Undergraduate student nurses' expectations and their self-reported preparedness for the graduate year role

The transitional journey through the graduate year: a focus group study

BACKGROUND

Becoming a new graduate nurse is both a complex and stressful transition. Graduates must socialise into the context of nursing practice, become accountable for patient care and ward activities, interact with other health professionals and develop their own clinical expertise. In Australia, many hospitals provide Graduate Year Programmes to assist new graduates to assimilate into their new roles and environments.

AIMS

This paper describes a study that explored how graduate nurses develop their knowledge and skills during their graduate programmes, as well as identifies factors assisting or hindering knowledge and skill acquisition.

METHODS

Employing a qualitative approach, this study used a series of focus groups and anecdotes to collect data from 25 participants recruited from four different hospitals in Victoria, Australia. Focus groups were conducted between 4 and 6 months, 11 and 12 months into, and 4-6 following completion of the graduate programme. Interview transcripts were analysed allowing feedback to be provided to participants.

RESULTS

Six themes emerged from the focus groups analysis that described graduates' knowledge and skill acquisition and reflected their development at the different stages. These were: 'gliding through' during undergraduate studies, 'surviving', 'beginning to understand', and 'sheltering under the umbrella' in the first interview, 'knowing how to', and 'we've come a long way' by the end of their programme.

CONCLUSIONS

The year following graduation is one of immense personal and professional development. Despite nurse education being in tertiary settings for many years, preparation of undergraduate students still appears unable to reduce reality shock and ease transition for graduates into their working lives.

The Impact of a Nurse Externship Program on the Transition Process From Graduate to Registered Nurse

This article reports the qualitative findings from a focus group interview conducted with six currently registered nurses who participated in a summer nurse externship program. It is Part II of a three-part study that examined the influence of nurse externship programs on the transition process from graduate to professional nurse. The focus group explored the perceptions of former nurses about the impact of the externship program on their transition into the professional nurse role. In the role of nurse externs, individuals were able to view, experience, and, consequently, come to understand the culture of nursing in an acute healthcare system without being full-fledged members of it. Three themes induced from the analysis of the findings were as follows: (1) being a part of the real scene; (2) figuring out the environment; and (3) gaining awareness and becoming frightened.

Working in London hospitals: Perceptions of place in nursing students’ employment considerations

During the past decade, a distinct body of research has started to investigate the dynamics between nursing and place. However, despite attention being paid to a wide-range of nursing subjects, few studies have engaged with the important topic of labour force recruitment. In this context, this study uses a combined questionnaire (n=650), interview (n=30) and focus group (n=7) survey of London-based students, and investigates the complex mix of experiences and perceptions that result in hospitals having varying degrees of popularity as potential workplaces. The findings suggest experiences and perceptions of institutions-often gained on clinical placements-to be important, particularly relating to feeling valued, the quality of patient care, clinical and educational opportunities and team cohesion. These are often combined with experiences and perceptions of locality, relating to factors such as cost of living, travel considerations and sense of personnel safety. The study demonstrates that place is relevant to employment decision-making on multiple scales from wards to regions. Furthermore, that perceptions of potential workplaces result from engagements with complex mixes of cultural, economic and physical features, many of which are the consequences of management. It is argued that in order to effectively unpack workplaces, geographical research of nursing labour may benefit from researching simultaneously both 'inside' institutions, focusing on their dominant cultures of production and sub-cultures, and 'outside', focusing on their local urban or rural contexts.

Promoting a sustainable mental health nursing workforce: an evaluation of a transition mental health nursing programme

The recruitment and retention of the mental health nursing workforce has been identified as a major issue both nationally and internationally. Transition to practice programmes has been identified as an important strategy in addressing these issues. There is, however, a paucity of literature addressing the potential or effectiveness of transition programmes in achieving these aims. This paper reports the findings of a survey administered to registered nurses at the commencement and completion of the Transition Programme into Mental Health Nursing, in Sydney, Australia. The findings suggest a high level of satisfaction with the programme. The results are directing the ongoing development of clinical placements, clinical supports, education programmes and recruitment and retention initiatives for nurses within the Central Sydney Area Mental Health Service.

Place(ment) matters: students' clinical experiences and their preferences for first employers

BACKGROUND

Although a significant volume of nursing research has focused on students' experiences of clinical placements, to date, none has considered these experiences in the context of workforce recruitment and specifically how they may impact upon preferences for working for health care providers.

METHODS

In this context, the research used a place-sensitive geographical perspective and a combined questionnaire (n = 650), interview (n = 30) and focus group (n = 7) method to collect data on the complex range of clinical experiences which together impact upon the perceived attractiveness of different health care settings.

FINDINGS

The data identified a range of experiential factors associated with mentorship, ward management, learning opportunities and racism. An important finding was that although students' experiences are obtained at the micro ward level, even if they may not necessarily reflect what happens throughout the hospital, they potentially impact, both positively and negatively, upon their broader perceptions of the hospital and the likelihood of seeking work there.

IMPLICATIONS

The study highlighted a variety of issues that should be addressed by both higher education institutions and hospitals so that they may be able to provide a more consistent and positive experience for students. In the longer term, this may pay dividends through increased recruitment of new graduates.

Do New Graduates of Registered Nursing Programs in Israel Perceive Themselves as Technically Competent?

BACKGROUND

Technical competency of graduate nurses is a much sought after commodity by nurse managers in this age of limited human nursing resources. Clinical coursework in nursing school should provide the graduate with the core skills necessary to function safely and competently in a variety of clinical sites.

METHODS

The research presented in this article examines the self-reported competency of 256 recent graduates of four different types of nursing programs in Israel, with respect to 53 technical skills. Information was collected via a structured questionnaire.

RESULTS

Graduates generally perceive themselves as competent, although levels of competence varied for the different skills. Type of nursing program, opportunity for skill practice in nursing school, and employment in a healthcare facility were found to be related to competency.

CONCLUSIONS

Suggestions for improvement in competency levels, such as the provision of more opportunities for practice, are offered based on the specific findings of this study and in light of previous research.

The scope of nursing in Australia: a snapshot of the challenges and skills needed

Contemporary nursing is an increasingly complex concept encompassing and encapsulating wide variation under the broad rubric of the nursing work place. This paper reports on a study that was designed to contribute to understandings of nursing practice by describing what nurses in Australia are doing everyday in various practice and work settings, the type of skills they need, the challenges they face and the interactions nurses have with other health workers. Drawing on the research which informed the National Review of Nurse Education in Australia in 2001, the paper raises issues critical to the management of contemporary nursing practice. Flexible approaches both to the day-to-day management of nurses and nursing, and educational preparation in partnership with key stakeholders, are a necessity if management of nursing is to keep pace with constant change in health care systems as well as facilitating the attraction and retention of nurses in those systems.

Nurses who left the British NHS for private complementary medical practice: why did they leave? Would they return?

BACKGROUND

Although the successful retention of National Health Service (NHS) nursing staff is a policy concern, evidence suggests that substantial numbers of registered nurses continue to leave the profession, and some to own and run small caring-related business. At the same time, private complementary medicine has undergone a rapid expansion in recent years, and initial impressionistic evidence suggests that many therapists are former nurses.

AIMS

The paper investigates the motivations and experiences of nurses who have either left nursing altogether, or substantially reduced their involvement, and who now practise complementary medicine in the private sector. It also investigates the issue of whether they would consider returning to practise complementary medicine within the NHS.

METHODS

A combined questionnaire (n = 63) and semi-structured interview (n = 11) survey was used to collect detailed attitudinal data from respondents. The analytical approach to the interview data used a form of constant comparative analysis which was derived from the principles of grounded theory. In particular, the interviews were developed and refined from each other as they progressed.

RESULTS

The majority of therapists operate independently, either from their own homes or from small rented premises. They were originally motivated by a disillusionment with the health service and particular aspects of their former jobs. However, equally they were attracted by the therapies themselves, the conceptual paradigms which underpin them and the different experiences of practice. Despite stating a disillusionment with the NHS, most respondents expressed a cautious willingness to potentially re-enter the NHS to practise complementary medicine.

CONCLUSIONS

Many practising complementary therapists are registered nurses who may be willing to re-enter the formal health service. It is therefore argued that a greater synergy between orthodox and complementary medicine may be one way of addressing shortages of nursing labour, and in particular this form of drop-out, whilst meeting evolving consumer health care demands.

What nurses say they do and need: implications for the educational preparation of nurses

The scope of contemporary nursing is a critical factor in determining the appropriate educational preparation of nurses today and in the future. This qualitative study involved interviewing nurses throughout Australia in a variety of work and geographical settings to develop a snapshot of what nurses are doing, the skills needed and the challenges faced.The snapshot of contemporary practice that emerged is one of considerable diversity, which poses challenges for educators of nurses in terms of what constitutes appropriate or adequate educational preparation for nurses. Understandings of what constitutes clinical skills, and consequently clinical education, are explored as is what calls for 'more' clinical education may actually mean. Caution is raised about educating for present needs that are based on limited conceptions of what constitutes a nursing workplace. It is argued that education for nurses, both initial and on going, must be cognizant of educating for what might be, not simply somewhat short-term imperatives.