Challenging graduate nurses' transition: Care of the deteriorating patient

Abstract

The findings identify needs of graduate nurses' during a high-stakes patient encounter and shed light upon one aspect of transition. Clinical leaders may use the findings from this study to improve preceptor development and transition programme curricula.

Changes in health behaviours and health status of novice nurses during the first 2 years of work

“…However, the amount and quality of sleep, depression and stress were worse at 6 weeks and then slightly improved after 6 months, which was still worse than at baseline. These experiences of novice nurses have been frequently reported in literature from other cultures (Bisholt, 2012;Della Ratta, 2016;Ketelaar et al, 2015;Nahm, Warren, Zhu, An, & Brown, 2012;O'Shea & Kelly, 2007). In addition to lacking the nursing knowledge and skills necessary for the multidimensional responsibility in clinical settings, novice nurses reportedly experience a lack of knowledge about and accessibility to health promotion strategies.…”

The art of balance: Preceptors’ experiences of caring for deteriorating patients

“…Debriefing sessions were also described by preceptors as essential to vent emotions arising from the event and to offer reassurance to novices. Novice nurses’ need for emotional support following emergency response situations has been previously noted (Della Ratta, ; Ranse & Arbon, ). The participants in the current study understood the impact that caring for a critically ill patient may have on new graduate role formation as they used debriefing sessions to reassure novices.…”

“…As a result, the ability to verbalise an accurate assessment and plan of the patient upon reflection was viewed by the preceptors as a more important indicator of clinical judgement development. Explicitly stating this to novices may provide reassurance as previous research focusing on deteriorating patient encounters from the novice perspective revealed that “success or failure” of their performance during the encounter was highly regarded as a measure of their own professional development and impacted transition (Della Ratta, ).…”

“…Hospital-based transition programmes aim to promote new graduate clinical judgement competency while easing transition to practice and reducing high turnover rates (Anderson, Hair, & Todero, 2012). Specifically, the preceptorship component has been identified as critical to novices' transition to complex work environments (Della Ratta, 2016;Moore & Cagle, 2012). The most common preceptorship model is that of a fixed preceptor/preceptee dyad who work together one-on-one for a period of 1-3 months (Ke, Kuo, & Hung, 2017).…”

“…From the perspective of new graduate nurses during their first year of practice, learning to care for deteriorating patients requires a trusted preceptor who will assist with clinical decision-making and be supportive of their emotional needs during high-stress encounters (Della Ratta, 2016;Ranse & Arbon, 2008). Developing preceptors to meet the needs of the next generation of nurses in this aspect of care is critical for several reasons.…”