Expected clinical competence from midwifery graduates during community service placement in Limpopo province, South Africa

Abstract

BackgroundThe implementation of community service for nurses commenced in January 2008 (Department of Health 2007) and was regulated by the South African Nursing Council (SANC) Regulation 765 of 24 August 2007 (SANC 2010). All nurses completed the 4-year nursing diploma or degree for registration as a nurse (General Community and Psychiatry) and as a midwife to 'practice a profession in a prescribed category' and to carry out 1 year of remunerated compulsory community service (Department of Health 2006). When placed in clinical environments, new midwifery graduates are expected to work autonomously and cope with increasingly high acuity patient workloads and major advances in technology (Morrow 2009). According to the SANC, community service must be performed for a period of 12 months. The aim of the community service strategy of the National Department of Health was to retain professional nurses through community service, with graduates obtaining clinical experience under the supervision of experienced professional nurses (Department of Health 2011). During this period, the new graduates must apply their learning from the academic setting into the clinical environment immediately upon entry into practice (Hickey 2009; Meechan, Jones & Valler-Jones 2011).The hospital managers and experienced midwives expect new midwife graduates to be job ready, demonstrate competence in the provision of evidence-based care, practise independently and assume accountability and responsibility for their own actions (Nursing and Midwifery Board of Australia 2006;Romyn et al. 2009; Wolff, Pesut & Regan 2010a). Although newly Background: Community service nurses are placed in a hospital within the first year after qualifying to obtain clinical experience under the supervision of experienced professional nurses. When placed in clinical environments, new midwifery graduates are expected to be job ready, demonstrate competence in the provision of evidence-based care, practise independently and assume accountability and responsibility for their own actions. Aim:The study aimed at exploring the expectations of experienced midwives of clinical competence of newly graduated midwives during transition. Setting:The study was conducted at the training hospitals of the five districts in Limpopo province. Method:The researcher used a qualitative approach which is explorative and descriptive in nature. The population comprised all the professional midwives with experience of 5 years and above working at the selected hospitals in Vhembe, Mopani, Capricorn, Waterberg and Sekhukhune districts of Limpopo province, South Africa. From each selected hospital, five experienced midwives were selected using non-probability, purposive sampling method. An in-depth individual face-to-face interview was used to collect data from the participants, until saturation was reached. The open-coding, Tesch's eight-step process was used to analyse data.Results: Results revealed that newly graduated midwives failed to meet the perceived expectations by experienced midw...

Operational nurse managers’ perceptions on the competence of community service nurses in public settings in the Western Cape

“…This starts with being a novice, passing through an advanced beginner, competent and proficient before finally reaching the fifth stage of advanced competence. This process should be supported as shown by the work of Netshisaulu and Maputle ( 2018 ) who showed that as students lack confidence and skills to take up the new roles and accountability, role transition support and a foundation period of preceptorship for midwifery graduates at the start of their careers help midwives to make the journey from a novice to an expert (Netshisaulu & Maputle 2018 ). The authors also advocated that a contextual transition programme should be developed by institutions to orientate and mentor graduate midwives in their new roles before they could function as independent practitioners (Netshisaulu & Maputle 2018 ).…”

Community service nurses’ experiences regarding their clinical competence

“…In a qualitative study conducted by Netshisaulu and Maputle (2018) in the Limpopo Province, it was identified that new graduate midwives placed for community service lacked a sense of independence and commitment to patient care and could not perform delegated duties with respect to ward coverage as per the expectations of experienced midwives. This lack of independence and commitment was seen to have an impact on the increased workload and frustration of the experienced midwives supervising CSNs (Netshisaulu & Maputle 2018). Therefore, experiences of CSNs in the NWP regarding their clinical competence during placement need to be investigated.…”

Developing a competency profile for newly graduated registered nurses in South Africa

“…NGRNs face several challenges when entering the practice environment after completing their studies. Typical challenges are lack of independence, low confidence and feelings of incompetence [ 3 , 4 ], thus, necessitating further investigation into the competencies nurses require to deliver quality patient care. As far as the authors could establish this was the first competency profile developed based on the perceptions of both nurse educators and final-year nursing students who were HCPs working within the clinical environment.…”

“…South African (SA) studies indicate that NGRNs have a lack of knowledge and skills, insufficient record keeping and are not following protocols [ 2 ], which again could be due to competency issues. Certain NGRNs show a lack of independence and confidence, as well as feelings of incompetence [ 3 , 4 ]. Further challenges were found to be: feeling overwhelmed and struggling with the transition from student to NGRN [ 5 ], insufficient practical experience as well as deficiencies and adequacies in their professional role [ 3 ].…”