Nurse Graduate Challenges - Essay Example

Nurse Graduate Challenges Introduction The phenomenal increase in demand for nurses all over the world has caused for the concomitant sprouting of nursing schools and other related facilities. The current trend showcases an apparent faster and far steadier demand for nursing graduates than what these institutions can supply. However, an in-depth analysis of this situation would foster the impression that only within a specific period, the maximum utility must be attained. I will also be discussing these challenges in light of my own experiences. The crux of the matter is that as the demand for nurses is not met by the influx of new graduates, the more lucrative the compensation and the benefits become for those holders of nursing licenses and for those intending to become one. The more rewarding a nursing career seems, then the greater number of students will be inclined to enroll and attend nursing schools. However, with the continued sourcing of graduates, over time, the limit set by the number of medical institutions and health facilities would invariably be met. As a result, after a certain period, there will be an oversaturation of nursing graduates and less or non-existent employment opportunities for them. But then again, the fact is that even after the lapse of a longer period of time than expected, the demand for nurses seems to be unchanged. How can this apparent condition exist? Why is there a steady demand for nursing graduates and how come the market is yet to be inundated with an oversupply of nurses despite the massive enrolment all over the world? To what can this be attributed? The conversion of nursing graduates into full-time nursing personnel is the core matter addressed in this paper. The fact is that while there is a continued influx of licensed nurses, there still remains a steady increase in demand. To state, there seems to exist a black hole in the transition of nursing graduates into practicing nurses. The transition of newly graduated nurses (NGOs) into professional service is on its surface, no different from the transition of a newly graduated teacher into becoming full-fledged professors. But an essential difference lies in the need for NGOs to alter their personal perceptions and shape them in accordance with their upcoming professional responsibilities (Heslop, McIntyre and Ives, 2001). Duchscher (2010) defines it as "consist[ing] of a nonlinear experience that moves the new practitioner through personal and professional, intellectual and emotive, skill and role relationship changes and contains within it experiences, meanings and expectations." This transition is also characterized as the evolution of the nursing student into hospital staff following four stages: (1) honeymoon, where the graduates are expectedly anxious to get a moving on their careers; (2) shock, where the professional value and intellectual credence of the graduates are forced to face the realities of the industry; (3) recovery, when the graduates begin to have a full rein on their careers and start to have the hang of things; and finally, (4) resolution, when the graduates are able to establish habits and form long-term goals (Kramer & Schmalenberg, 1978). This NG transition has been classified as the initial twelve months into practice where character transformations, perception changes, intellectual enhancement, emotional adjustment, physical development and even social maturity are attained (Duchscher, 2010). Challenges Associated with Transition The main crisis in the transition of graduating nursing students into practicing or professional nurses lies in the difficulty to translate their numbers into the field (Duchscher, 2010). That is, the number of students that are apparently graduating is not equivalent, actually less than the number of nurses entering service in health institutions and hospitals. Somehow, a large fraction of the graduates opt out of the industry and take on employment in private facilities or even to some extent, prefer to work in fields outside of their realm. The obvious hesitation and diffidence of NGOs to follow through their course plan poses as the major threat in their transition. I personally attribute this indecision to the doubts cast by the graduates to the level of education they have received and reckon themselves as lacking in skill and unprepared to face the challenges in the workplace (Lundberg, 2008). As such, NGs either enter graduate schools or enroll in further studies or keel to other work offers where their education may be put to use but not a focal requisite. The disparity in numbers of the students entering nursing schools and the number of practicing nurses is the most concrete proof to exculpate the fact that these students are faced with the issue of having to decide whether they have enlisted in the right program. After all, there is a myriad of factors that influence this evident change of mind in NGs. Factors Influencing Transition I have realized from experience that the current state of the health services leaves a lot to be desired. Nurses like myself are over-worked, the system is out-dated and there is a massive premature exit of nurses from the workplace due to physical and emotional exhaustion. These factors and several others pose a threat in evening out the supply and demand for nurses. Brown (1999) lists down four major factors that disturb the otherwise smooth transitioning of graduating nursing students into practicing personnel, these include: (1) intolerable working environment in hospitals; (2) unsuitability and insufficiency of knowledge in practical application; (3) tendency of hospitals and similar facilities to run the establishments as businesses and not as service-oriented institutions; and, (4) existence of more lucrative opportunities other than hospitals and health institutions. Additionally, one study conducted on nursing trends in five countries – United States, Canada, England, Germany, and Scotland reveal another five challenges that directly affect the transition of the nursing graduates into practicing professionals (Tiffany, 1992). These are: (1) the obsolete structure of the nursing system; (2) the continued decline in personnel that leads to the ballooning of the nurse-to-patient ratio and its resulting overwork; (3) increase in absenteeism attributable to physical and emotional exhaustion of personnel; (4) failure of the employers to address the needs of their workers; and, (5) the tendencies of new nursing graduates to look for greener pastures and not stay on a certain job longer. During the initial twelve-month period in the professional career of nurses, problems such as the lack of self-confidence and skill, the difficulty in creating relationships with colleagues and the high work demand pose additional challenges in NG transition (Duchscher, 2010). The demand for nurses remains unsatisfied due to the failure of the employers to address the clamor of the practicing nurses to improve their working conditions. Physical and emotional exhaustion and the existence of employment alternatives are the two of the main reasons why NGs opt out of their chosen career (Tiffany, 1992). Other factors such as the lack of motivation due to the continued disregard of NGs position and work condition, the failure of educational institutions to provide the students with the necessary background to function effectively and the apparent mismatched nurse-to-client ratio that causes work fatigue and exhaustion constitute the other causes that prevent the proper transition of NGs to professional nurses (Brown, 1999). The dominant opinion threw to the concept of nursing likewise affects the transition of NGs to professional nurses. At the onset, the concept of nursing has been largely hampered by a social stigma that attaches the job to women and the common notion of employee exploitation of the hospital and ill-treatment from patients (Carlson, Kotzé and Van Rooyen, 2005). This relegated identity has forced a significant attitudinal change in most NGs to seek work opportunities in institutions other than hospitals or other similar healthcare facilities. Problematic Issues During Graduate Year During the senior year, NGs often begin to have misgivings and start to doubt their competencies (Tiffany, 1992). It is after all, the year which would bridge them to their ultimate goal of working in a health service facility where their four-year toil will be put to use. But the fact remains that during this time, several problems beset the graduating class. The typical problem of graduating students is whether to plunge straight ahead into practical service or to enroll in further studies to enhance what they already know (Tiffany, 1992). That is, as nursing students, they have the option to enter into a grad year program or other educational package offered by institutions or work directly for a hospital or similar setup. This option is the consequence of the self-impression of the students of being inadequate and not prepared to face the real scenario in hospitals and similar facilities (Drexler, 2009). Most of these graduating students are forced to measure their learned skill and acquired knowledge against the emergency and possibly perilous conditions in the workplace and somehow end up assessing themselves as lacking and ill-equipped (Lundberg, 2008). As such, most of them, during their senior year, debate the merits of furthering their studies or entering the profession as full-fledged nurses. Another issue faced by NGOs during their senior year is the unending search for the appropriate organization that would suit their perception of an ideal institution (Tiffany, 1992). Oftentimes, we enter nursing school with a concrete manifestation as to how we want our careers to flow (Carlson, Kotzé and Van Rooyen, 2005). However, as soon as they are through with the lessons in school and are obliged to practice their profession, they immediately find out the disparity in what they aspired as to what really exists. As such, the graduating student relentlessly searches for the suitable establishment where they believe they can become an asset by reforming the system, improving the structure or by just plainly performing exceptionally only to find out that such utopia does not exist (Carlson et al., 2005). One other issue that I had to face during the graduate year is time management (Tiffany, 1992). With the existence of several significant issues besetting the hospital industry, we become cautious in entering these institutions who pose ever increasing demands on the graduating nurse (Lundberg, 2008). With the reports of the decline in health service efficiency, licensed nurses in hospitals are forced to work longer hours and made to attend to a larger quantity of patients (Heslop et al., 2001). Physical and emotional exhaustion thus became the rewards of NGs after their four-year educational toil in nursing schools (Brown, 1999). Because of the stringent demands on time, NGs begin to consider other work opportunities where their knowledge will be out to use but without the hazards associated with the current standard of the nursing field. Yet another issue that we are beset with is teamwork. Since most of us graduates are lead into feeling ill-suited and unprepared to face the tasks that lie ahead of us, we also find it difficult to mingle with a multi-disciplinary team who has had more experience than us (Tiffany, 1992). With the abrupt change in their environment from the school setting into service-oriented institutions requiring quick response and efficient reaction, most of us leave the service, enter other fields or re-enter learning institutions to allow them time to re-assess themselves (Heslop et al., 2001). It then becomes necessary to equip these students with the necessary educational background and teamwork skills that would sustain them in the workplace with a concomitant avowal that there are certain realities and issues that beleaguer the industry (Theobald and Mitchell, 2002). This would afford the students to manage their expectations so as not to cause them to lose sight of their aspirations as they plunge into the field of professional nursing. There are a lot of problems that most graduating nursing students face. But the fact of the matter is that most of these issues are directly triggered by the remarkable disparity in what is perceived by the students as the ideal and what is actually present and happening in the industry. As such, the smooth transitioning of these students into professionals is thrown into a limbo. Plan of Action for Addressing Problematic Issues Bridges (1991) believed in the necessity of recognizing the need to undergo a certain transition period in order to be able to cope with the necessary changes associated with that phase. Furthermore, Bridges argued that due to the fact that the transitional stage undergone by nursing graduates into becoming professionals involves a total turn-around from being spoon-fed in their universities into being holistically responsible to all the aspects of their life and career. This is characterized by a remarked transformation in decision-making and planning that was absent during their stay in their schools. Likewise, this transitional period is marked with the quick personality modification of the students into being individuals able to manage responsibilities, balance schedules and provide the best service to patients. Chang and Daly (2008) mentioned that these newly graduated nursing students have strong ideas which they may or may not lose as they enter practice and that the current condition of the health industry is the chief cause of these students to lose sight of these ideals. As Duchscher (2010) mentioned, the new graduates enter the profession with an oblique view of the profession largely due to the ideals they hold and the personal principles they possess. As such, their transition is invariably made more difficult by the necessity of having to adjust their standards and make do with the real scenario coupled with the varied transformations in their physical, emotional and social state. Likewise, this transition is made even more taxing with the nature of their responsibility in taking care of the ailing, giving comfort when they themselves are constantly confronted with issues in their affairs and personality. Benner (1982) further states that "the heart of the difficulty that the novice faces is the inability to use discretionary judgment" which is the main reason why these NGOs are not able to do well and adapt to clinical practice. What then should be done to aid the smooth transitioning of the rings into practice? While it is fact that the current number of practicing nurses is remarkably lesser than the patients requiring attention, it is believed that the NGOs would function more effectively if they are allowed to gain entry into the industry through a careful and calculated process assisted by a more seasoned colleague (Theobald and Mitchell, 2002). That is, it lessens the culture shock in the NGs if they will be integrated into the system through a prudent initiation procedure not marred with overly long work hours and intense clinical matters to be faced on their own. Also, a fresh entry nurse must be assigned to a more senior nurse with whom they could form a trusting relationship and who would assist them in the transition from school to the workplace (Theobald and Mitchell, 2002). From the perspective of the industry as a whole, it would benefit the NGOs and even the licensed and practicing nurses if they are afforded with regular training programs and orientation sessions that would constantly reinforce their knowledge and foster their continued zeal for the industry (Duchscher, 2010). These programs may also allow the nurses to keep better hold of their ideas and allow them to generate seeds to cultivate its determination as they will have a more conscious regard for the industry. A kinship with the rest of the community will bolster initiatives and other developments in the system. The current working condition of nursing professionals is a problem that is deeply rooted in the very nature of the profession itself as the nursing practitioner is required to render all-out service. This then entails that the very disposition of the calling which makes it grand is itself is the greatest folly. As a profession, the nursing industry is in constant need of practitioners. The number of schools and universities offering courses in nursing spells out the viability of this particular field. But the fact that the need for nurses is seemingly not likely to be reached, a deeper delve into the matter would illustrate that there appear to be deeply-ingrained issues that beset the profession. These problems may at the surface-level appear too complex to resolve, but the very context and personal proclivities of the nursing students to keep strong senses of idealism well into the workplace is the best solution that the industry can hope to have. References Benner, P. (1982). From novice to expert. American Journal of Nursing, March, 402-407. Bridges, W. (1991). Managing transitions: Making the most of change. Reading, MA: Addison Wesley. Brown, P. (1999). Graduate nurses. What do they expect? Kansas Nurse, 74(5), 5-10. Carlson, S., Kotzé, W. J., & van Rooyen, D. (2005). Experiences of final year nursing students in their preparedness to become registered nurses. Curationis, 28(4), 65-73. Chang, E. & Daly, J. (2008). Transitions in nursing (2nd ed). Sydney: Elsevier. Drexler, L. (2009). Strategies to improve final year nursing students’ confidence. Retreived on October 9, 2011 from: http://juns.nursing.arizona.edu/articles/Fall%202009/improve%20final%20year.htm. Duchscher, J. (2010). Nursing the future. Retreived on October 9, 2011 from: http://www.nursingthefuture.ca/transition_theory. Heslop, L., McIntyre, M., & Ives, G. (2001). Undergraduate student nurses’ expectations and their self-reported preparedness for the graduate year role. Journal of Advanced Nursing, 36(5), 626-634. Kramer, M., & Schmalenberg, C. (1978). Bicultural training and new graduate role transformation. Wakefield, MA: Contemporary Publishing, Inc. Lundberg, K. M. (2008). Promoting self-confidence in clinical nursing students. Nurse Educator, 33(2), 86-89. Theobald, K., & Mitchell, M. (2002). Mentoring: Improving transition to practice. Australian Journal of Advanced Nursing, 20(1), 27-33. Tiffany, J.C. (1992). What to expect from your first year of nursing practice. NSNA Imprint, 39(1), 33-37. Read More