The nursing practice is a complex and continuously changing profession. It’s dedication to providing excellence patient center care, improving the quality of life for all patients, and upholding patients’ rights. As a new graduate nurse, it can be hard to transition into such a field, and you may find it to be overwhelming and difficult to meet the demands of the patient and workplace.
As a new graduate nurse transitioning into the nursing practice, the Quality and Safety Education for Nurses (QSEN) six core and five Institute of Medicine (IOM) core competencies are tools and guidelines that can be used to support you in transitioning into the nursing practice. The QSEN six core competencies was developed to provide a means to meet the challenges of preparing future nurses and new graduate nurses with the tools necessary to improve the quality and safety of the healthcare systems where they work.
The first core competency is patient-centered care; this will assist in providing care that identifies the patient as the source of control, which means the patient care will be based on respect for the patient’s wants, needs, preference, and values. This is giving the patient all of the control and encouraging the patient’s involvement in their care, which will benefit the patient in the continuity of care and maintaining their health after hospitalization. This will help the nurse provide holistic patient care (Masters, 2016). The next core competence is teamwork and collaboration.
This core competence explains how it teamwork and collaboration functions effectively within the nursing and other team members, fostering open communication, mutual respect and shared decision making to achieve quality patient care. Teamwork and collaboration is what nursing are all about. It is important to be a good team player and help your fellow nurses. It is also important to collaborate with other team members, to be all on the same page about what the plan of care will be and what is going on with the patient from different standpoints.
Collaborating is a must in the nursing practice, as a nurse, you collaborate with the doctors about the plan of care and orders, with pharmacy about medications and doses recommended, with physical and occupation therapy, and so many other team members. As my nursing leader discussed, teamwork essential, and when unsure ask your fellow nurse for clarification, instead of jeopardizing the patient safety. Nurses help make safe and efficient decisions regarding the patient needs preferences and values.
Communication is a key aspect to providing safe and effective care especially in nursing and with other inter-professional team members. Miscommunication can lead to medication errors, sentinel events and or death of the patient. New graduate nurses can use this to assist with the transition into the nursing practice as a means to providing effective collaborative care and use teamwork to support them when doing something that may be new to them such as setting up for a blood transfusion or transferring a patient to a higher level of care.
New graduate nurses may encounter situation unfamiliar to them, and this is where they can collaborate with other and use teamwork to make sure they are providing safe and effective patient care. In the nursing practice, care is based on evidence-based practice (EBP), this core competencies will assist new graduate nurses transition into the practice by providing them with a framework of what is the best current way to provide safe and effective care. Nurses will know that they are practicing and providing care with the best and current evidence supporting it.
This will also facilitate new graduate nurses to do research and make sure that the practice being taught is up to date and the best way to provide care. Along with EBP, nurses can use the next core competence Quality Improvement to assist them, by using data to monitor outcomes of care processes and then evaluate this data and improve the methods used thus improving the quality and safety of care and the healthcare system within their workplace (Masters, 2016). Nursing within its self is all about safety, so the next core competence Safety can help new graduate nurses by minimizing risk and harm to the patients.
This is done by knowing policies and procedures at your work place, understanding that human error is something we can control and safe guard patients from by following guidelines set before us, examining basic safety precaution and being aware of unsafe practices and knowing how to effectively use the technology and standardized practices that support safety in your work place. Orb? k et al. (2015) discuss how technology driven medication process is complex, involving advanced technologies, patient participation and increased safety measures.
Medication administration can be safely done if understanding the technologies, professionalism and patient safety are three crucial elements in the medication process to prevent and avoid errors. Technology has become such a big part of nursing, the core competence Informatics, which involves using information and technology to communicate, manage knowledge, mitigate errors and support decision making, can assist new graduate nurses by being a means to utilize safety and safe guard patients from errors.
Nurses can use the electronic health records to find information about their patient as well as look up a medication they may not know what it is used for or side effect to tell the patient to report. The Institute of Medicine (IOM) describes five core competencies that will assist new graduate nurses transition into the nursing practice by 1) provide patient center, this will assist nurses in making the patient the center of all decision and care provided. 2) work in interdisciplinary teams, this will assist nurses in integrating patient care with different team members. ) Employ evidencebased practice; this will assist nurses in practicing using the best research and clinical expertise to provide the best and safe care. 4) Apply quality improvement, Applying quality improvement will help nurses recognize potential errors and hazards to safe patient care, thus safe guarding the patients. 5) Utilize informatics, which will assist the nurse in communicating with the interdisciplinary team and safe guarding errors (Roberts, 2016).
According to Sherwood & Zomorodi (2014) preventable errors are a main issue in health care and the complexity of health care, requires interactions among numerous providers for any patient multiple times a day, and the nurses are the constant presence with patients and have an important role in coordinating the contributions of the myriad of caregivers (Sherwood & Zomordi, 2014). Because nurses are the last line of defense, The QSEN and IOM core competencies will provide new graduate nurses with ways to deliver safe and effective evidence-based care (Morris & Hancock, 2013).
Semester Observation During this semester, I’ve observed nurses who have been a nurse for less than one year struggle with the demands of the nursing practice. I also got to experience how they worked under the pressure and demands of the patients, doctors and management team. I worked with nurses who have over 20 years of experiences. There was a big difference in how the new graduate nurse worked and how the experienced nurse work.
The new graduate nurse followed policies and procedure with detail, such as when administering medication, the new graduate nurse would check and scan the arm band and have the patient state their first and last name and date of birth. But the experienced nurse would just scan the name band. The new graduate nurse would go over each medication and tell the patient about common side effect and make sure the patient had that medication before, but the experienced nurse would just scan the medication and tell the patient, this is your usual morning or evening medications.
The new graduate nurse would do a full assessment of the patient, but the experienced nurse would do most of their assessment by just looking at the patient, sometime not even removing the patient’s sock to assess their feet. Although the experience nurse did not follow policies and procedures exactly, she did not struggle to keep up with the demands of the patients or doctors. The experienced nurses was able to chart and complete patient care effective and safely and manage her time. The new graduate nurse was not.
Quick changes caused the new graduate nurse to struggle even more, but the experienced nurse was able to handle the situation effectively and proficiently. My nurse leader has been a nurse for over 20 years. She was a charge nurse at Arrowhead Hospital on the progressive care cardiac unit and worked her way up to clinical coordinator then clinical manager, then house supervisors. After talking with my nurse leader, it was clear that it is important to have a good preceptorship to make the transition a little easier.
My nurse leader made it clear that it is important to feel comfortable with your skills as well as your preceptor. After interviewing with my nurse leader, there is a lot that goes into the nursing practice, much more than just patient care. It is a team effort, and you will be working with more than just the patient but the patient’s family and other members of the team, you will need to have time management skills, multitask and function well under pressure.
My leader made it clear that you need to have proficient nursing staff, and to be proficient in nursing staff, you need to be an active member in your workplace and to do this you must attend conferences and in-services to stay up to date on the latest evidence-based practice Transitioning Boehm & Tse (2013) discusses the transition of nurse graduate nurse that has included a didactic and skills-based orientation accompanied by a period of preceptor practice.
But they found methods do not ensure that new graduate nurses will have a successful transition and reduced anxiety to fully interact with their new environment. In this article, Boehm and Tse, discuss how the transition into the nursing practice can cause anxiety, reality shock and moderate to severe stress, which can be a hinders nurses in providing safe and effective patient care.
And a way to help new graduate nurse transition and learning eeds from qualitative research conducted in a communitybased novice nurse transition program. The new graduate nurse transition and learning needs are examined through new graduates and the nursing leaders and preceptors who work with them. One piece of advice my nurse leader would give to the novice nurses to help them transition and succeed in the first year nurses would be to have a safe nursing practice, she tells this to all the new nurses that come to her unit.
What this means is 1) always ask yourself if I’m sure and practicing safe nursing because learning is a working progress every day. 2) Always safe guard your patient, 3) follow the 5 rights of medication administration, 4) practice visual assessment and do not rely on the monitors all the time and if you practice safe nursing, safe guarding your patient, thereby you as a nurse safe guarding your livelihood, your RN license.
