Lack of Experienced Nursing Staff and Risks to Morbidity, Mortality, and the Incidences of Unwanted Effects - Essay Example

Lack of experienced nursing staff Name Institution Date Lack of experienced nursing staff Fresh graduate nurses provide a big deal of capacity when they come to their initial nursing position. When they come from school of nursing, nurses are accompanied with an array of capacities such as profession’s enthusiasm, anxiety concerning their capacity to fulfill the expectations’ profession, and eagerness to acquire new skills (Burton & Ormrod, 2011). It has actually been established that there exist a turnover among fresh nurses in their initial years as staff nurse, which is able to be partially moderated through orientation and mentorship intervention for the fresh nurse (Cowen & Moorhead, 2011). When graduate nurses are initially employed, the fundamental requirement is to familiarize them to the profession of nursing and to the details of every unit (Chang & Daly, 2012). The way the nurse is assisted to adapt to nursing from the school of nursing is vital to ascertain that the graduate nurse is received into the nursing profession and is aided in obtaining the information required to succeed in autonomous nursing practice. A number of the fresh nurses might not have done work within a hospital past their clinical experiences in nursing, whereas others might have worked on part time as assistant nurses or practical nurses that are licensed while attending school (Levin & Feldman, 2006). New graduates’ past experience is also important to their success during the departments because they might have been previously introduced to the profession during a hospital environment (Burton & Ormrod, 2011). Even though graduate nurses come from nursing with enough knowledge in relation to nursing, the big issue though is that these nurses lack the experience required to deliver quality health care. This is an issue because the present shortage of experienced nurse is hitting every nursing sector, even the critical care. Due to the complexity in attracting experienced nurses for employment, various units such as the critical care frequently turn to fresh graduate nurses who are inexperienced to fill the gap of nursing staff (Cowen & Moorhead, 2011). When directly coming from the school of nursing and beginning their careers within clinical setting, fresh nurses can start without defined thoughts concerning nursing care. On the other hand, they come with inexperience, absence of self-belief within their own capacities, as well as the necessity for professional encouragement. Patricia Benner a nursing theorist views every nurse as progressing via a life cycle of career from the starting fresh graduate to evidently the professional clinician (Burton & Ormrod, 2011). Benner asserts that a nurse goes through an identifiable journey starting as a nurse who is novice to an experienced nurse. With regards to clinical reflection, I have observed that most of the time inexperienced nurses such as graduate nurses are expected to do a lot. Students and new grads work together which should not happen. Additionally, wards are almost full with new graduates. This is indeed an issue that needs to be addressed. Care that is offered by experienced nurses has the potential to prevent complications, promote wellbeing, save money, prevent suffering, and save lives (Chang & Daly, 2012). Quality care that is safe commands that services of health have: enough number of skilled nurses; a proper skill mix in terms of proportion of nursing assistants, enrolled nurses and registered nurses; nurses who are prepared educationally as well as clinically; a manageable nurses’ workload; and adequate resources to facilitate delivery of the best feasible care (Cowen & Moorhead, 2011). Failure to present these measures poses considerable effects on the quality and safety of care. Additionally, they are fundamental elements in the inappropriately great risks of mistakes and unwanted occurrences that happen within Australian hospitals as well as settings of health care (Chang & Daly, 2012). Nonetheless, nurses frequently experience the problem of rationalizing demands for sufficient staffing in addition to manageable workloads (Carayon & Alvarado, 2007). Failure to give nurses organizational support as well as the power essential to control resources’ allocation within their places of work is affecting quality and safety of care (Chang & Daly, 2012). Risks to morbidity, mortality, and the incidences of unwanted effects are all significantly elevated when an insufficient nurses’ number are accessible for the provision of quality, safe care (Cowen & Moorhead, 2011). The evidence indicates that there exist considerable relationships involving levels of nursing education and outcomes of the patient; patient outcomes and nurse staffing; patient outcomes and nursing workload; patient outcomes and work environment of the nurses; and between patient outcomes and nurses’ skill mix providing care. Nursing care provision care avoid a lot of unwanted patient outcomes like pressure ulcers, sepsis, UTIs, postoperative infections of the wound, pneumonia, medication error, and death (Cowen & Moorhead, 2011). Again, there are significant relationships involving nursing workload, nurses’ work environment, nurse staffing and the nurses’ wellbeing: identified more frequently as burnout, stress, and occupational injuries (Chang & Daly, 2012). One significant factor that adds to quality of nursing is the experience that a nurse has in nursing (Aiken et al., 2009; Dunton, 2009). Burritt & Steckel (2009) contend that numerous experiences of assessing cues, and identifying patterns that relate to status of the patient that require attention in specific manners, result in higher extents of clinical performance. A nurse who is experienced may perform an assessment to the similar patient like an inexperienced nurse does but differently respond based on subtle cues (changes) that act as indicators of serious underlying issues. Current trend to install teams of response to provide expertise and resources in favor of bedside nurses is a frequent organizational response to foster different staff experience’s levels (Cowen & Moorhead, 2011). Response teams act to strengthen clinical assurance on the element of nurses that are less experienced and coach these nurses the way of interpreting the subtle changes of patient’s early deterioration. It is reported that nurses who are novice seem to learn via formal training, like review of procedures and policies as well as attendance at educational meetings. On the contrary, professional practitioners complement formal training with an established knowledge base which they have established for a long period of time (Cowen & Moorhead, 2011). Clinical competency has been identified in various stages. The initial stage is described as the novice stage. Nurses in this stage are shown rules that assist them perform their tasks; and they appear to deploy these rules generally. The second stage comprises of advanced starters who use standards grounded on experience and knowledge to direct their actions. Competent nurses are placed within the third stage. They execute habitual skills focusing on outcomes instead of specific tasks. Proficient nurses are in the next stage and they cite learning from various past occurrences and start developing intuition feeling (Chang & Daly, 2012). Lastly, expert nurses are considered to be in final phase. These nurses make use of various information sources to a broader extent unlike how the novice nurses do. It has also been added that these nurses have an insightful grasp of every situation and focus on the precise area of the subject without careless consideration of a wide range of unproductive, alternative diagnoses, as well as solutions. In general, the level of comfort and expertise of clinical nursing proficiency grow along a course (Cowen & Moorhead, 2011). Tactic or skill knowledge, contrary to academic knowledge, is primarily acquired through experience, not excluding collaborating with mentors, preceptorship opportunities of learning, and observational experiences (Evans & Donnelley, 2006). A lot of approaches for accelerating the growth and protection of professional nursing personnel are coming up in nursing currently. Clinical and school organization partnerships are recommended as an approach to accelerate learning as well as transition from one practicing at the level of a student to taking part at the level of profession (Delunas & Rhoda, 2009). Nurse residency plans and professional apprenticeships have been proposed as well to accelerate the development of fresh nursing graduates in the course of experience path (Pine & Tart, 2007). According to Orsolini-Hain & Malone (2007), long-term mentorship is very important. Furthermore, simulated experiences of learning are now provided as a substitute to conventional standards of competency development (Benner et al, 2010). Nursing expertise is controlled by significant experience and related factors, like educational opportunities and learning styles. Within a qualitative research comparing the skills of assessment of expert nurses and novice nurses, it was noted that nurses that are expert appear to make more inquiries and explain more concerns in the course of patient’s handoff than do nurses that are less experienced (Chang & Daly, 2012). Recognition of cues, supported by experience and additional learning, was a factor used to represent the intended connection of information illustrated by professional nurses. Recognition of cues is illustrated by nurses recognizing symptomatology of a patient outside the routine custom and seeking further information and data. It is also added that information have fostered the perception that professional nurses use the history of a patient and other applicable clinical data to give the basis for making decision, whereas novice nurses depend more often on directives and written orders (Hill & Prevost, 2011). These findings have been supported by Evans & Donnelley (2006), stating that professional nurses develop international standards regarding the patient. These standards entail components of skill, knowledge, and judgment. Professional nurses more often assess patients and their families within a wider context via pattern recognition, incorporating both insightful and cognitive processes, unlike what the novice nurses do (Buerhaus et al, 2009). It is also noted that expert nurses are cited to consider a holistic method to their practice, as they grow salience sense that permits them to differentiate less significant information and tasks from the ones that are more significant. More currently, proficient nurses are described are clinically wise (Uhrenfeldt & Hall, 2007). Given the proof existing concerning the connection between quality of care and nurse experience, there is concern expressed about the figure of nurses that are experienced approaching the age of retirement and thinking about leaving the labor force (Chang & Daly, 2012). A reduction in the senior nurses’ number in healthcare is basis for concern, with respect to the knowledge and skills of care giving required for clinical care of present multifaceted, high acuity clients. Proficient nurses who leave the work arena leads to loss of knowledge that is experience-based, a circumstance that has threatening implications for care of patients (Bleich et al, 2009). Retention of experienced nurses and knowledge transition from generation to generation of nurses need to be addressed by nurse leaders (Hatcher et al, 2006). Nursing knowledge’s focus within the environment of health is shifting from a focus that is skill-based to a framework that is knowledge-based fostered by the utilization of science, evidence, and knowledge. Nurses are aware that they require ongoing education in order to fit in today’s swiftly changing environment. However, regularly they are not given support in acquiring the knowledge needed to keep on working (Coomber & Barriball, 2007). As a recommendation, new nurses should work together with their mentors in order to learn more. When fresh nurses are left to work alone especially in critical cases, a lot of errors that can be avoided are increased. Therefore, working together with their mentors is very imperative. This facilitates confidence development in one another as the starter grows into units within the hospital. Early during mentoring, the graduate nurse will require the mentor’s help more often (Buerhaus et al, 2009). This typically is in terms of help regarding patient care documentation or troubleshooting the technical technology. Even though it is important to look at the connection between quality care and proficiency in the practice of nursing , the available data have demonstrated already that experience years in nursing encourage proficiency and have positive impacts on the provide quality of care (Chang & Daly, 2012). It is hence imperative to devise and execute strategies to maintain nurses that are experienced in the workforce. The ANMC (2010) stipulates that RNs should delegate elements of care in accordance with role, capabilities, functions, and learning needs. This is important because a nurse who is inexperienced is able to decline tasks that are not within his or her scope of practice. This is done through raising concerns regarding inappropriate designation with the correct RN. Reference Australian Nursing and Midwifery Council. (2010). National Competency Standards for the Registered Nurse. Dickson ACT:Australian Nursing Council. Hill, K. (2010). Improving Quality and Patient Safety by Retaining Nursing Expertise. OJIN: The Online Journal of Issues in Nursing. 15(3). Aiken, L., Havens, D. & Sloane, D. (2009). The Magnet nursing services recognition program; a comparison of two groups of Magnet hospitals. JONA, 39(7/8), S5-S14. Dunton, N., & Montalvo, I., (Eds.). (2009). Sustained improvement in nursing quality: Hospital performance on NDNQI indicators, 2007-2008. Silver Springs, MD: American Nurses Association. Burritt, J., & Steckel, C. (2009). Supporting the learning curve for contemporary nursing practice. JONA, 39(11), 479-484. Evans, R., & Donnelley, G. (2006). A model to describe the relationship between knowledge, skill and judgment in nursing practice. Nursing Forum, 41(4), 150-157. Delunas, L., & Rooda, L. (2009). A new model for the clinical instruction of undergraduate nursing students. Nursing Education Perspectives, 30(6), 377-380. Pine, R., & Tart, K. (2007). Return on investments: Benefits and challenges of a baccalaureate nurse residency program. Nursing Economics, 25(1), 13-18. Orsolini-Hain, L. & Malone, R. (2007). Examining the impending gap in clinical nursing expertise. Policy, Politics & Nursing Practice, 8(3), 158-169. Uhrenfeldt, L., & Hall, E. (2007). Clinical wisdom among proficient nurses. Nursing Ethics, 14(3), 387-398. Bleich, M., Cleary, B., Davis, K., Hatcher, B., Hewlett, P., & Hill, K. (2009). Mitigating knowledge loss: A strategic imperative for nurse leaders. JONA, 39(4), 160-164. Hatcher, B, Bleich, M., Connolly, C., Davis, K., Hewlett, P., & Hill, K. (2006). Wisdom at work. Retrieved May 15, 2013 from www.rwjf.org/newsroom/newsreleasesdetail.jsp?productid=21894. Coomber, B., & Barriball, K. L. (2007). Impact of job satisfaction components on intent to leave and turnover for hospital-based nurses: A review of the research literature. International Journal of Nursing Studies, 44, 297-314. Carayon, P. & Alvarado, C. (2007). Workload and patient safety among critical care nurses. Crit Care Nurs Clin North Am, 8(5):395–428. Buerhaus, P., Staiger, D., & Auerbach, D. (2009). The future of the nursing workforce in the United States; Data, trends and implications, p. 210. Studbury, MA: Jones & Bartlett. Cowen, P. S., & Moorhead, S. (2011). Current issues in nursing. St. Louis, Mo: Mosby Elsevier. Levin, R. F., & Feldman, H. R. (2006). Teaching evidence-based practice in nursing: A guide for academic and clinical settings. New York: Springer Pub. Co. Hill, K. S., & Prevost, S. S. (2011). Magnet environments: Supporting the retention and satisfaction of nurses. Philadelphia, PA: W.B. Saunders/Elsevier. Burton, R., & Ormrod, G. (2011). Nursing: Transition to professional practice. Oxford: Oxford University Press. Chang, E., & Daly, J. (2012). Transitions in nursing: Preparing for professional practice. 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