2 paragraph article summary
This is a two paragraphassignment. In the first paragraph, present the main idea of the reading. Do this in two-three crystal clear sentences that are grammatically correct. Be sure to double space all academic writing. Also present the author and title early in your response.In the second paragraph, present a two-sentence direct quotation that supports the main idea. Introduce this quotation in your own words and follow the direct quotation with another sentence or two of additional analysis and commentary
May-June 2018 • Vol. 27/No. 3 199
Sonya Blevins, DNP, RN, CMSRN, CNE, is a Member of the MEDSURG
Nursing Manuscript Review Panel, Simpsonville, SC.
From Nursing Student to Registered
Nurse: The Challenge of Transition
M
aking the transition from nursing student to
registered nurse (RN) is an exciting yet over-
whelming time for new graduates. The new
role includes increased responsibilities and socialization
to the profession. Making the transition comes with var-
ious highs and lows, impacting the nurse’s confidence,
retention, and tenure in the profession (Maria, Mei, &
Stanley, 2017). Literature often reviews what healthcare
facilities need from new graduate nurses; however, it is
important to analyze what new graduate nurses need to
be successful in transitioning to their new role.
Why Should We Listen?
The nursing shortage is not improving. The need for
more nurses is growing, expected to persist through
2025 due to increased retirement of experienced nurses
and the number of aging patients requiring more com-
plex care (Kacik, 2018). The U.S. Bureau of Labor
Statistics (2017) projected 1.09 million nurses will be
needed by 2024 due to nursing replacement and health-
care growth.
Training of nurses is expensive, ranging from $37,700
to $58,400 per nurse. In some states, the range can be
higher (The University of New Mexico, 2016).
According to The University of New Mexico, 17.5% of
newly licensed nurses only work for 1 year while 43% of
newly licensed nurses leave the hospital within 3 years
of starting. Financially, this has a negative impact on
hospitals. Each year, the loss of these nurses costs hospi-
tals $5.2-$8.1 million. This attrition of newly licensed
RNs is not limited to the United States. Australia,
Canada, and the United Kingdom face the same issue
(Murray-Parahi, DiGiacomo, Jackson, & Davidson,
2016).
Promoting Success
Issues with successful transition to professional prac-
tice were identified in the 1970s. Kramer (1974) defined
the issue as reality shock, referring to the difference
between preparation in academia and integration into
practice (Ankers, Barton, & Parry, in press; Mellor &
Gregoric, 2016). More recently, the term as been rede-
fined as transition shock. While academia can prepare
students for some realities of practice, it cannot prepare
for all of them. Increased communication and partner-
ships between academia and hospitals can identify gaps
and develop plans to address them (Murray-Parahi et al.,
2016).
The transition from nursing student to RN is a grad-
ual process. Expertise in nursing comes over time. Upon
graduation, these nurses cannot simply hit the road
running. A transition period has to be allowed to pro-
mote success and retention in nursing (Mellor &
Gregoric, 2016). The transition process is facilitated by
two main concepts: structure and socialization (Ankers
et al., in press). Continuous support is needed as a part
of both concepts.
Structure
Throughout the United States, nurse residency pro-
grams have provided a structured approach to integrate
new RNs into the hospital as well as the nursing profes-
sion. In other countries such as Australia, they are called
transition programs (Ankers et al., in press). These pro-
grams enhance nurses’ critical thinking skills and pro-
mote a comradery among them as they go through the
same stress and emotions. Just as with simulation, resi-
dency programs provide a safe environment in which
nurses can share experiences and debrief (Mellor &
Gregoric, 2016). Nurses share experiences and ask for
guidance on how to handle unfamiliar situations.
Mellor and Gregoric suggested nurse residency educa-
tors role play situations and offer assistance in how to
best address them. By working with the nurses, educa-
tors also can increase their confidence in dealing with
unfamiliar situations.
Socialization
Working as an RN occurs in a much different envi-
ronment than college. New nurses thus need to be
socialized not only to the profession but also to their
clinical units. They are the most vulnerable during this
transition time. Without effective socialization, new
nurses may get discouraged, impacting their productiv-
ity and engagement in patient care. This discourage-
ment can cause them to leave the profession (Murray-
Parahi et al., 2016).
A support system is important. The unit nurse educa-
tor, preceptor, and fellow staff should be engaged in the
development of new nurses to promote their success.
New nurses feel comfortable in seeking advice from
individuals who demonstrate a level of caring and
approachability. When they have questions, new nurses
appreciate interaction and explanation of processes so
they can learn further. When these actions are done,
Nurses as
Educators Sonya Blevins
May-June 2018 • Vol. 27/No. 3200
new nurses believe they can become an effective part of
the team. In turn, their anxiety is reduced and their
engagement on the clinical unit increased (Ankers et al.,
in press).
One of the most difficult situations new nurses expe-
rience is lateral violence in the workplace. The notion
that some nurses eat their young may increase the anx-
iety of new nurses while making them feel isolated. New
nurses need to feel encouraged even if they make a
minor error. In handling these situations, the new nurse
critically needs the support of the unit nurse educator
and preceptor. If a positive relationship has been devel-
oped between new nurse and preceptor, the nurse will
feel comfortable in mentioning any situations where
lateral violence is occurring. The issue thus can be
addressed instead of being a constant problem in the
workplace (Leong & Crossman, 2015).
The Preceptor
An effective preceptor makes a tremendous difference.
When hiring a new graduate, the manager should select
as preceptor a nurse who has the desire as well as training
in effective methods of precepting. Consistency of pre-
ceptors is important because the new RN may train on
multiple shifts. When multiple preceptors are used, new
nurses may perceive they are being passed around with
no structure or consistency of guidance. Having assigned
preceptors allows the development of a relationship in
which the preceptor can assess the growth of the new
nurse over time and provide constructive feedback on
areas of strength and opportunity. The feedback should
be consistent, with areas of need identified early so cor-
rective training can occur (Mellor & Gregoric, 2016). In
this relationship, the preceptor builds the level of confi-
dence of the new nurse (Maria et al., 2017). Knowing the
areas of strength and opportunity allows the preceptor to
build the new nurse’s patient assignment gradually. The
acuity and number of assigned patients can be increased
as the new nurse achieves specific orientation milestones
(Ankers et al., in press).
Conclusion
As a new RN enters practice, a great deal of transition
occurs during acclimation to the profession. Hospital
leaders must understand the needs of these nurses so
the orientation provides a positive environment of
growth and development. Benefitting from structure
and an effective support system, new nurses have the
resources to be successful (Phillips, Kenny, & Esterman,
2017). Not only does this further their growth, but it
enhances the function of the clinical unit.
REFERENCES
Ankers, M.D., Barton, C.A., & Parry, Y.K. (in press). A phenomenological explo-
ration of graduate nurse transition to professional practice within a transition
to practice program. Collegian, 1-7. doi:10.1016/j.colegn.2017.09.002
Kacik, A. (2018). Nursing shortage will continue to pinch hospital margins.
Retrieved from http://www.modernhealthcare.com/article/ 20180307/
NEWS/180309921
Nurses as Educators
Kramer, M. (1974). Reality shock: Why nurses leave nursing. Philadel phia, PA:
Mosby.
Leong, Y.M.J., & Crossman, J. (2015). New nurse transition: Success through
aligning multiple identities. Journal of Healthcare Organi zation and
Management, 29(7), 1098-1114.
Maria, H.S.Y., Mei, W.L., & Stanley, L.K.K. (2017). The first year of professional
nursing experience: The transition challenges faced by new graduate nurs-
es. Paper presented at Global Healthcare Conference, New York, NY.
Mellor, P., & Gregoric, C. (2016). Ways of being: Preparing nursing students for
transition to professional practice. Journal of Continuing Nursing Education,
47(7), 330-340.
Murray-Parahi, P., DiGiacomo, M., Jackson, D., & Davidson, P.M. (2016). New
graduate registered nurse transition into primary health care roles: An inte-
grative review. Journal of Clinical Nursing, 25(21-22), 3084-3101.
Phillips, C., Kenny, A., & Esterman, A. (2017). Supporting graduate nurse transition
to practice through a quality assurance feedback loop. Nurse Education in
Practice, 27, 121-127.
University of New Mexico. (2016). The high cost of nurse turnover. Retrieved from
https://rnbsnonline.unm.edu/articles/high-cost-of-nurse-turnover.aspx
U.S. Bureau of Labor Statistics. (2017). Employment projections 2016-26.
Retrieved from http://www.bls.gov/news.release/pdf/ecopro
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