Challenges and Strategies for Improving Confidence in Inter-professional Collaboration in New Graduate Nurses - Literature review Example

Challenges and Strategies for Improving Confidence in Inter-professional Collaboration in New Graduate Nurses Introduction New graduate nurses transiting to practice and entering the workforce face various challenges that include inadequate expertise as well as confidence to navigate the highly dynamic and intense clinical setting burdened by growing levels of patient acuity and nursing workload (Pfaff et al, 2014). Inter-professional collaboration (IPC) is one area that new graduate nurses lack confidence and this hinders delivery of safe and quality healthcare due to lack of effective IPC. Inter-professional collaboration refers to collaborative care delivery between multiple healthcare professionals from different disciplines to provide comprehensive and quality patient care (Crawford et al, 2016). There are various obstacles that hinder new graduate nurses from engaging effectively in inter-professional collaboration. Some of the obstacles include inadequate exposure to inter-professional collaboration in academia and stress-laden transition experience (Dyess & Sherman, 2009). In regard to inadequate exposure to IPC, undergraduate nursing programs provide inadequate experiences for students to engage in inter-professional collaboration (Martin et al, 2016). This results to student nurses lacking adequate education in regard to collaborative practice. In spite of this gap of preparing new graduate nurses for inter-professional collaboration, competency in inter-professional collaboration is required for responsible, accountable and knowledge-based practice and should be demonstrated by new graduate nurses at entry to practice. According to Crawford et al (2016) a high number of new graduate nurses report lack of adequate preparation for inter-professional collaboration and the lack of preparedness can result to reduced confidence during interactions with other healthcare professionals. Evidence shows that this lack of confidence in interacting with other professionals can result to communication failures where new graduates avoid consulting other healthcare providers due to lack of confidence and fear (Dyess & Sherman, 2009). The lack of preparation for inter-professional collaboration in new graduate nurses represents a huge risk to patient safety and can even compromise delivery of quality healthcare. Another hindrance to inter-professional collaboration among new graduate nurses is emotional stress. According to Dyess & Sherman (2009) transition to practice for new graduate nurses is typified by stress, anxiety and reality shock. Specifically, the main cause of emotional stress is lack of confidence, knowledge and experience, impractical workloads as well as lack mastery over work setting. Additionally, new graduate nurses face perceptions of susceptibility that can be amplified by fears of rejection by team members. New graduate nurses also have high levels of anxiety when floating to other units, when assigned responsibility and also when they are taking part in code situations (Pfaff et al, 2014). All these stressors involve inter-professional collaborative interactions and are aggravated by lack of confidence and lack of experience. Therefore, it is important to improve confidence in inter-professional collaboration to enhance both recruitment and retention of new graduate nurses. There are various strategies that can be used in improving and supporting confidence in new graduate nurses to engage in inter-professional collaboration. According to Pfaff et al (2014) supportive relationships for the new graduate nurses has been shown to facilitate and improve confidence in inter-professional collaboration. The most common sources of support for the new graduate nurses include preceptors, mentors as well as organizational leaders. Therefore, it is important for these sources to offer support to the new nurses in every way possible in order to enable the new graduate nurses feel that they are supported (Roots & MacDonald, 2014). This enables the new graduate nurses to improve in their weak areas and not fear of making mistakes because they know they have the support and eventually this increases their confidence in practice and inter-professional collaboration as well. Evidence also shows that charge nurses and inter-professional team members play an important role in enhancing new graduate nurse confidence in inter-professional collaboration (Foronda, MacWilliams & McArthur, (2016). A study conducted by Pfaff et al (2014) found out that charge nurses, mentors, preceptors and organizational leaders role-model collaborative behaviors and support the socialization of new graduate nurses to team and organizational cultures. Charge nurses can act as knowledge brokers in regard to inter-professional plan of care where they can enlighten the new graduates regarding what is expected of them in inter-professional collaboration. On the other hand, organizational leaders such as managers and administrators can act as sources of invaluable support for the new graduate nurses, especially during inter-professional conflicts (Pfaff et al, 2014). For instance, the management and administration have the authority to correct and caution inter-professional team members who are not behaving as required and who maybe mishandling new graduate nurses. Working as a team is highly dependent on the manager (Roots & MacDonald, 2014). Another strategy that can improve confidence in new graduate nurses is implementing mentoring programs for new graduate nurses. In regard to inter-professional collaboration, hospitals should have a structured approach for developing mentorship programs that should allow new graduate nurses to be mentored on how to effectively collaborate with other healthcare providers (Roots & MacDonald, 2014). A good example of a mentorship model was developed by Morton-Cooper and Palmer where new graduate nurses are mentored on how to improve communication skills in order to enable them to successfully establish interpersonal relationships. This model also has a collaboration phase where the mentor and the new graduate nurse collaborate (Thomas, 2016). More importantly, all healthcare organizations should ensure that there are programs for new graduate nurses’ transition to practice. The new graduate programs should be designed to meet the needs of nurses during their transition to practice by include instilling confidence and competence in new graduate nurses (Roots & MacDonald, 2014). Ensuring that team members and other healthcare provider respect one another can also improve confidence in new graduate nurses in inter-professional. According to Ulrich et al (2010) when new graduate nurses are satisfied with the team, this has a high likelihood of enhancing confidence in inter-professional collaboration. Respectful interaction with other healthcare professionals has been found to play an important role in supporting and improving confidence towards inter-professional collaboration among new graduate nurses (Crawford et al, 2016). A study conducted by Pfaff et al (2014) found out that disrespect and recurring challenging interactions with inter-professional team members led lack of confidence in inter-professional collaboration among new graduate nurses. Therefore, ensuring that there is mutual respect between healthcare professionals is a key to improving confidence in inter-professional collaboration in new graduate nurses. Additionally, new graduate nurses should be involved in all decisions that influence their practice as this enables them to better manage the difficulties and complexities involved in healthcare setting and also cope with stress associated with transiting to practice (Thomas, 2016). When the other healthcare providers involve the new graduate nurse during decision making, the new graduates will feel that they are valuable in the team and thus this can significantly improve their confidence in inter-professional collaboration. Potratz (2012) further adds that shared governance provides all healthcare professionals with a platform for discussing matters that may be affecting their practice. As a result, new graduate nurses who might be having issues that hinder their inter-professional collaboration may air out their grievances and have such matters solved. When new graduate nurses are actively involved in decision making there are likely to feel empowered and this increase their confidence (Potratz, 2012). Moreover, inter-professional decision making is likely to promote professional environment that encourages respect and improves confidence (Potratz, 2012). New graduate nurses also need to be exposed to both formal and informal inter-professional collaboration opportunities to increase their confidence. As per Martin et al (2016), exposing new graduate nurses to such opportunities allows them to meet different healthcare professionals, learn regarding their roles and finally share in decision-making about care. Opportunities likely to increase the confidence also include team strategies like inter-professional rounds and case management meetings. Generally, such opportunities provide new graduate nurses opportunities to speak up, interact and work collaboratively with other professionals and this increases their confidence (Potratz, 2012). In addition, such opportunities also provide new graduate nurses with experience in inter-professional collaboration and this is a significant confidence builder (Roots & MacDonald, 2014). Through experiences, new graduate nurses gain plausible knowledge that allow them to provide relevant recommendations towards patient care planning. Repeated experiences with other disciplines eventually increase confidence in inter-professional collaboration. Most importantly, there should be undergraduate programs that prepare new graduate nurses for inter-professional collaboration. Presence of inter-professional educational opportunities for nursing students can provide positive experience that can help them understand the practice roles of other healthcare disciplines as well as gain inter-professional communication skills (Foronda, MacWilliams & McArthur, 2016). According to Potratz (2012) gaining experience in inter-professional collaboration during undergraduate studies provides new graduate nurses with experience in inter-professional collaboration and this increases their confidence when engaging in inter-professional collaboration. Team support is an equally important factor in promoting confidence in new graduate nurses within inter-professional collaboration. Ulrich et al (2010) suggest that prioritization of new graduate nurses in a team structure is important because such opportunities increase new graduate nurse experience in inter-professional collaboration and hence results to more confident inter-professional interactions. It is important for team members to understand and support new graduate nurses whenever they have shortcomings allied to inter-professional collaboration. This is because being unsupportive and devaluing their knowledge and experience can bring about feelings of low confidence. Such opportunities encourage inter-professional dialog. Evidence shows that dialog is essentially supportive because it encourages team involvement instead of secluding. Potratz (2012) is line with this and argues that to help new graduate nurses balance clinical expectations with inter-professional collaboration, it is important to give them so free time from the hectic patient care atmosphere where they can effectively and freely participate in inter-professional collaboration (Pfaff et al, 2013). Therefore, when working as a team, it is always important that the other experienced registered nurses spare the new graduate nurses some time from the normal patience care and give them some time to participate in inter-professional collaboration (Thomas, 2016). This will not only provide them with experience but also increase their confidence in IPC. Team leaders having new graduate nurses in their team should ensure that there is inclusive team atmosphere that supports the needs of new graduate nurses. This means that the team leaders need to make sure that new graduate nurses feel a sense of belonging and acceptance within the inter-professional team (Pfaff et al, 2014). It is obvious that in case new nurses feel that they are not accepted in the inter-professional team, they are likely to lose confidence during collaboration. According to Ulrich et al (2010) supportive and available organizational leaders boost confidence of new graduate nurses in inter-professional collaboration. Additionally, leaders in organizations can further increase confidence in new graduate nurses by making sure that collaborative learning opportunities are promoted and opportunities for interacting with the new graduate nurses are provided through avenues such as regular progress meeting or being present on the unit (Pfaff et al, 2014). Studies further show that nurse development strategies that focus on nurses’ knowledge and expertise in inter-professional collaboration should be prioritized both in academic setting and at organizational level as well (Noureddine et al, 2016). In order to ensure that new graduate nurses are confident and well prepared for inter-professional collaboration; training institutions need to integrate inter-profession collaboration in both theoretical and experiential contents in undergraduate curricula. This is because it has been shown that inter-professional education can fill the knowledge and experiential gaps in inter-professional collaboration during transition to practice (Foronda, MacWilliams & McArthur, 2016). Educational models have been proposed where confidence within inter-professional collaboration is supposed to be theoretically improved when students take part in inter-professional education and attain the knowledge, skills, attitudes as well as behaviors necessary for effective and competent inter-professional practice (Foronda, MacWilliams & McArthur, 2016). Interventional strategies such as inter-professional lectures and roundtable discussions, inter-professional simulation experiences, and highlighting on collaborative practice in clinical practice can be used in educating student nurses as well as new graduate nurses on inter-professional collaboration (Noureddine et al, 2016). Such interventions have the ability of enhancing knowledge and experiential develop in inter-professional collaboration and thus improve their confidence. Conclusion New graduate nurses face various challenges when transiting to practice. One of the challenges is lack of confidence when working with other healthcare professionals. Some hindrances to inter-professional collaboration for new graduate nurses include emotional stress and inadequate exposure to inter-professional collaboration in their education. Some of the strategies that can be used to improve confidence in inter-professional collaboration for new graduate nurses include establishing supportive relationships for them. Preceptors, mentors and organizational leaders can be fundamental sources of support because they can even intervene during conflicts in inter-professional teams. Mentoring programs and exposing them to formal and informal inter-professional collaboration opportunities to increase their confidence can also increase their confidence. In conclusion, there is need to incorporate inter-professional collaboration in the theoretical and experiential contents in undergraduate curricula so that when they transit to practice they will be confident enough to interact with healthcare professionals from other disciplines. References Crawford R, Gallagher P, Harding T, McKinlay E & Pullon. (2016). Inter-professional undergraduate students talk about nurses and nursing: A qualitative study. Nurse Education Today. 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