing students to be practice-ready on completion of their nursing courses. Design: A descriptive quantitative design was used. Methods: Participants were recruited through the Australian Nursing and Midwifery Federation, Victorian branch. A brief explanation of the study and a link to the survey were promoted in their monthly e-newsletter. A total of 245 qualified nurses in the state of Victoria, Australia participated in this study. A survey tool of 51 clinical skills and open-ended questions was used, whereby participants were asked to rate new nursing graduates' abilities using a 5-point Likert scale. Results: Overall participants rated new nursing graduates' abilities for undertaking clinical skills as good or very good in 35·3% of skills, 33·3% were rated as adequate and 31·4% rated as being performed poorly or very poorly. Of concern, essential clinical skills, such as critical thinking and problem solving, working independently and assessment procedures, were found to be poorly executed and affecting new registered nurses graduates' competence. Conclusion: The findings from this study can further serve as a reference for nursing education providers to enhance nursing curricula and work collaboratively with healthcare settings in preparing nurses to be competent, safe practitioners on completion of their studies. Relevance to clinical practice: Identifying key areas in which new nursing graduates are not yet competent means that educational providers and educators from healthcare settings can focus on these skills in better preparing our nurses to be work ready.
Description:
Over the past decade, many questions have been raised about graduates' clinical competence and fitness for practice upon completion of their undergraduate education. Despite the significance of this issue, the perspectives of registered nurses have rarely been examined. This systematic review explores the perceptions of experienced registered nurses regarding the clinical competence of new nursing graduates. Original research studies published between 2004-2014 were identified using electronic databases, reference lists, and by searching "grey literature." Papers were critically reviewed and relevant data extracted and synthesized using an approach based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis. From 153 studies initially identified, 15 original research papers were included. Four main research themes were identified: clinical/technical skills, critical thinking, interaction/communication, and overall readiness for practice. Areas of concern in relation to the clinical competence of new nursing graduates specifically related to two themes: critical thinking and clinical/technical skills. Further research is required on strategies identified within the literature with the ultimate aim of ensuring new nursing graduates are safe and competent practitioners.
Description:
Background: Papers continue to be cited by authors even after they have been retracted. Retraction notices provide readers with information about retracted papers and may help minimise post-retraction citation. To date, a review of the quality of retraction notices in nursing science has not been reported. Design: An audit of retraction notices associated with 29 retracted manuscripts published in nursing science journals. Methods: Retraction notices were reviewed again using the Committee on Publication Ethics (COPE) guidelines. Results: In total, 28 retraction notices were retrieved and reviewed (one retracted paper did not have a retraction notice). Details of the retracted manuscripts were included in all reviewed notices and, in all but two, author names were reported. Details of the time between a paper being published and retracted were not reported and generally there was a little information in notices about how the retraction decisions were made. All retraction notices were freely available. Seven notices stated who had made the decision to retract. Twenty-two (77%) notices stated the reason for retraction. Notices were brief and contained factual information. The webpages of three retracted articles did not clearly indicate that the paper had been retracted. Conclusion: More detailed and informative retraction notices will inform readers and may help reduce post- retraction citation.