What can community pharmacy learn from the experiences of transition to practice for novice doctors and nurses? A narrative review

Abstract

Objectives In the absence of literature reporting the transition experiences of novice community pharmacists, peer-reviewed evidence on the transition experiences of novice doctors and nurses was identified and reviewed. Specific objectives included identifying the challenges to transition and their perceived impact, before considering the implications for novice community pharmacists. Methods The electronic databases MEDLINE, EMBASE, CINAHL, PsycINFO and ScienceDirect were searched for full peer-reviewed original research papers published 1990-March 2015, reporting the transition experiences of novice doctors and nurses. A narrative review following coding of themes was undertaken to synthesise findings with transferability. Key findings Twenty-five papers using qualitative and quantitative methods were retrieved from nursing (18) and medicine (6). Challenges were categorised into three themes: personal experiences (where acquiring professional accountability, failing to meet expectations, and emotional, cognitive and physical demands of the job heightened stress), social experiences (where support and acceptance at work were hindered by organisational culture, hierarchy or interpersonal conflict) and challenges from job-related experiences (high workloads, task complexity, staffing, rotations and shift patterns). Challenging transitions were perceived by novice practitioners and their peers as impeding learning, impairing performance and having negative implications for patient care. Conclusions While some of these findings may be transferable to community pharmacy settings, contextual differences exist: relative isolation from professional peers, commercially driven private-sector settings, full and immediate acquisition of professional accountability and the lack of clinical career pathways or formalised support. Given these differences, is it appropriate that 'day-one' community pharmacists are fully and immediately accountable? Empirical research exploring transition to practice in the community pharmacy setting is needed.

Changing status in health care: community and hospital pharmacists’ perceptions of pharmacy practice

“…The problem occurs when these internal divisions are visible at national level reducing a profession's ability to bargain with the State affecting its reprofessionalisation efforts . Larson speculates that professional socialisation fosters ideological solidarity and improves professional cohesion, which can be achieved in pharmacy through embedding a formal postgraduate clinical career pathway with additional relevant training that is represented in practice …”

“…[11,26,27,46] Larson speculates that professional socialisation fosters ideological solidarity and improves professional cohesion, which can be achieved in pharmacy through embedding a formal postgraduate clinical career pathway with additional relevant training that is represented in practice. [12,57]…”

Health workforce planning in Namibia: assessing a pilot workforce survey of pharmacists

“…In addition, inappropriate planning and maintenance of the health workforce can lead to wastage of precious resources . Research in health workforce has sought to inform decision‐making though is necessarily broad to include, for example, issues around needs assessment, migration patterns, sector monitoring, retention, representation, trainee intentions post‐qualification,brain‐drain’ and task‐shifting . Health workforce observatories can also play a role in mapping educational opportunities, understanding of workforce supply, describing specific settings or countries that can inform health strategy and policy, and quantifying staffing needs in specific settings .…”

Community pharmacists at transition to independent practice: Isolated, unsupported, and stressed

“…A detailed review (Magola, Willis, & Schafheutle, ) exploring transitions of novice nurses and doctors found that they experienced challenges [or stressors] when they interacted with the workplace environment and reacted to their new roles, as proposed by Meleis' transition theory (Meleis et al, ). In this review, challenges associated with transition were categorised as personal, social, or job related (Magola et al, ).…”

“…A detailed review (Magola, Willis, & Schafheutle, ) exploring transitions of novice nurses and doctors found that they experienced challenges [or stressors] when they interacted with the workplace environment and reacted to their new roles, as proposed by Meleis' transition theory (Meleis et al, ). In this review, challenges associated with transition were categorised as personal, social, or job related (Magola et al, ). Personal challenges described the novice's response to their role (psychological pressure, cognitive impairment, emotional, or intellectual stress), social challenges resulted from workplace relationships (interpersonal/interprofessional conflict, fitting in or mismatched expectations) and job‐related challenges resulted from role demands (shift patterns, responsibility for complex patients, rotation, or time constraints).…”