The Transition to Practice from Registered Practical Nurse to Registered Nurse Roles - Assignment Example

The Transition to Practice from RPN to RN Roles 0 Introduction The nursing profession is associated with demands which are stressful; the stressful demands are normally elicited by various aspects, such as the failure to meet the demands of the work, the stress of using the emerging technology, as well as the involvement in the emotions and suffering of the patients. Typically, nurses normally assist and experience the life transition of various patients: on the other hand, nurses also have their individual issues. The new Registered Nurses normally bring academic knowledge in the nursing setting; however, the Registered Nurses normally lack the practical knowledge to engage in a number of the clinical scenarios in an effective fashion. It is typical that a large number of the new Registered Nurses give up during the transition from the academic knowledge to the practice. Conversely, a number of the new Registered Nurses succeed to transit from the academic world to practice. This paper is focused on applying the Transition Shock Framework to evaluate the transition to practice from Registered Practical Nurse to Registered Nurse roles. The paper will use the four quadrants which are provided Judy Duchscher in the Transition Shock Framework. The four quadrants include Knowledge, Relationships, Responsibilities and Roles; these aspects reflect the newly RN graduates’ emotional, intellectual, physical and socio-development while they interact to produce the transition shock that is characterized by the new Registered Nurses. 2.0 The Transitional Shock The concept of transitional shock surfaced as the experience of transiting from the ordinary role of a student to the comparatively less well-known role of the professional nursing practice. Similarly, the transitional shock concept is also important among individuals that are transiting from the roles of the Registered Practical Nurse to those of the Registered Nurse. The importance of this transition is dependent on the fact that there is a significant contrast between the roles, knowledge, responsibilities and relationships that exist between the roles of the Registered Nurses and Registered Practical Nurses. Typically, for a large number of professionals there is always the urge to transit smoothly to the comfort zones of the Registered Nurse without experiencing difficult moments. In most cases, the Registered Practical Nurses wish to transit to the Registered Nurses’ roles without facing either time or personal energy (Duchscher, 2009). Normally, the roles of the Registered Nurses seem to be challenging among the Registered Practical Nurses; however, this achievement is normally possible with personal efforts, time and the pursuit of further education. As a result, these professionals are likely to be acknowledged for their prime knowledge in the nursing practice. In order to ensure a successful transition, a Registered Practical Nurse is normally connected to a senior professional nurse who help in a number of practical areas; the senior professional nurse normally educate the Registered Practical Nurse the routines and duties that are performed in accordance to the roles of the Registered Nurse. The transition from the roles of the Registered Practical Nurse to those of the Registered Nurse is associated with various expressions, such as doubt, confusion, disorientation and loss. 3.0 Analysis of Responsibility, Relationships, Roles and Knowledge 3.1 Responsibilities Among the responsibilities of the professional Registered Nurse include the social-cultural assimilations. The Registered Nurses would execute total nursing care activities among patients of different cultural backgrounds. Additionally, the Registered Nurses are expected to work with professionals from different social-cultural backgrounds. In this respect, the transition from the Registered Practical roles to those of the Registered Nurse would call for the social-cultural assimilation among the RPNs. Halfer and Graf (2006) argue that the transition from the Registered Practical Nurse to the Registered Nurse would require the RPN to be associated with leadership skills; in this regard, the Registered Practical Nurse would be required to learn about the delegation of roles to the RPNs in order to transit successfully to the roles of the RN. It is expected that a qualified Registered Nurse would be delegating a number of the nursing care activities to the Registered Practical Nurses. Moreover, a successful transition would require a new qualified Registered Nurse to balance the roles of workplace and home. It is evident that a number of the new qualified Registered Nurses face difficulties of balancing the roles of home and workplace; in this regard, the new qualified nurses are responsible for ensuring a balance is stricken between the work at home and workplace to experience a successful transition to the roles of a Registered Nurse (Boblin, Baxter, Alvarado, Baumann, & Akhtar-Danesh, 2008). Although the Registered Practical Nurses experience the practical knowledge of coordinating the nursing care for patients, this level of providing the nursing care is normally directed to clients with less complicated conditions. As a result, the new qualified Registered Nurses are expected to learn the clinical practice by providing a total nursing care services to all patients. The bottom line is that the Registered Nurses are responsible for the nursing care services that are administered directly to patients or via delegation to the Registered Practical Nurses. While working as a RPN, I have made a number of decisions with a view of addressing the need of a client. For instance, I would call a responsible doctor to ask for a change in medication since the past diagnosis revealed an adverse result. Having helped clients in the clinical setting while working as an RPN, I am confident that I would be successful as far as the roles of the Registered Nurse are concerned. 3.2 Knowledge The new qualified Registered Nurse would be required to be associated with a broad knowledge as far as the nursing profession requires. In order to experience a successful transit, the Registered Nurse is expected to appreciate the professional culture of nursing; the Registered Nurse should be familiar with a number of regulations, such as the clinical ethics, which guide the behavior of professional nurses while providing the nursing care services. The Registered Nurse is also expected to acquire a broad range of skills and roles that are required to be demonstrated in any healthcare organization that is associated with the provision of nursing care services. Among the tasks that the Registered Nurse is required to learn is the daily routine, such as coordinating the nursing care services among patients who are perceived to be complex. Additionally, for a successful transition, the Registered Nurse should learn the performance expectations; among the expectations of Registered Nurse include the provision of quality and professional nursing services that are likely to improve the health status of a large number of families. Moreover, it is fundamental to understand thoroughly the transitional that is experienced from the roles of a Registered Practical Nurse to a Registered Nurse. This would help a Registered Nurse to appreciate the link that exists between the world of practice and education. Martin and Weeres (2012) confim that the failure to link the four-years nursing degree and the nursing practice may have a negative impact on the application of the comprehensive knowledge learned in school to practice (Duchscher, 2009). I am determined to use researches and studies which are associated with significant clinical results that provide treatments that are practical in the nursing practice. Additionally, I am aware of a number of nursing terminologies. This would help me to experience success as far as knowledge is concerned. 3.3 Relationships A successful transition from the roles of the Registered Practical Nurse to a Registered Nurse demands the interdisciplinary and intra-disciplinary relationships. The intra-disciplinary relationships refer to the association and link that are created between nursing professionals in the same field; on the other hand, the relationship that is created by nursing professionals from different fields denotes the interdisciplinary relations. Both these types of relationships are important among the new Registered Nurses. The association is normally associated with the imparting of practical knowledge among the new qualified Registered Nurses. In addition, the relationships that are created normally lead to significant elimination of doubt and confusion. Moreover, a successful transition to the roles of the Registered Nurse is also associated with professional and personal relationships between the new qualified Registered Nurses and the experienced professional nurses; this type of relationship is significant in reducing the sense of loss that is faced by a majority of the Registered Practical Nurses who are transiting to the practical roles of the Registered Nurse. It is also relevant for the new Registered Nurses to demonstrate social maturity at the workplace; the Registered Nurses would in a number of cases deal with patients directly- this would require a heightened social maturity in order to uphold the profession of nursing. I have managed to develop confidence while talking to senior physicians while addressing the needs of patients. I would evaluate at how the Registered Nurses perform their roles; I would learn from them how to be self-assured with respect to performing various functions. I have learned to work with the RNs in the operating room overnight while helping in various activities. This experience and relationship would help me to transit smoothly to the RN’s roles. 3.4 Roles The mastering of the roles that required to be performed by the Registered Nurses is crucial as far as the nursing professional is required; specifically, there is a need to distinguish the differences between the roles of the Registered Nurse and Registered Practical Nurse. The Registered Nurse has the autonomy to perform the entire nursing care, as well as delegating a number of these activities to the Registered Practical Nurse. Additionally, Meleis, Eun-OK, Hilfinger Messias and Schumacher (2000) argue that there is a need to manage stress and straining that is associated with the performance of the diverse activities that relate to the Registered Nurse’s profession. Other important roles include acting as a leader as far as the professional roles are concerned; this would include delegating a range of the professional nursing care activities to the Registered Practical Nurses, as well as supervising the activities. It is evident that the guidance of the Registered Practical Nurses can contribute to the total delivery of exceptional healthcare services to clients. Moreover, a successful transition would entail a complete transitional change from the role of a student pursuing a 4-years degree course to the practical role of a professional nurse. Besides the career, a successful transition from the roles of the Registered Practical Nurse, (the transition from the RN to RPN is associated with a further learning) to those of the Registered Nurse would entail the balancing of the roles as a parent, child, spouse and professional nurse. Last, but by no means the least, while performing the roles of the Registered Nurse, the RN should ensure that care is taken to avoid overlapping the Registered Practical Nurses’ functions. These factors would ensure a successful transition from the functions of the Registered Practical Nurse to those of the Registered Nurse. Figure 1 The Conceptual Framework of the Transitional Shock Source: Duchscher, J. (2009). Transition shock: the initial stage of role adaptation for newly graduated Registered Nurses. Journal of Advanced Nursing, 65(5), 1103-1113 At the end of a post-orientation process, the fatigue and seclusion that feeds and stems from confusion, doubt, disorientation and loss aspects that represent the new experience encouraged an intentional withdrawal from the intensified shock transition. The expressions of the transitional shock among the Registered Practical Nurses who are transiting to the Registered Nurse’s roles are demonstrated by physical, intellectual, emotional and socio-developmental as shown on figure 1. 4.0 The Assessment of Emotions, Physical, Intellectual and Socio-Cultural and Developmental 4.1 Emotional The transit from the Registered Practical Nurse to the Registered Nurse’s roles is associated with overwhelming emotions. There is a tendency to use various words such as ‘horrible’ and ‘scary’. A number of participants indicate persistent anxieties during the period of transition. A good number of individuals that transit from the Registered Practical Nurse are normally associated with intensive stress in the first four months of post-orientation; the stressful experiences are usually attributed to inadequate emotional support, as well as lack of enough practical experience. Lack of confidence with respect to communicating and associating with new members in the field of the Registered Nursing is also likely to result in overwhelming emotions. Trauma among the new Registered Nurses also emerges as a result of the impracticable performance expectations by an organization, fellow workmates and the Registered Practical Nurses. It is common to experience the senior nurses consciously challenging the practice background of the new Registered Nurses. This attempt is perceived to be destroyable given the fact that it can undermine the low level of confidence that is associated with the new Registered Nurses. Generally, the new Registered Nurses are normally characterized by a number of fears as they experience from the roles of the Registered Practical Nurse to those of the Registered Nurse. One of the fears relate to the situation of being declared incompetent professionals, as well as unsuccessfully offering of quality care and unconsciously hurting the patients. The other fear includes the failure to keep up with the assigned tasks and responsibilities. Given that an individual is required to pursue further education to realize a successful transition from the roles of the Registered Practical Nurse to those of the Registered Nurse, there is a tendency of a new RN to experience a lack of adequate support from the recent educators and colleagues as far as counseling is concerned. In this respect, the new Registered Nurses are likely to feel a sense of self-doubt and loneliness. While working on diverse work schedules, I have encountered difficult situations whilst engaging with clients and workmates. In this respect, I would be successful when dealing with various emotions. 4.2 Physical The physical reaction of the Registered Practical Nurses to the transition shock learning is based on the total energy that is consumed while attempting to execute diverse new roles. This energy is consumed in various ways, including the making of clinical decisions which the new Registered Nurses perceive that they have not attained proper qualifications although they are totally responsible. The straining of the transit from the Registered Practical Nurse’s level to that of the Registered Nurse is encouraged by the managers and peer’s expectations which are perceived to be unclear. The sleep periods are characterized by dreams regarding work; as a result, the new Registered Nurse is likely to be exhausted during the orientation period. 4.3 Social Cultural and Developmental As regards the transition shock, there is disconnect with respect to what a new Registered Nurse had learned in school and the reality in the practical world. Although a new Registered Nurse is always prepared for the tasks that relating to the provision of safe practical world, the Registered Nurses are typically reinforced or challenged. The new Registered Nurses also report straining while attempting to relate with the senior professionals (Duchscher, 2008). 4.4 Intellectual The graduates of a 4-years degree are normally oriented in the new nursing practice setting; the new Registered Nurses are occasionally shown the nursing roles that they are expected to perform, as well as the scope of the practice. It is common for a majority of participants that are transiting to the roles of the Registered Nurse to have significant levels of energy and eagerness during the initial stages of orientation as a result of increased expectation of practicing independently. Mostly, the orientation is associated with an aspect that faces an increasing challenge; the new Registered Nurse relate the orientation process similar to the degree course which is challenging as a student progresses from one year to the other. Despite the interest and eagerness of the new Registered Nurses to experience an independent practice, the participants lack adequate support from experienced nurses as far as mentorship and friendly are concerned (Goodwin-Esola, & Gallagher-Ford, 2009). I will ensure I have trained effectively in utilizing the inquiry aptitudes in relation to the patient’s assessment and clinical scenario, as well as the use of the conflict resolution measures. Additionally, I would research various internet sources with respect to the intervention of medical conditions. 5.0 Conclusion The shock model illustrates that the new Registered Nurses graduates would face a process of transiting from learners to Registered Nurses which is characterized by diverse challenges and setbacks as far as their lives are concerned. In this respect, the newly Registered Nurses would be required to practice adjustment and facing losses in various situations. The knowledge acquired at the university, the past experience of working as a Registered Practice Nurse, the peers one would work with the Registered Nurses who are initiated in the practice and the management one would experience in the transit are the determinants of a successful transition to the roles of a Registered Nurse. References Duchscher, J. (2009). Transition shock: the initial stage of role adaptation for newly graduated Registered Nurses. Journal of Advanced Nursing, 65(5), 1103-1113. Boblin, S., Baxter, P., Alvarado, K., Baumann, A., & Akhtar-Danesh, N. (2008). Registered Nurses and Licensed/Registered Practical Nurses: A Description and Comparison of Their Decision-Making Process. Nursing Leadership, 21(4), 56-72. Duchscher, J. E. (2008). Transition Shock: The InitialSstage of Role Adaptation for Newly Graduated Registered Nurses. Journal of Advanced Nursing, 1103-1113. doi:doi: 10.1111/j.1365-2648.2008.04898.x Goodwin-Esola, M., & Gallagher-Ford, L. (2009). Licensed Practical Nurse to Registered Nurse Transition. Journal for Nurses in Staff Developent, 1-5. Halfer, D., & Graf, E. (2006). Graduate Nursing Perceptions of the Work Experience. Nursing Economics, 24(3), 150-155. Retrieved from http://www.fchs.ac.ae/fchs/uploads Martin, D., & Weeres, A. (2012). Retaining RPNs: Impact on Quality Care. 1-35. Retrieved July 19, 2013, from http://www.rpnao.org.../RPNAO%20Retention%20Project_ Meleis, A. I., Eun-OK, I., Hilfinger Messias, D. K., & Schumacher, K. (2000). Experiencing Transitions: An Emerging Middle-Range Theory. Advances in Nursing Science, 23(1), 12-28. . Read More