The first thing nursing students learn during orientation is the ability to make timely clinical judgments. The orientation process involves making the nursing students aware of their most important responsibilities in preserving patients' health (Etheridge, 2007). Once a student demonstrates the ability to make proper clinical judgments, the next step is to take them through a process of building confidence and accepting responsibility (Clark & Springer, 2012). For a nursing student to acquire the self-assuring ability that they can accept the responsibility that comes with their professional calling, they must be willing to adapt to the continually changing relations with colleagues and, be able to think more creatively and critically.
Beyond the phases of orientation is the on-course training of the nursing students. The students are taught both the technical issues to do with patient care and non-technical issues to do with preparing patients psychologically to accept treatment (Clark & Springer, 2012). In the process of classwork training, the students are already in the procedure of orientation for the field practice (Etheridge, 2007). The multiple clinical experiences during attachments, the shared experiences with peers, the support from the experienced nurses and faculty staff is enough to make the students understand what is needed to grow from studentship to field practice.
The process of transition from being a student nurse to a fully approved clinical nurse is the most challenging to most recruits on the field. Most of the time, the students have been used to regulated practice because their knowledge is limited and as such they must work under the guidance and supervision of the experienced nurses (Duchscher, 2008). The actual field practice usually comes as a shock to the newly-graduated nurses. The nursing students undergo a complete transitional phase that is mostly learned gradually as the graduate gets accustomed to the field practice. The nurses get exposure to the prevailing conditions of the field characterized by the heavy workloads, pressure, and fatigue. The transitional period is divided into three phases: the doing stage, the being phase, and the knowing phase. The transition is evolutionary and progressive but neither linear nor prescriptive.
Newly graduated nurses entering the practice are still in the excitement phase of their lives. Almost all the new nurses have not-so-realistic expectations and anticipations. The first time recruits experience unexplained differences between what they do and what they initially thought are their defined responsibilities as nurses (Duchscher, 2008). The workload on the actual field is overbearingly demanding. There are so many non-nursing duties mandated to them, and there is a realization that the medical field attaches low value to the contribution of the nurses in providing quality and professional services (Clark & Springer, 2012). The doing phase is the stage of disruptive awakening to the newly-graduate nurses entering the field.
Before a nurse can develop a stable professional identity, they usually come to terms with the high pressure, fluctuations of emotions and range of duties that were not anticipated. The process in the doing phase includes learning on-the-field skills, performing, concealing, adjusting and accommodating (Duchscher, 2008). The disappointment of the working conditions sends the newly graduate nurses into a series of learning and performing actions to meet standards and goals set by the seniors, understand what is expected of them and working to achieve them in a way that does not compromise their codes of ethics and patients' health and completing their set tasks on time (Clark & Springer, 2012). The doing phase is where the patients learn how to multitask to beat the frustrating situations of the non-corresponding nurse to patient ratios.
The being phase is a post-orientation phase that serves to adjust the nurses such that they can acquire the important ability to think faster, advance their knowledge and experience level and to polish their skill competency. At this stage, a nurse has acquired an established professional identity and can work in a way that neither the on-practice inconsistencies shock them nor does it slow their efficiency (Duchscher, 2008). At this stage, most nurses have adapted so well and are assertive enough to refuse exploitative situations like overtime and frustrations from colleagues. Most nurses at this stage have known who to interact with, how to avoid troublesome colleagues and how to manage stressful senior staff members (Clark & Springer, 2012). The nurses at this stage have the practical decision-making skills and only consult their bosses instead of undergoing close supervision and taking instructions all the time.
The last phase, referred to as the knowing phase, comes after 12 months of active practice and is a point where a nurse joins the broader community of experienced nurses. The nurse can supervise the students on attachment and can do orientations to recruits. The nurses at this stage have accepted to work in the field with all the challenges that surround the workplace environment (Duchscher, 2008). There are fewer struggles to achieve efficiency in service delivery, and the margin of error is significantly reduced. The nurses at this stage work on honing their ability to cope with the work environment (Etheridge, 2007). The work schedule in the knowing phase forms a predictable pattern, and the nurses can design their social lives and duty to work in harmony to reduce chances of burnouts.
Clark, C. M., & Springer, P. J. (2012). Nurse residents' first-hand accounts of transition to practice. Nursing Outlook, 60(4), e2-e8. doi:10.1016/j.outlook.2011.08.003
Duchscher, J. B. (2008). A Process of Becoming: The Stages of New Nursing Graduate Professional Role Transition. The Journal of Continuing Education in Nursing, 39(10), 441-450. doi:10.3928/00220124-20081001-03
Etheridge, S. A. (2007). Learning to Think Like a Nurse: Stories From New Nurse Graduates. The Journal of Continuing Education in Nursing, 38(1), 24-30. doi:10.3928/00220124-20070101-05
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