12.1 Graduation Transition Flashcards
Influences on new grad Transition
Intrapersonal
- Assertiveness
- Burnout
- Coping Strategies
- Demographics (age/gender)
- Educational Preparation
- Health Status
- Job Readiness
- General Self-Concept
- Professional Tenure
- Prior Experiences
- Psychological Capital
- Psychological Empowerment
- Resilience
- Self-Efficacy
- Social Skills
- Work Attitudes/Values
Interpersonal
- Authentic Leadership
- Authentic Preceptorship
- Incivility/Civility
- Respect
- Role Models
- Social Support
- Workplace Bullying
- Workplace Ties and Relationships
Organizational
- Effort/Reward
- Hospital (location/size/structure)
- Job control
- Job demand/difficulty
- Job satisfaction
- Job role/stress
- Orientation
- Patient workload
- Staffing
- Structural empowerment
- Work-related attitudes
- Work Attributes (full time, voluntary, mandatory OT, shift length, time of day, hours worked, floating, benefits)
Reality Shock
- Occurs during transition from educational to service settings with different priorities and pressures
- Inconsistencies between academic world and world of work
Role Conflict
- Resolves when new grads see ways that they can influence their work environment
Reality Shock Phases
Honeymoon Phase
- Experienced during orientation. Everything is as the new grad expects, sharing orientation with other new grads with similar motivation/interests
Shock (Rejection) Phase
- Begins when nurse starts work on their assigned unit. New nurse comes in contact with conflicting viewpoints and different ways to preform skills (not like how they were taught in school). Can cause them to feel less secure, not having an expert, and may experience feelings of rejection and lack of accomplishment
Recovery Phase
- New nurse may gain a sense of humor, begin to understand their new culture and experience less stress and anxiety.
Resolution Phase
- Occurs when the new nurse works through this phase and grows as a person and a nurse
- Work expectations are more easily met and nurse has developed strategies to elicit change
New Graduate Fears
- Being exposed as clinically incompetent
- Failing to provide safe care to patients and causing injury
- Not being able to cope with designated roles and responsibilities
- Rejected as a valued member of the team
- New grads go to great lengths to disguise feelings of inadequacy
- Not having easy access to previous educators and preceptors creates feelings of isolation and self-doubt
Signs of Stress
- Apathy
- Anxiety
- Irritability
- Mental fatigue
Behaviors
- Avoidance
- Relationship/Substance/Legal issues
- Comfort eating
- Administrative Issues
Physical Signs
- Excessive worrying about health
- Frequent illness
- Exhaustion
- Engaging in self-medication
Recommendations for New Grads
- Place in relatively stable clinical setting for the first year
- Encouraged to increase exposure to advanced scenarios gradually and strategically
- Given regular, frequent feedback to reinforce teaching and developing skills/knowledge
- Offered opportunities for safe sharing with other new grads as well as experienced colleagues
Stages of Skill Aquisition
Novice
- Few experiences with clinical expectations
- Tell me what to do and ill do it
Advanced Beginner
- Preforms adequately and has prior experience in actual situations to recognize meaningful components. Able to make judgements based on experience.
Competent
- Able to look at long term goals and mastering skills (2-3 years into practice)
- Plans their own actions based on analytical thinking.
- Helps to achieve greater efficiency and organization
Proficient
- Able to view situations as a whole and develop solutions
Expert
- Intuition and decision making are instantaneous. Performance is fluid, flexible, and highly proficient. Not all nurses reach this level.
Residency Programs
- Designed to move nurses from novice to competent.
