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

Assessment of Differential Perceptions of Core Nursing Competencies between Nurse Managers and Nursing Graduates: A Cross-Sectional Study

BACKGROUND

The literature review on perceptions of nursing competencies shows a critical shortage of studies addressing this topic.

AIM

To examine and compare perceptions of important nursing competencies of nursing graduates, and nurse managers.

METHODS

A cross-sectional study was conducted among 148 students, who were recent graduates of the nursing school with RN degrees and had completed advanced training lasting 3 months at the Sheba Academic School of Nursing and the Academic School of Tel Aviv-Yafo, and 183 nurse managers with at least one year of seniority in the position in hospitals and community clinics in Israel. The recruitment and data collection of the nurse managers lasted 12 months, from July 2021 to July 2022, and for nursing graduates, two months, from June 2022 to July 2022. An online questionnaire was constructed and validated by five professional and experienced individuals in the research domains for adequate content validity. The questionnaire consisted of 47 items in total. Domains included: (1) professionalism in research; (2) skills for direct treatment; (3) support and communication; (4) professional knowledge; (5) personal abilities; and (6) critical thinking and innovation.

RESULTS

Overall, 331 valid questionnaires were collected (85% response rate). The difference in the nurse's research professionalism index was found to be statistically significant with a higher rating given by nurse managers, p = 0.003. However, the difference in the direct treatment index of nurses was found to be statistically not significant, p = 0.610, between newly graduated nurses and nurse managers. The independent sample t-test indicated a significant difference with a higher rating among nurse managers in the nurse's support and communication index, p = 0.020; professional knowledge index, p < 0.001; personal abilities index, p < 0.001; and critical thinking index, p = 0.006, between newly graduated nurses and nurse managers.

CONCLUSION

Nursing education programs aimed at training future nurses with core competences should include a curriculum designed to promote the acquisition of these six core competences leading to a congruence between the role expectations of nurse managers and those of newly graduated nurses.

Senior Nursing Students' Perceptions of Their Readiness for Practice Prior to Final Year Internship: Part 2-A Qualitative Perspective

INTRODUCTION

Preparing nursing students for their role as future registered nurses is an essential and complex endeavor. It is a responsibility that is shared between academic and clinical health care organizations. Arguably, the prevailing economic climate places additional pressures on the fiscal and manpower aspects of health care management. Maintaining a quality practice learning environment for students against this backdrop has become increasingly challenging. Indeed, students themselves have raised these concerns. The authors sought to explore these concerns further with the students, and this article will present the qualitative findings of a study exploring final-year students' perceptions of their readiness for practice in a school of nursing in the Republic of Ireland.

METHODS

Two open-ended questions were included on a quantitative survey, which sought to ascertain students' self-reported level of readiness for oral medication administration. A convenience sample of 24 final-year students undertaking a 4-year BSc (honors) in general nursing program was involved. Content analysis was employed to explore and elicit the key components of participants' written responses to the open-ended questions.

RESULTS

Participants highlighted the constraints that they have witnessed in some practice areas, the consequent impact on the availability of particular learning opportunities, and their level of preparedness for practice. Three key areas of concern emerged including medication management, patient caseload management, and communication. A recurring issue centered on the delegation of the more fundamental nursing tasks to students by qualified nurses, to the detriment of students' experience of the more complex aspects of holistic patient care. This proved quite exasperating for these participants.

CONCLUSION

This study demonstrates that final-year undergraduate nursing students in a school in the Republic of Ireland are concerned about their readiness for practice. Specific areas of concern for students relate to their capacity to develop competence for registered practice. These findings provide both a timely reminder and opportunity for those charged with the responsibility of preparing nurses for registration, in both clinical and academic settings, to raise awareness of factors that can impact on the student experience and learning in practice. They highlight the importance of a collaborative approach to addressing the issues that emerged, if competence and patient safety are to be safeguarded and maintained in the future.

Evidence-Based Resilience Intervention for Nursing Students: a Randomized Controlled Pilot Trial

Nursing students report chronic stress, and burnout is common. One factor related to lower burnout is resilience, though little research has studied resilience interventions in nursing students. This study had two objectives: 1) to examine the effects of a pilot resilience intervention, and 2) to investigate student attitudes about the intervention. This was a randomized controlled trial that took place from January 2017 - June 2017 at a Midwest university in the United States. First-year nursing students (N = 27) were randomly assigned to the intervention (N = 14) or control (N = 13) group. The intervention group participated in a five-week resilience intervention. Both groups completed three online surveys (before, immediately after the intervention, and three months later). Using Wilcoxon signed-rank tests to compare pre- and post-intervention scores, neither group reported significant changes in resilience or the burnout facet of cynicism. The burnout facets of exhaustion and professional efficacy significantly decreased in the intervention group, but not the control group. Participants reported satisfaction with the intervention, though most wanted more hands-on activities. This resilience intervention may be valuable for reducing burnout in nursing students, but interventions should first conduct a needs assessment.

Exploring the meaning of undergraduate nursing students' experiences and confidence in clinical skills using video

BACKGROUND

Students and health care faculty staff report a lack of confidence in graduating nurses' clinical skills practice. Traditional approaches to support nursing students' clinical skills development have relied on small group, face-to-face, practice-based learning in clinical laboratories. However, with changing curricula, increased numbers of students, and pressure on laboratory timetables and availability, alternate methods of delivery are necessary to ensure students gain confidence in the development of their clinical skills. Video podcasting is an innovative approach that is being used to stimulate active and ongoing learning of clinical skills.

DESIGN

A hermeneutic phenomenological approach.

METHOD

Data were collected through in-depth interviews with 10 second-year, undergraduate nursing students about their experiences using three clinical skills video podcasts and their perceptions of how this impacted on their learning of these clinical skills and confidence in practice.

FINDINGS

Three themes emerged from the data: 'Accessibility for learning the skill'; 'Preparation for learning and practice'; and 'Student-directed learning'. These themes provided an insight into the students' engagement with video podcasts, demonstrating their sense of confidence was increased in clinical skills development.

CONCLUSION

The findings of this study provide an insight into the students' engagement with video podcasts in relation to their confidence in clinical skills development, and indicate that undergraduate nursing students value the use of video podcasts in their learning of clinical skills. However, it was evident that students still value face-to-face delivery to guide their study, which suggests that video podcasts could be used as an adjunct to teaching to support learning.

Closing the gap on nurse retention: A scoping review of implications for undergraduate education

OBJECTIVES

Newly qualified nurses leave the profession at a higher rate than any other year of experience. Undergraduate education influences nurse retention following qualification. However, it is unclear if the factors associated with intent to leave are included within programmes to aid retention once qualified. A scoping review was conducted to explore the literature within nursing as well as social work undergraduate education to obtain viewpoints from an allied profession with similar retention barriers.

DESIGN AND DATA SOURCES

Following PRISMA extension guidelines for scoping review, the research question used to explore the literature was: What is the impact of undergraduate nurse and social work education on retention when newly qualified? Databases searched were BNI, CINAHL complete, Science Direct, PsycINFO, Medline Complete, Academic Search Complete and ERIC.

REVIEW METHOD

One author undertook a comprehensive electronic and hand-search of relevant research articles. These were then discussed with two authors for inclusion within the review and data extracted for thematic analysis.

RESULTS

Limited through search inclusion and quality of research, ten research papers met the criteria for this review. Main themes found were resilience and commitment, perceived knowledge and confidence, preparation for transition and expectation of supervision.

CONCLUSION

The literature presents the need to strengthen resilience-building within undergraduate education in the transition to newly qualified practitioner, support to cope with the emotional and physical impact of professional practice as well as developing confidence in one's skills, guidance for career progression, promotion of authentic leadership in work-place mentors and commitment of both the University and health or social organisation to support staff to be healthy and feel valued.

Effect of a clinical skills refresher course on the clinical performance, anxiety and self-efficacy of the final year undergraduate nursing students

Although the final year of nursing undergraduate programs that focus on clinical education are planned to prepare nursing students to better transition to the real world of health care service; evidence has shown that this program is not sufficient to reach this end goal. This controlled trial study was to investigate the effectiveness of a basic clinical skills refresher course for nursing students before entering the internship program. The sample consisted of 160 undergraduate nursing students assigned into two groups. The intervention was a three-day refresher course directed by nurse instructors for intervention group focused on 10 basic nursing procedures in the clinical skill lab. The control group did not receive any intervention. The students' anxiety, clinical self- efficacy and clinical skills practice were measured before and after intervention in both groups. The results indicated that the students who took part in the refresher course experienced lower anxiety levels, higher levels of clinical self-efficacy, and have better clinical skills during their internships. The undergraduate nursing curriculum can be strengthened by the basic clinical skills refresher course. This refresher course can bridge the theory - practice gap and provide a better transition from the student to nurse role.

New midwives' experiences of transition support during their first year of practice: a qualitative systematic review protocol

REVIEW QUESTION/OBJECTIVE

The current review aims to investigate new midwives' experiences of transition support during their first year of practice as registered midwives. A further objective is to identify the social support experiences of new midwives during their first year of practice as registered midwives.Specifically, the review question is: How do new graduate midwives experience transition and social support during their first year of practice?

Evaluation of an outreach education model over five years: Perception of dental students and their outreach clinical mentors

INTRODUCTION

The objective was to investigate changes in students' and clinical mentors' perceptions of a model for outreach education over a 5-year period, 2006-2010.

MATERIAL AND METHOD

Two cohorts of last-year students of a dental problem-based curriculum and their clinical mentors in the Public Dental Service (PDS) were invited to respond to a questionnaire. In 2006, 85% of 54 students and 72% of their 54 mentors responded; 98% of 40 students and 88% of 41 of the mentors did so in 2010. Participants scored their level of agreement with different statements on a numeric rating scale and gave comments.

RESULTS

Dental students and their clinical mentors reported that they shared a consistent and favourable perception of this outreach education model over 5 years. The students reported increased professional confidence and self-reliance. Clinical mentors expressed a transfer of knowledge to their clinics. Differences in scoring were seen between students and mentors for two statements in 2006 and two statements in 2010 (P < 0.05).

CONCLUSIONS

The current model for outreach education received favourable and stable ratings over the 5-year period. This model resulted in that students perceived that they became self-reliant, which may facilitate their transition from being a student to becoming a professional. The current model supports exchange and professional development for students, faculty and outreach clinics. This leads us to look at outreach education as an opportunity to form a mutual learning community comprised of the outreach clinics and the dental school.

The effectiveness of and satisfaction with high-fidelity simulation to teach cardiac surgical resuscitation skills to nurses

BACKGROUND

There are few reports of the effectiveness or satisfaction with simulation to learn cardiac surgical resuscitation skills.

OBJECTIVES

To test the effect of simulation on the self-confidence of nurses to perform cardiac surgical resuscitation simulation and nurses' satisfaction with the simulation experience.

METHODS

A convenience sample of sixty nurses rated their self-confidence to perform cardiac surgical resuscitation skills before and after two simulations. Simulation performance was assessed. Subjects completed the Satisfaction with Simulation Experience scale and demographics.

RESULTS

Self-confidence scores to perform all cardiac surgical skills as measured by paired t-tests were significantly increased after the simulation (d=-0.50 to 1.78). Self-confidence and cardiac surgical work experience were not correlated with time to performance. Total satisfaction scores were high (mean 80.2, SD 1.06) indicating satisfaction with the simulation. There was no correlation of the satisfaction scores with cardiac surgical work experience (τ=-0.05, ns).

CONCLUSION

Self-confidence scores to perform cardiac surgical resuscitation procedures were higher after the simulation. Nurses were highly satisfied with the simulation experience.

Senior student nurse proficiency: A comparative study of two clinical immersion models

This study focused on identifying the best clinical learning model that would support nursing practice readiness following each immersion experience. Practicum preceptors completed surveys in which evaluated student preparation/readiness by assessing clinical knowledge, technical skills, critical thinking, communication, professionalism, management of responsibilities, and overall performance. The study results yielded no statistical significance when comparing both models. Future research is needed to analyze the impact of clinical hours offered in the senior immersion experience along with the curriculum content differences among various models of clinical experiences in undergraduate nursing programs to ensure practice readiness of nursing graduates.

The effect of an enrolled nursing registration pathway program on undergraduate nursing students' confidence level: A pre- and post-test study

BACKGROUND

In the latter half of the 20th century, registered nurse education moved to university degree level. As a result, there has been a reduction in access for students to clinical experience. In numerous studies, nursing graduates have reported that they do not feel prepared for practice. The importance of maximising every learning opportunity during nursing school is paramount. At Edith Cowan University, a program was initiated that allows students to become enrolled nurses at the midway point of their degree to enable them to work and therefore gain experience in the clinical practice setting during their education. This study investigated the effect of the program on the nursing students' perception of their clinical abilities and explored their ability to link theory to practice.

METHODS

The research design for this study was a quasi-experimental, prospective observational cohort study. The study included 39 second-year nursing students not enrolled in the program (Group 1), 45 second-year nursing students enrolled in the program (Group 2), and 28 third-year nursing students who completed the program and are working as enrolled nurses (Group 3). Participants were asked to complete a Five Dimension of Nursing Scale questionnaire.

RESULTS

The quantitative analyses showed that students in Group 1 had statistically significant higher pre-questionnaire perceived abilities across all domains, except in two dimensions when compared to Group 2. The post-questionnaire analysis showed that Group 1 had statistically significant lower perceived abilities in four of the five dimensions compared to Group 2. Group 1 also had significantly lower abilities in all dimensions compared to Group 3. Group 3 had a significantly higher perception of their clinical abilities compared to Group 2.

CONCLUSION

This study highlights the value of meaningful employment for undergraduate nursing students by providing opportunities to increase confidence in clinical abilities.

Boredom in the Workplace: Reasons, Impact, and Solutions

Boredom in the workplace is not uncommon, and has been discussed widely in the academic literature in relation to the associated costs to individuals and organizations. Boredom can give rise to errors, adverse patient events, and decreased productivity-costly and unnecessary outcomes for consumers, employees, and organizations alike. As a function of boredom, individuals may feel over-worked or under-employed, and become distracted, stressed, or disillusioned. Staff who are bored also are less likely to engage with or focus on their work. In this article, we consider the nature of boredom and also the reasons why employees, including mental health nurses, become bored in the workplace. We also discuss the role that can be taken by employees and employers to recognise and address the problem of boredom and we consider how best to develop sustainable workplaces that are characterised by engaged employees who provide the best possible service in healthcare settings.

Job stress and job satisfaction among new graduate nurses during the first year of employment in Taiwan

Nurse graduates are leaving their first employment at an alarming rate. The purpose of this study was to explore the relationships between job stress, job satisfaction and related factors over time among these nurses. This study applied a longitudinal design with three follow-ups after nurse graduates' first employment began. Using convenience sampling, participants were 206 new graduates from a university. The Work Environment Nursing Satisfaction Survey and the Clinical Stress Scale were used in this study. Results indicated that job stress remained moderate across three time points. Participants working 12 h shifts exhibited less job stress. Job satisfaction significantly increased in the twelfth month. Participants working 12 h shifts had a higher degree of job satisfaction. Job stress was negatively correlated with job satisfaction. The 12 h work shifts were related to job stress and job satisfaction. These results implied that health-care administrators need to provide longer orientation periods and flexible shift schedules for new graduate nurses to adapt to their work environment.

Newly qualified South African nurses' lived experience of the transition from student to community service nurse: a phenomenological study

BACKGROUND

This study attempted to fill a gap in the published South African literature regarding newly qualified nurses' preparedness for and experience of role transition to a 1-year compulsory commitment of community service nurse.

METHODS

Husserlian descriptive phenomenology, characterized by inductive extraction of units of meaning from transcribed audiotaped recordings, was used to establish the "essence" of the lived experience of role transition. Data were collected from eight participants through two semistructured individual interviews: in July 2011, 2 weeks before the start of community service, and in September 2011, 6 weeks after community service placement.

RESULTS

Findings showed that before placement, participants experienced a sense of achievement in having successfully completed a 4-year diploma program. However, they also experienced uncertainty and fear about the immediate future. In the first month after placement, community service nurses experienced reality shock.

CONCLUSION

Preparation for the role transition from student nurse to graduate community service nurse requires a 4-year structured program that includes training in conflict management, assertiveness, and practical ethics.

New graduate nurses' experiences in their first year of practice

AIMS

This study aimed to explore new graduates' experiences of entering the nursing workforce in NSW, Australia, and to identify factors that impact on their transition to the workforce, satisfaction and likelihood of retention.

BACKGROUND

The nature of new graduates' experiences in their first year of employment has been shown to have a significant impact on their future career directions. It is well reported that often these experiences are stressful and unsatisfying.

METHODS

A mixed method cross sectional design was used combining quantitative and qualitative approaches. Data was gathered by online survey and focus groups.

RESULTS

A total of 282 new graduates, aged 21 to 54, responded to the online survey (response rate 24%). Overall, respondents were satisfied with their recruitment process (mean 3.54) and support for professional development (mean 3.37) but job satisfaction was rated lower (mean 2.91). Qualitative findings from focus groups and survey comments revealed a number of key factors impacting on the experience of transition for new graduates. These are; the nature of the workplace environment, the level and nature of support available to new graduates, together with their propensity to learn and adapt to workplace cultures and to accommodate their own expectations and the expectations of others, and to a lesser degree, the amount of prior experience.

CONCLUSION

There is an urgent need to develop and test a range of evidence based approaches that will both empower nurses and embed systematic approaches that enable equitable and contextually relevant stewardship of new graduate nurses into the future.

Progressive learning: structured induction for the novice nurse

A consistent specialty induction framework within the acute care hospital facility is essential to the development of both generic and specialty knowledge and skills that transfer to different domains. Providing a structured and progressive learning pathway with accessible resources applicable to the context in which learning is applied supports cross-specialty demands in clinical practice today. A broad consultative process among stakeholders at the facility is essential so that patient governance and human capital investment are collectively monitored and evaluated. This article describes the structure, content and delivery of a 6-week novice nurse surgical induction programme using a newly implemented knowledge and skills framework. While the programme is conducted at a tertiary referral hospital in Sydney, Australia, the subject is transferable to other countries.

Using high-fidelity simulation to bridge clinical and classroom learning in undergraduate pediatric nursing

In Patricia Benner's book, Educating Nurses: A Call for Radical Transformation, she recommends essential changes in policy, curriculum, and in the way nursing programs approach student learning. This study explored how two of Benner's key recommendations, (1) integrating the theoretical component and the clinical component and (2) moving education from an emphasis on critical thinking to an emphasis on clinical reasoning, could be achieved by integrating the use of high-fidelity patient simulation in a pediatric curriculum. Qualitative and quantitative data were collected from the group of traditional and nontraditional baccalaureate students (n=131). The quantitative data revealed learning objectives were met over 80% of the time in simulation exercises and the qualitative themes revealed a positive experience with the simulation exercises with a large proportion of students offering the sentiments that these scenarios become requirement prior to the start of clinical rotations.

The effects of a deliberate practice program on nursing students' perception of clinical competence

BACKGROUND

New nursing graduates' readiness for practice often does not meet the requirements needed in the real situation of clinical sites. Therefore, nurse education has placed more emphasis on developing students' technical skills to cultivate proficiencies needed for clinical sites.

OBJECTIVES

To develop a program including deliberate skill practices and technical skill testing, each conducted before students' clinical practicum, and to examine the program's effects on nursing students' clinical competence.

DESIGN

The study was a repeated measure correlational design.

SETTINGS

One nursing university.

PARTICIPANTS

Two-hundred-fifty-six and 266 nursing students in a RN-to-BSN night school program in Taiwan completed pretest and posttest surveys, respectively in 2009 and 2010. Their mean age was 22.61 years and had worked 12.75 months as a nurse.

METHODS

Students were asked to participate in the deliberate nursing practice program, which includes skill practice and tests, before their last clinical practicum. The Clinical Competence Questionnaire was used to measure the outcome of deliberate practice.

RESULTS

Findings indicated that participants who had nursing work experience, a higher grade point average, practiced their skills by watching videos, and higher pretest competence scores exhibited significantly higher posttest competence scores. Participants who worked in the operating room/outpatient department, scored higher on self-confidence in clinical performance, and had a higher level of future job stress exhibited significantly lower posttest competence scores.

CONCLUSIONS

Although work experience increased clinical competence, working in the operating room/outpatient department where many nursing skills were not performed did not have the effects. In contrast, skill reviews and better performance before practice promoted competence. Attaining motor skill competency is a slow process requiring practices. Thus, providing deliberate skill-practice program is suggested to help students increase their competence.

The retention of health human resources in primary healthcare centers in Lebanon: a national survey

BACKGROUND

Critical shortages of health human resources (HHR), associated with high turnover rates, have been a concern in many countries around the globe. Of particular interest is the effect of such a trend on the primary healthcare (PHC) sector; considered a cornerstone in any effective healthcare system. This study is a rare attempt to investigate PHC HHR work characteristics, level of burnout and likelihood to quit as well as the factors significantly associated with staff retention at PHC centers in Lebanon.

METHODS

A cross-sectional design was utilized to survey all health providers at 81 PHC centers dispersed in all districts of Lebanon. The questionnaire consisted of four sections: socio-demographic/ professional background, organizational/institutional characteristics, likelihood to quit and level of professional burnout (using the Maslach-Burnout Inventory). A total of 755 providers completed the questionnaire (60.5% response rate). Bivariate analyses and multinomial logistic regression were used to determine factors associated with likelihood to quit.

RESULTS

Two out of five respondents indicated likelihood to quit their jobs within the next 1-3 years and an additional 13.4% were not sure about quitting. The top three reasons behind likelihood to quit were poor salary (54.4%), better job opportunities outside the country (35.1%) and lack of professional development (33.7%). A U-shaped relationship was observed between age and likelihood to quit. Regression analysis revealed that high levels of burnout, lower level of education and low tenure were all associated with increased likelihood to quit.

CONCLUSIONS

The study findings reflect an unstable workforce and are not conducive to supporting an expanded role for PHC in the Lebanese healthcare system. While strategies aiming at improving staff retention would be important to develop and implement for all PHC HHR; targeted retention initiatives should focus on the young-new recruits and allied health professionals. Particular attention should be dedicated to enhancing providers' role satisfaction and sense of job security. Such initiatives are of pivotal importance to stabilize the workforce and ensure its longevity.

Teaching nursing psychomotor skills in a fundamentals laboratory: a literature review

AIM

The aim of this article is to determine the most effective methods of teaching psychomotor skills.

BACKGROUND

Research has pointed to a gap between nursing practice and nursing education. Due to a number of conditions, nursing students are learning basic skills in laboratories, rather than clinical settings.

METHOD

A literature review was conducted to evaluate studies published since 1995 that compared alternative and traditional methods of teaching skills to novice nursing students.

RESULTS

Of the 13 studies found, most assessed computer-related methods. A few examined alternatives, such as the use of standardized patients, high-fidelity manikins, and a mental-imaging technique.

CONCLUSION

Based on this limited evidence, it appears that teaching methods providing access to online interactive materials were significantly more effective than others.Three studies found that a combination of traditional lecture and demonstration methods plus computer use was more effective than either method alone.

A cross-sectional survey to compare the competence of learners registered for the Baccalaureus Curationis programme using different learning approaches at the University of the Western Cape

The purpose of the study was to compare the extent to which the different teaching approaches applied in the Baccalaureus Curationis programme adequately prepare graduating learners for professional competence. The research methodology was a quantitative approach, based on descriptive research, with a clinical competence development model to guide the data collection procedure. The target population of the study included a sample of 250 learners in the four-year B.Cur programme, that extended from first-to-fourth-year. Stratified random sampling was applied to select the sample learners for this research and data were collected by means of a five-point Likert scale questionnaire. Data were organised and managed using the SAS statistical software package. Descriptive statistics were gathered with measures of central tendency and dispersion included, and their findings were illustrated on descriptive tables. A correlation technique was applied to determine the effects of the independent variable on the dependent variable.The results of the study indicated that progression in competence did not occur as learners progressed through higher levels of their training, except during the third-year of study. However, the study's results confirmed the strengths of the Case-based clinical reasoning approach to teaching and learning. This approach is able to combine the strengths of the traditional methods, which dealt with large class sizes and that had a focus on learner centred learning, with a focus on clinical practice. This approach provides realistic opportunities for learners to experiment with solutions to dilemmas encountered in real life situations, from the protected and safe environment of the classroom. The first-year learners who were observed in this study, who although novices, were exposed to Case-based teaching approaches and showed more self-perceived competence than learners in later years. This occurred in spite of the limited exposure of the first-year learners to real life clinical situations. The outcome of this study recommends that more studies are conducted, in the School of Nursing at the University of the Western Cape (UWC), to explore teaching and learning approaches that fully maximise the clinical and theoretical competencies of the learners. The outcome further recommends that learner-centred teaching approaches, such as Case-based method, are applied to all year levels of study in the B.Cur programme, due to its proven value when it was applied to first-year learners. The Case-based clinical reasoning approach to learning, that has been implemented at the school, promotes competence and self confidence in learners and has enhanced their sense of responsibility to be actively involved in their own learning.

Pre-registration paid employment choice: the views of newly qualified nurses

In Australia, nurse education was transferred from hospital based nursing schools to the higher education sector. This transfer resulted in a change for students, from hospital employee to an unpaid, supernumerary role during professional placements. The majority of undergraduate nursing students now combine part time employment with their studies, working mainly within health settings or service sectors such as hospitality and retail. The aims of this study were to identify if newly qualified registered nurses engaged in paid employment during their final year of undergraduate studies, the types of employment they chose, reasons for that choice, skills acquired and their views on any link between employment choice and transition to practice. Focus group interviews involving sixty seven new graduates were conducted. From the data, four organising themes were identified; financial independence and autonomy, confidence and experience, future opportunity and ease of transition. The global theme maximising opportunity describes nurse's views about their decisions on student employment. Participants had differing views on employment choice and transition to practice. Further research is needed in the area to identify whether there is any link between student employment choice and transition to practice.

Valuing teamwork: Insights from newly-registered nurses working in specialist mental health services

In this qualitative study, the experiences of a small cohort of registered nurses (RN) during the first 2 years of mental health employment were documented. A total of 13 semistructured interviews were completed from within a specialist mental health setting. Eleven issues were identified: (i) teamwork; (ii) experiential learning; (iii) self-development; (iv) confidence; (v) listening; (vi) rapport; (vii) keen observation; (viii) patience; (ix) empathy; (x) learning from colleagues; and (xi) maintaining a positive approach towards patients. The nurses focused on the here-and-now circumstances, rather than on future plans, or past preparation, and were able to elucidate the qualities and skills that they brought to their clinical work. Participants were most proud of achievements that bridged the personal and professional, such as self-development, working closely with patients to develop rapport, experiential learning, and teamwork. Findings highlight the importance of teamwork to newly-graduated RN entering the mental health environment. It is known that teamwork can convey a sense of belonging and help create an environment in which applied experiential clinical learning can occur. Therefore, it is important that efforts are made to facilitate team building and opportunities for teamwork when new graduates are transitioning into the mental health clinical practice environment.

Transition to psychiatric/mental health nursing programs: Expectations and practical considerations

Mental health services have developed transition programs to attract staff, including new graduates, staff with mental health nursing experience without formal qualifications, experienced nurses wishing to move into mental health, and nurses returning to the workforce. Transition to psychiatric/mental health programs are considered to be particularly significant in the mental health field because of the relative under-representation of mental health content in undergraduate curricula. Unfortunately, transition programs have received only minor attention in the literature and there is a paucity of published evaluations to determine their effectiveness. The aim of this paper is to examine transition programs and consider how they meet the expectations of stakeholders, such as consumers of mental health services, and program participants' expectations. It is concluded that published systematic evaluations are lacking, particularly those considered from the perspective of stakeholders. Consideration of these expectations should be reflected in the design and delivery of mental health nursing transition programs.

The prevailing winds of oppression: understanding the new graduate experience in acute care

TOPIC

The experience of new graduates in acute care.

PURPOSE

The majority of newly graduated nurses make their initial professional role transition in acute care. Being socialized into the dynamic culture of today's hospitals creates significant challenges not only for the nurses themselves but also for institutions of higher education, healthcare administrators, and policy makers across this country. Demanding workloads for hospital nurses, an aging nursing workforce, and the high level of stress inherent in workplaces across North America are factors contributing to an exodus of both new and seasoned nurses out of acute care. This article outlines the implicit and explicit factors that may be contributing to the dissatisfaction and distress in nursing graduates entering professional practice through hospital nursing.

SOURCES OF INFORMATION

CINAHL, MEDLINE, Sociolit, and PubMed.

CONCLUSION

Discussion is focused on the oppressive context in which hospital nursing continues to be situated and explores the ideological, structural, and relational aspects of domination that continue to surface in the work experiences of novice as well as seasoned nurses. Suggestions for addressing the issues that plague the acute care environment are integrated throughout the article, and a detailed framework of empowerment for this nursing context is offered.

Fostering maturity for senior nursing students: a pre-graduation clinical placement

BACKGROUND

There is considerable literature on graduates' role transition to registered nurse from the employer's perspective. Few studies have discussed issues and strategies related to nursing students' preparedness. In response to the Bachelor of Nursing (Honours) senior nursing students' needs in terms of role transition, a pre-graduation clinical placement (PGCP) was implemented.

AIM

The aim of this paper is to report the learning experiences and outcomes of the PGCP.

METHODS

Both quantitative and qualitative approaches were used. All students (n=37) and preceptors (n=33) involved in the PGCP consented to participate in summer 2002. The data included: students' and preceptors' appraisal of pre- and post-Inventory for Nursing Competencies (INC), students' formative and summative reflective journals, and post-PGCP focus group interviews. Paired t-tests were done to compare students' and preceptors' pre- and post-INC scores, and thematic analyses were carried out for qualitative data.

RESULTS

There were statistically significant improvements in students' INC. Three themes - learning to work with ward nurses and preceptors, learning total aspects of care, and acting as RNs - were revealed.

CONCLUSION

The success of the PGCP demonstrates the promising outcome of a long consolidating clinical block prior to graduation in fostering maturity for role transition.

Transition to mental health nursing through specialist graduate nurse programs in mental health: a review of the literature

Specialist graduate nurse programs (GNPs) in psychiatric/mental health nursing have been widely implemented across public healthcare services throughout Victoria, Australia. Broadly, these programs aim to assist newly graduated nurses during the transition from nursing student to registered nurse. This paper presents a review of the literature relevant to GNPs; specifically focusing on graduate transition. An adequate orientation to clinical areas and ongoing support throughout the transition process were identified as significant determinants of new graduates" satisfaction with the initial post-qualification period. However, the literature suggests that the inadequacy of psychiatric/mental health nursing content in undergraduate nursing courses creates additional difficulties within this specialty area of practice. Moreover, the current literature review emphasises the need for further research to evaluate the effectiveness of GNPs for nursing in general and for psychiatric/mental health nursing in particular.