Internship in Nursing, Preceptor, Factors Affecting Internship, Preceptor- Preceptee Relationship, Selection, and Preparation of Preceptors - Literature review Example

Internship in Nursing Date: Affiliation: Internship in Nursing Definition of internship According to Brideson (2011) Internship is an opportunity granted by the employer to some potential employees known as interns to work in a company for a given time so that they can acquire relevant skills that will help them in their entire profession. Mostly interns are undergraduates and college student who are seeking to gain skills in their relevant fields. The internship usually lasts from as low as a week to as long as one year. Another name for the internships is the “work placements.” Bogossian et al., (2011), adds on the above definition and asserts that, “internship as the process of graduating from being a student to a professional worker. It is the process of changing from being unskilled to becoming skilled professional.” It is a period of gaining the relevant information which is applicable in the respective field. Many professional jobs such as teaching, nursing, medicine, engineering all require one to go through internship so that he or she may gain the required skills. The above studies agree on the notion of internship based on experience and expertise in the field of nursing. The development programs ensure that the educational experience changes from theoretical to practical experience whereby an individual can take care of the patients using the learnt skills. Colleen, 2012 affirms that transition period is marked with confusion and pandemonium whereby the interns are not sure of themselves and mostly they make mistakes. For instance, the Australia government started the graduate development programs which aimed at ensuring that the graduates are incorporated in the working and professional environment. The program was started in 1984 with the purpose of making the graduate nurses efficient in their work. However, Colleen affirms that most nurses are dissatisfied with program. The investigative study through cross section design (focus groups, interviews and questionnaire) in Canberra University affirmed great dissatisfaction among graduate nurses’. It proved that most of the graduate nurses are having problems especially relating to preceptorship and coping with the hospital environment. On the contrary, Broyles 2012 indicates that, Prior to the introductions of the program, the nurses were trained in the hospital environment and, therefore, gaining the practical skills was not difficult. They got used to the hospital environment and the preceptoship program started immediately on their first day in work, hence the program was more effective than the current tertiary system. The graduate development program has not only provided an avenue to grow, but it has also enhanced conglomeration of the academic and practical skills. Collen 2012 further explains that several nurses agreed that graduate programs were effective especially in enhancing practical skills. This was recorded from various interviews conducted within Australian hospitals and the universities. The Mackay Hospital and Health in Queensland is one of the areas where interviews took place and the graduate nurses were optimistic about the entire graduate program. Mackay Hospital is entirely committed in supporting the development of the post graduate Registered nurses in their first year of professional practice and beyond. The commitment is reflected through the escalating number of postgraduate nurses the hospital has employed in the recent years. The step of hospital adds weight on the program hence becoming efficient in the program. In addition, the graduate nurse transition 2015 aims to ensure that there is a successful transition from being a student to a registered nurse who can practice efficiently. The purpose of the graduate development program is consolidating the undergraduate skills and experience to expertise that will enable the intern to become a better and effective nurse (Colleen, 2012). Definition of preceptors, challenges and roles of preceptors According to the Webster dictionary 2014, a preceptor is a practicing physician who is entitled to supervise and instruct medical student or a young and learning physician. Preceptors can be doctors who supervise nurses and younger doctors who are practicing or even an experienced nurse who can supervise the practicing nurses. The relationship between the preceptor and the preceptee should be cordial and professional so that learning can take place efficiently. Precepting is paramount in promoting competence, confidence, familiarity and security of the new intern nurses in the new working environment .There are standardized and universally accepted guidelines for the curriculum to be included in the model of preceptorship. The role as a preceptorship has several challenges that make the job a bit bothering and tiresome. Broyles 2012 study asserts that if a doctor or a nurse is acting as a preceptor, it means that he or she will spend considerable time in the job observation and guidance which translates to reduced productivity. For example in Mackay Hospital, the nurses’ have specific number of patients they are supposed to attend and that translates to at least ten patients per day. The allocated time for the student will automatically consume time meant for the patients. The interviews and focus groups carried out in the hospital as per Broyle’s 2012 assertion affirms that nurses were undergoing a difficult time when handling the preceptees and it posed as a great challenge to them. This is because they were required to complete tasks and at the same tine hit the target. Fetherston, 2011 agrees with the finding and posits that many hospitals and health units have performance contract forms which are evaluated by the end of the month. If the doctor or nurse has not managed to hit the target, the set penalties may affect the career hence ruining the preceptor. In as much it may sound odd and detrimental, those are some of the working conditions and in such cases, and precepting becomes a challenge. Considering the above, the case many experienced nurses even those who are internationally accepted will not allow working with preceptors because they know that it comes along with reduced performance. Lumby, 2013 in his studies indicated another main challenge facing the preceptor being the relationship between the two parties. He affirms that women are known to have to attach high emotional attachment to the preceptorship program compared to men. The NNRU study carried out in 1997 and 1998 in Canberra University and several hospitals within the city affirmed that female candidates regarded highly the emotional support aspects related to preceptorship compared to men. Men are not so much concerned with the emotional set up of the preceptorship and, therefore, they are likely to learn fast and that makes it convenient for the preceptor. It was also noted that women in the cohort disability required more time in preceptorship compared to men and it translated to 74% vs58% for women and men respectively. The child and adult diplomats were essentially possible to attach the importance of emotional support. Therefore, the characteristic of the preceptee also poses as a challenge to the preceptor. The study proved that relationships are vital in the establishment of preceptorship program. The relationship between the preceptees and the preceptor is another challenge facing the preceptors. Majority of the respondent named in the above study affirm that the relationship between the two parties should be viewed from a positive perspective. It is paramount for the preceptee to be honest and ready to accept positive criticism. It is only trough such criticism that the intern will be in a position to learn and become a professional. The study postulates that some preceptors preferred frequent contact while others preferred working all the time with the preceptor. The differences in a relationship may pose as a challenge to the preceptor who thinks that it is paramount for the relationship to favor both the learner and the preceptor. The information affirms that approximately 80%of the transition programs have been successful though there are few areas that require to be furnished. Where the relationship was not working, it was noted that the allocation of the preceptor was not voluntary rand it did not allow the students to choose their own. The NNRU cohort study continued to affirm that the wrong relationship with the preceptor not only disrupted effective training but also contributed to a premature ending of the preceptorship program (Hitchcock, 2010). Workload in the organization has also posed as challenge t the preceptors. Most of the studies have proved beyond reasonable doubt that lack of enough time has contributed to inefficient preceptorship. Time factor can be affiliated to shortage of staff and existence of high dependency patients where students may not be engaged. Moreover, reduced specialized staff has also contributed to the part whereby they cannot afford to teach the interns and at the same time handle the patients. Following the situation, it has become impossible for the preceptors to deliver quality service to the patients and at the same time engage the preceptees. The study is real and authentic since, at times, it becomes impossible for an individual to manage two tasks efficiently (Gill et al, 2010). Differences in the employing companies are a challenge that affected the operation of many preceptors. There is some limited evidence which affirms that preceptorship experiences differ in employing organizations. Studies that focused on adult and children nurses are employed by NHS.NNRU cohort careers involved learning disabilities of the diplomates and 14% of the people were appointed for the first job which was outside the NHS. Although they were less likely to get the preceptorship compared to those used by the NHS, the satisfaction regarding the quality of the preceptorship was a bit higher in those in the private sector compared to those who are NHS. However, the study was not able to account for the differences that had occurred (Madsen et al, 2009). Definition of preceptee, factors affecting internship, receptor- preceptee relationship, Selection and preparation of preceptors A preceptee is a learner or medical student who is working under the supervision of a preceptor who might be a doctor or a nurse. Preceptees mainly are college and graduate who are in the internship program. Most of the interns must work under supervision of an experienced medical officer (nurse of physician) in an effort to grasp relevant skills and finally becoming useful in the profession. There are different challenges that preceptees face in the effort to seek knowledge and understanding of the relevant fields. The challenges may be categorized into personal, professional and finally organizational. First under professional challenge is the responsibility and advanced decision making face on the daily basis (Newton& McKenna, 2009). Remember that these are fresh students from college and they are in a different working condition which involves making some major decisions and also advanced levels of responsibility. For example, if a patient comes and the doctor is not around, the law allows intern that preceptee faces on a daily basis. He or she must use his or her information efficiently and ultimately overcomes the challenge that may be arising from the issue. Moreover, the preceptee nurse is supposed to develop the professional identity and appropriate skills and attitudes which will help in the nursing career. For example, there are many cases of lost identity and negative attitude of the job by the preceptee nurses as a result of the challenges. Inefficient and limited skills also contribute to the latter and it is important for the preceptees to seek help in the higher rank of the preceptor when there is a need to do that (Bateman, 2012). According to Colleen ( 2012)The organizational structure is also another form of challenge that affects the preceptee in their effort to practice in the health care facilities. First, it is not easy to shift from being a student and the next time you are working in the hospital. The experience may not be very pleasing and that may contribute to stress in one way or the other. The environment of the hospital may be horrifying at times and this makes it difficult for preceptees to learn effectively in the area. Multidisciplinary approach to the hospital environment is also a challenge faced by many preceptees.They have to know their roles in a multidisciplinary environment whereby there are doctors’ nurses, surgeons, and other specialists such as psychiatrists. Additionally, the increased rate of bullying more especially in the hospital setting has escalated the levels of challenges. It is difficult to conceptualize bullying since there is no standard definition of bullying. However, bullying involves any bad behavior another disciplinary actions which are intermittent. However, bullying is any form of generalized abuse that takes place in the workplace. The degree and actions of bullying vary from place to place though they all contribute to one thing that is an irritation and psychological stress. Some behaviors which involve bullying may include, dirty looks, social exclusion, calling the intern's crazy names or else saying they are crazy, criticizing them excessively, harassing them for real. Such behaviors will confirm bullying and that is not acceptable especially for the interns. Bullying kills the morale of the workers and they feel that they are unaccepted in the workplace (Fetherston, 2011). The preceptor -preceptee relationship is one of the factors that have continued to affect the internship of nurses in Australia. Respondents from several studies have asserted that much dissatisfaction has been noted when it comes the above mentioned relationship. The studies have affirmed that the relationship is not good at all and efforts are needed to ensure that it is streamlined. The dissatisfaction was related to the aspect of choosing the preceptor. Some students who were allowed to choose their own preceptors ended having a good time in the internship while those who lacked the chance ended up getting preceptors who they did not desire. Consequently, there crashes here and there which disrupted the learning. For example, if a girl got a male drunkard employee she ended up shortening the period of her internship just to end the horrible times. Therefore, matters a lot especially in the case of preceptorship (Giallonardo et al, 2010). Good and friendly relationship translates to effectiveness while unhealthy relationship translates to poor performance and minimal training. In an effort to provide a cordial relationship between the preceptee and the preceptor, the student should choose his or her respective preceptor. When the student chooses his preceptor, the choice is based on the tastes of the student and, therefore, it will be easy for them to interact efficiently. In such a case, learning will be possible to achieve the goals of the business (Gill et al, 2010). Benefits of internship The internship is a basic process and it is worth adopting in all the professional organizations. It helps students to integrate the theoretical knowledge into practical which is the most essential thing in the world of medicine and nursing. For example, it is only through the process that learners are able to adapt the organizational environment bearing in mind that they are fresh from college (Senanayake, 2010). Decision, attitude and general behavior in the business are crucial in every business and internship helps in the process of learning. Moreover, internship enables the learners to overcome any fear that may culminate from inexperience. Experience helps the learner to overcome fear and that is only possible through internship. Competency and professionalism are also part of the learning process and internship helps in strengthening the values. It is only through practice, that one becomes an accustomed nurse and mere theory and observation cannot improve the skills. Through the internship, the preceptee is in a position to overcome the associated challenges and ultimately become a professional in the field. References Bogossian, F. E., Long, M. H., Benefer, C., Reid, L. J., Kellett, S. E., Zhao, I., et al. (2011). A workforce profile comparison of practising and non-practising midwives in Australia: Baseline data from the Midwives and Nurses e-cohort Study. Midwifery, 27(3), 342-349. Brideson, G. (2011). Flight nursing and midwifery in Australia. Australasian Emergency Nursing Journal, 14. Broyles, B. (2012). 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