Socializing into a Profession with High Early Turnover: Nursing Students' Expectations for Leader-Member Relationships

The nursing profession is wrought with high levels of turnover, particularly among new nurses. One reason for this turnover may be explained by a disparity between what new nurses expect in terms of communication from leaders and coworkers and what they realistically receive. This study uses a mixed-methods experimental design to explore young adult nursing students' preferences for manager communication behaviors, how different managerial archetypes influence nursing students' perceptions of their leader, and how personal factors may influence nursing students' preferences for various managerial styles. Findings suggest that new nurses prefer more mentor- and teacher-type managers and that managerial archetypes influence young adult nursing students' perceptions of leader credibility, effectiveness, leader-member exchange, and employee commitment. Furthermore, personal factors such as self-worth and desire for relational communication behaviors influence preferred manager type. Participants' qualitative responses reveal several task and behavioral wants and needs of new nurses. Findings from this study can informatively help to bridge the gap between expectations and reality in the nursing profession, thus addressing a potential reason for consistent turnover.

Nature and extent of intellectual disability nursing research in Ireland: a scoping review to inform health and health service research

OBJECTIVES

To capture the extent and nature of intellectual disability nursing publications in Ireland.

DESIGN

Scoping review using Arksey and O'Malley approach.

DATA SOURCES

Six databases (PsycINFO, CINAHL, Medline, Academic Search Complete, Scopus, Embase) were searched along with a web-based search of the eight academic institutions delivering intellectual disability nurse education in Ireland for publications indexed from the earliest available date to the 31 December 2020.

ELIGIBILITY CRITERIA

Publications by an academic, practitioner or student working in intellectual disability practice or education in Ireland relating to intellectual disability nursing, care or education.

DATA EXTRACTION AND SYNTHESIS

Data pertaining to type of paper/design, authors (academic/professional/student), year, collaboration (national/international), topic/content area and title were extracted from each paper. Data were analysed by two authors using Colorafi and Evans content analysis steps where data was tabulated, and a narrative synthesis undertaken.

RESULTS

The reporting of the review is in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and PRISMA extension for Scoping Reviews Checklist. Database and web-based searching resulting 245 articles meeting the criteria for this review. Through content analysis the 245 articles were mapped onto six themes: supporting inclusion, future planning, aspects of health, interventions, education, professional development and research, and personal and professional accounts of caring.

CONCLUSIONS

This review highlights the extent and nature of intellectual disability publications by academic, practitioner or student working in intellectual disability nursing in Ireland together with opportunities for future growth and development. From the findings it is apparent that there is an ongoing need for intellectual disability nurses to define their role across the full trajectory of health provision and to make visible their role in person-family centred support, inclusion, and contributions in health education, health promotion and health management.

Joining the workforce during the COVID-19 pandemic: views of Allied Health Profession students

In the United Kingdom, the onset of the COVID-19 pandemic placed great pressures on universities to ensure final year health care students completed their studies earlier than planned in order to join the National Health Service workforce. This study aimed to explore the anticipations and support needs of final year allied health profession students transitioning to practice during a pandemic. Final year university students across seven healthcare professions were asked to complete an online survey. Demographic data were analyzed by descriptive statistics and responses to open questions were explored using content analysis. Sixty participants completed the survey. Content analysis regarding students' anticipations, fears, and support needs identified the following themes: professional identity and growth; opportunities for improvement; preparedness for transition from university to the workplace, the workplace environment; COVID-19; support from lecturers; daily support within the workplace and innovative methods of support. Although the transition from student to practitioner continues to be a stressful period, only a minority of participants reported COVID-19 as an explicit stressor. However, as the effects of COVID-19 continue to evolve in the United Kingdom, universities and healthcare trusts must ensure adequate supports are in place for recent graduates navigating this transition during a healthcare crisis.

Performance competence of pregraduate nursing students and hospital nurses: A comparison study

AIMS AND OBJECTIVES

To compare and contrast the competence in clinical performance between pregraduate nursing students and hospital nurses. The study also explored the most difficult technical skills for the participants to perform.

BACKGROUND

Assessment, communication and critical thinking are competencies that help in providing safe and appropriate care for patients. Yet, self-perceived competence was mostly measured while performance competence that reflected nurses' performance in real cases has seldom been explored in literature.

DESIGN

A cross-sectional design was applied. The study adhered to the STROBE guidelines to improve reporting quality.

METHOD

Fifty-two nurses and 50 nursing students completed the Computerized Model of Performance-Based Measurement system, which measures performance competence including the steps of critical thinking, conflict resolutions and common clinical technical problems. Six case scenarios containing 107 test questions were completed.

RESULTS

Only 53.85% of nurses and 20.0% of students achieved a satisfactory level of performance competence. They showed low scores on the steps of critical thinking: "collecting data from on-site physical assessment," "processing information," "recognising/prioritising problems" and "arranging a course of action for patient care," as well as solving common technical problems and conflicts. The three most difficult skills to perform were CPR, reading EKGs and venipuncture/starting intravenous lines.

CONCLUSIONS

The study captured the participants' weaknesses in the critical thinking process and the nursing skills that were difficult to perform. These skills are imperative to nursing care and need to be strengthened in school and in-service education. The academic curriculum and course design for students as well as training programmes for nurses need to be reviewed to address the challenges to be faced in a clinical setting.

RELEVANCE TO CLINICAL PRACTICE

Teaching-learning strategies that focus on enhancing critical thinking and performing difficult skills need to be designed and implemented both in practice and in school.

Challenges for Newly Credentialed Athletic Trainers During Their Transition to Practice

CONTEXT

Understanding the challenges faced by newly credentialed athletic trainers (ATs) as they transition into clinical practice could assist employers and professional programs in developing initiatives to enhance this transition.

OBJECTIVE

To explore the challenges faced by newly credentialed ATs during their transition from student to autonomous practitioner.

DESIGN

Qualitative study.

SETTING

Individual phone interviews.

PATIENTS OR OTHER PARTICIPANTS

A total of 34 ATs certified between January and September 2013 participated in this study (18 women, 16 men; age = 24 ± 2 years; work settings = college, secondary school, clinic, and other). Data saturation guided the number of participants.

DATA COLLECTION AND ANALYSIS

An interview guide was used. All interviews were recorded and transcribed verbatim. Data were analyzed via phenomenologic reduction, with data coded for common themes and subthemes. Trustworthiness was established via intercoder reliability, member checks, and peer review.

RESULTS

Initially, participants had difficulty making decisions independently. However, making decisions and receiving positive feedback helped them develop confidence. Communication with coaches and parents was challenging, especially for those in the secondary school setting. Participants also experienced role ambiguity, as they were unsure of basic organizational and administrative structures and expectations. Mentor inaccessibility was the final challenge described by respondents. In particular, those in the secondary school setting and with part-time employment felt they did not have a supervisor or mentor whom they could contact for support and guidance.

CONCLUSIONS

Professional programs should educate students on potential challenges to help them understand what they might encounter during the transition to clinical practice. Employers should provide clear expectations and job descriptions to alleviate some of the stress and role ambiguity. If a mentor is not provided by the employer, the newly credentialed AT should seek one to assist during the transition.

Perceptions and short-term experiences of newly qualified radiographers performing compulsory community service

INTRODUCTION

Compulsory community service (CCS) is a concept that was adopted by many countries as a strategy to address the shortage of health workers. CCS was initiated in 1997 in the South African healthcare system to alleviate improper distribution of health workers in the public sector. CCS experiences of various health professions excluding radiographers were explored where debates regarding the impact, experiences and perceptions of the CCS year are ongoing. This study aimed to describe the perceptions and short-term experiences of newly qualified radiographers performing CCS in Gauteng, South Africa.

METHODS

A cross sectional descriptive study was conducted using a questionnaire distributed to 81 newly qualified radiographers who had started CCS in the Gauteng province in 2017 across 11 radiology departments. A response rate of 48.1% (n = 39) was obtained.

RESULTS

Newly qualified radiographers understood the objectives of CCS and felt adequately prepared for their roles as CCS radiographers in terms of education skills acquired and role expectations. Participants felt confident to commence their duties and were not intimidated by their work environments. Orientation, mentoring and supervision were identified to be the main challenges during the CCS year.

CONCLUSION

The concept of CCS is widely accepted and regarded beneficial by CCS radiographers. Similar challenges emerged as reported by other health professionals despite the presence of role models. The development and implementation of structured guidelines regarding orientation and mentoring of CCS health professionals is strongly recommended to address the needs identified by this study.

Piloting a practice model in a Norwegian nursing home- A student-managed ward: A way to empower students for the nursing role

This paper focuses on the experiences of nursing students on a student-managed ward, the purpose of which was to empower students for the nursing role. Five nursing students operated and managed a nursing home ward for eight weeks during their final year of nursing education. The students claimed that a group of five students was beneficial. However, a group of five was too large for one nurse to follow up. The students reported that they needed visible supervisors in order to develop professional nursing skills, both in terms of knowledge and practical implementation. The students argued that they became more independent through this form of organisation, since the supervisor was not constantly watching everything they did. The students felt more responsible for the daily running and follow-up of the patients because they were in charge. Peer-assistant learning was highly recommended in relation to self-esteem, and improved results and skills in the students' practice. Collaboration with some of the assistant nurses was challenging. The results indicate that this kind of clinical training can contribute to more empowerment and better preparation for the nursing role than the traditional way.

Midwifery students' experiences of their clinical internship: A qualitative descriptive study

BACKGROUND

Globally the safety of mothers and babies is fundamental in maternity care. Central to ensuring this safety is appropriate preparation of midwifery students' to ensure graduates are equipped to assume the responsibilities of delivering safe and effective maternity care. In preparation for autonomous practice Irish midwifery students' undertake a 36 week internship in the final year of the BSc Midwifery programme. Within this paid internship midwifery students' have the opportunity to develop professional behaviours, consolidate knowledge and learn necessary skills to fulfil the role of midwife under the supervision of registered midwives.

OBJECTIVE

To explore midwifery students' experiences of the internship period.

DESIGN AND METHOD

A descriptive qualitative study using focus groups with ethical approval.

SETTING AND PARTICIPANTS

BSc Midwifery students' in the final year of their programme (n = 17) in an Irish University were invited to participate in a focus group interview midway through their internship. All participants (n = 13) had experience of working in two sites used for internship at the time of data collection.

RESULTS

Key findings include the importance of the internship period in consolidating clinical skills and building confidence and competence for midwifery practice. Midwifery students' experience considerable stress during the internship period. Demands identified as stressors include providing care in increasingly complex clinical areas, meeting academic deadlines and maintaining a work life balance. Negative interpersonal experiences and dismissive attitudes to reflection on practice were barriers to learning. Midwifery students' articulated the importance of learning through doing, a supportive learning culture and philosophy in the unit, protected time for reflection and being included and valued as part of the midwifery team.

CONCLUSIONS

The benefits and challenges associated with internship in midwifery are apparent, particularly when students' are contending with two geographically distant sites. Support mechanisms and suggestions for improvements are considered.

A multisite evaluation of readiness to transition to newly qualified nurse in a cohort of children's nursing students

BACKGROUND

The post-qualifying and preceptorship period in nursing has been well-researched, however, there is limited evidence about the immediate period before qualifying.

AIM

To explore the experiences of role transition of London-based final placement (FP) children's nursing students and to identify what support is required for future cohorts of students.

METHOD

Four London universities circulated an online questionnaire to FP students. The questionnaire content included FP student experiences, preparation for role transition and employability.

RESULTS

Seventy seven students responded (27%). Twenty seven students (35%) felt well-prepared to transition. The main concerns included: becoming an accountable practitioner, employers' expectations and availability of support in the newly qualified period. Students wanted more employability support and the opportunity to talk to newly qualified nurses and prospective employers.

CONCLUSION

Universities and clinical partners need to do more to develop better education and support for FP students and deliver it in a timely way.

A comprehensive literature review of guidelines facilitating transition of newly graduated nurses to professional nurses

Literature shows that successful transition of newly graduate nurses to professional nurses is imperative but does not always take place, resulting in difficulty in performance, cognizance or behaviour of a role as a nurse, affecting the quality of patient care negatively. No integrative literature review could be found to summarize available guidelines facilitating transition of final year nursing students to professional nurses. An extensive search of the literature by means of an integrative literature review was conducted in 2014 and updated in June 2017, following a five-step process. All relevant studies were subsequently appraised for rigour and quality using the AGREE II tool by two independent reviewers. Eight (n = 8) guidelines on transitions were independently extracted. After thematic analysis was done, three factors to facilitate transition of final year nursing students to professional nurses were found: 1) support for new graduates, 2) the graduate's need for socialization and belonging, and 3) a positive clinical learning environment. The availability and implementation of guidelines on transition of final year nursing students by educational institutions and healthcare facilities could ease the transition from being final year nursing students to becoming professional nurses as well as improve retention of newly qualified professional nurses.

Perceptions of newly-qualified nurses performing compulsory community service in KwaZulu-Natal

BACKGROUND

Compulsory community service (CCS) for nurses commenced in South African January 2008 after it was legislated in the new Nursing Act (Act No. 33 of 2005). Nurses completing their registered nurse programme are registered as community nurse practitioners (CNPs) during the CCS period and make up the largest number of health professionals serving CCS. Whilst health institutions have welcomed CNPs as additional resources for the shortage of nursing staff, no structured guidelines have been provided at a regional level as to how these nurses should be utilised or managed during the CCS year. To date, no large-scale study has been conducted on nurses carrying out CCS in order to generalise the findings.

OBJECTIVES

To establish the perceptions of newly-qualified nurses carrying out CCS in KwaZulu-Natal, South Africa.

METHOD

A quantitative survey design was used to obtain data from a randomly selected sample of the 2012 cohort of nurses carrying out CCS in KwaZulu-Natal.

RESULTS

CNPs have a positive attitude toward CCS and perceive themselves as being well prepared for the year of community service in terms of knowledge, skills and ability to administer nursing care. They identified positive benefits of the year of community service.The concerns raised were limited orientation and support; and a few CNPs experienced problems of acceptance by the nurses with whom they work.

CONCLUSION

It is recommended that all health institutions who receive CNPs develop structured orientation and support for these nurses in order to promote their development, thereby enhancing their benefit to the communities they serve.

Understanding Transitions to Promote Student Success: A Concept Analysis

AIM

The purpose of this analysis is to provide an extensive exploration of the concept of transitions, specifically within the context of nursing students.

BACKGROUND

Transitions are a universal part of life. The concept of transitions is rooted in disciplines such as anthropology, sociology, psychology, and business. Transitions are also a central theme in nursing. While various definitions of the concept exist, most agree that transitions involve a process, which over time results in transformation of self.

DESIGN

Walker and Avant's eight-step method of concept analysis served as the framework for exploration of the concept.

REVIEW METHODS

The databases Cumulative Index to Nursing and Allied Health Literature, MEDLINE, Education Resources Information Center, ProQuest, and Academic Search Premiere were searched using the search terms transition, transitions, transformation, nursing students, anxiety, and clinical education. Quantitative and qualitative studies, published concept analysis, and transition theory articles were included.

CONCLUSIONS

During a transition, people experience stress and anxiety. This applies to nursing students as well, who often report much stress and anxiety upon entering the initial clinical experience. However, consequences of a successful transition include increased knowledge, attainment of new skills, and identify reformation. By understanding the concept, nurse educators can develop effective teaching strategies to facilitate successful transitions, which will improve the educational experience, support student retention, and promote graduation of competent practitioners. Hart Swenty.

The influence of undergraduate education on professional practice transition: a comparative descriptive study

BACKGROUND

Graduates from Problem/Context Based Learning (CBL) undergraduate nursing programs often express concern that they may not be as well prepared for transition to graduate nursing practice as their colleagues from more traditional lecture-based programs.

AIMS

To determine if there is a difference in how graduates from CBL and non-CBL programs describe their transition to graduate practice within the first 2 years of graduation.

METHODS

This was a comparative descriptive study that involved the use of a web-based survey. A convenience sample of 163 graduate nurses with 1 to 2 years of experience consented to be part of the study. They completed a researcher-designed questionnaire, which consisted of 26 items based on entry to practice competencies identified by the provincial professional nursing organization.

RESULTS

There was no significant difference in the transition experience of graduates from CBL and traditional education programs within their first 2 years following graduation. These results confirm the findings of authors who compared transition among CBL and non-CBL graduates who had graduated anywhere from six months to several years following graduation.

CONCLUSIONS

It is clear that CBL programs do prepare graduates to successfully transition into graduate nurse practice. Graduates from both CBL and non-CBL programs indicated a need for more formal agency sponsored orientation and transition assistance programs at the beginning of their initial employment.

Helping community-based students on a final consolidation placement make the transition to registered practice

The pressure of role transition on new nurse registrants has affected recruitment and retention, which, along with an ageing workforce, has resulted in a global shortage of nurses that is now reaching crisis point. This article examines and discusses what can be done to attract and prepare the future workforce in the community, focusing on helping students to make the transition to registered practice that begins during their final consolidation of practice placement. There is currently limited evidence on the effectiveness of how community placement teams prepare finalist students for registered practice and this could be seen as an opportunity lost given the urgent need to recruit more registered nurses to work in primary care. Recommendations for enhancing this crucial stage of the student journey are made, and a case for the need to know more from students about how they experience their final practice placement when allocated to a community setting is presented.

Self-assessed level of competence of graduating nursing students and factors related to it

BACKGROUND

The transition from a nursing student to a professional nurse is both challenging and stressful. Competence of graduating nursing students is related to patient safety and there is a need for assessment of competence. However, there is a lack of research on the level of competence at the moment of graduation.

OBJECTIVES

To describe the level of competence of graduating nursing students based on students' self-assessments and to identify possible related factors.

DESIGN

Cross-sectional survey design.

METHODS

The data were collected using an on-line survey (the Nurse Competence Scale) in 2011 and administered to 302 graduating nursing students in Finland practicing in their final clinical placement in university hospitals. The sample contained 154 students (response rate 51%). The data were analyzed statistically.

RESULTS

The self-assessed overall competence was on good level (66.7, VAS 0-100). The competence was highest in helping role and in diagnostic functions, being slightly lower in therapeutic interventions and work role. Pedagogical atmosphere during the final clinical placement had a statistically significantly positive correlation with the overall level of competence.

CONCLUSIONS

Graduating nursing students have good competence at the moment of graduation based on their self-assessments. Self-assessment is a basis for competence development, and systematic self-assessments should be used during the education. Teacher and supervisor assessments and knowledge-tests could be used alongside with self-assessments of competence to give a wider picture of the competence.

Nurses' role transition from the clinical ward environment to the critical care environment

AIM

To explore the experiences of nurses moving from the ward environment to the critical care environment.

BACKGROUND

Critical care areas are employing nurses with no critical care experience due to staff shortage. There is a paucity of literature focusing on the experiences of nurses moving from the ward environment to the critical care environment.

METHODOLOGY

A Heideggerian phenomenology research approach was used in this study. In-depth semi structured interviews, supported with an interview guide, were conducted with nine critical care nurses. Data analysis was guided by Van Manen (1990) approach to phenomenological analysis.

RESULTS

Four main themes emerged: The highs and lows, you need support, theory-practice gap, struggling with fear. The participants felt ill prepared and inexperienced to work within the stressful and technical environment of critical care due to insufficient education and support.

CONCLUSION

The study findings indicated that a variety of feelings and emotions are experienced by ward nurses who move into the stressful and technical environment of critical care due to insufficient skills and knowledge. More education and support is required to improve this transition process.