Supporting New Graduates through their Transition -Angela Peterson BSN, RN

Introduction Transitioning from nursing school to being a new graduate nurse is a big adjustment Nursing students learn in a supportive conducive environment geared towards new nurses, allowing for growth, encouragement, and positive feedback Nurses transition from having a knowledgeable mentor to making decisions on their own (Van Patten, 2014) Nursing involves combining book knowledge with hands on experiences, these skills may take time to develop

Introduction Cont. When nurses graduate they receive brief training by their employer and an experienced nurse but are quickly on their own to make critical decisions and provide care With the combination of higher acuity patients being in the hospital and the shortage of nurses, orientations for new grads is shorter and nurses are on their own quicker (Dyess & Sherman, 2009) It is easy for new nurses to often feel overwhelmed, stressed, and worried about making the wrong decisions. Low self-esteem and confidence can stem from a lack of organization and competence (Van Patten, 2014) Image retrieved November 15, 2016 from : http://www.emergingrnleader.com/what-new-graduates-need-from-their-nurse-leaders

Introduction Cont. It is imperative for new nurse grads to receive proper training and support as they transition from nursing students to being on their own Utilizing a preceptor or mentor has proven to increase important skills such as communication, leadership, organization, and critical thinking (Van Patten, 2014) New grads need to feel comfortable asking questions and feel a sense of support and community in their work environment

Literature Review New grads are not receiving the support and training that they need to properly transition as new nurses (Mellor & Gregoric, 2016). New nurse grads struggle with trying to accomplish everything, Mellor and Gregoric (2016) emphasized the importance of emotional competence and self-regulation through reflection to help prioritize care Many new grad programs currently range from 3-6 months, longer programs are encouraged as they promote development and growth as a nurse (Dyess & Sherman, 2009)

Literature Review Many new nurses leave their place of employment due to job dissatisfaction (Andrews, 2013). Teamwork is an important concept that has increased job satisfaction especially among millennials New nurses experience an array of emotions upon beginning their nursing career, ranging from excitement to stress (Andrews, 2013). Caring for multiple patients at once, being independent, interacting with families/health care providers, and limited amount of practice experience can affect new nurses stress and anxiety about their new jobs (Andrews, 2013). Image retrieved November 15, 2016 from : https://www.google.com/search?q=nursing+books&source=lnms&tbm=isch&sa=X&ved=0ahUKEwiK-ML1lazQAhXCOSYKHf1fCS4Q_AUICSgC&biw=1366&bih=659#imgrc=oNhz_nHpLK6PYM%3A

Literature Review With the shortened time between graduation, taking licensure exam, and beginning working as a nurse, nurses are responsible for patient care sooner than in the past (Sherman, 2011). Many of the struggles of a new nurse is a lack of professional confidence, horizontal violence, and feelings of isolation (Sherman, 2011). Image retrieved November 5, 2016 from: https://www.google.com/search?q=nurse+isolation&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjqysqfmKzQAhUL0WMKHZUFBDMQ_AUICCgB&biw=1366&bih=659#tbm=isch&q=nurse+stress&imgrc=R1qRn-x55LbfCM%3A

Image retrieved November 15, 2016 from: https://www.google.com/search?q=nursing+books&source=lnms&tbm=isch&sa=X&ved=0ahUKEwiW7oimg6zQAhVFbSYKHfMRCJ4Q_AUICSgC&biw=1366&bih=659#tbm=isch&q=henry+ford+quote+coming+together+is+a+beginning&imgrc=c6grmuzSaYzcbM%3A

Implications for Nursing Leaders It is important that new grads receive support from nursing leaders, allowing them to be supported, empowered, and engaged (Mellor & Gregoric, 2016) Leaders need to learn about their new employees and may have to adjust mentor programs or orientation programs to ensure optimal learning of new employees (How to effectively manage, 2015). It is important to create a comfortable environment and for leaders to be approachable, this will allow new hires to thrive, seek answers, and discuss apprehensions (How to effectively manage, 2015). “Flipping” the classroom, where students complete assignments prior to class, has been proven beneficial in allowing nurses to apply facts in real scenarios (Billings, 2016). This allows students to apply what they have learned in a controlled environment and it encourages teamwork and provides timely feedback (Billings, 2016) Image retrieved November 15, 2016 from : https://www.google.com/search?q=nursing+leader&source=lnms&tbm=isch&sa=X&ved=0ahUKEwj5m_fJlazQAhUW5GMKHfIQAq4Q_AUICCgB&biw=1366&bih=659#imgrc=1EsC0CgFfZOCDM%3A

Implications for Nursing Leaders Nursing leaders should help coach and mentor their new grads. Transition to practice programs allows nurses to develop critical thinking skills, decrease risk to patients, and help new grads transition into their role as a nurse (Marquis & Huston, 2015). It is important for nursing leaders to continue to oversee new hires during and after their orientation period, this can be done by (Sherman, 2011): Managing assignments Selecting preceptors that enjoy teaching and are supportive Monitoring for horizontal violence Being approachable Ensuring that education and training requirements are met

Implications for Nursing Leaders Retention of new nursing grads can save health care facilities a lot of money, stressing the importance for nursing leaders to have structured management, a supportive environment, and clear expectations (Andrews, 2013). It is important for nursing leaders to be approachable and encourage nurses to seek answers and discuss concerns (Sherman, 2011). Having an extended nurse transition program can improve nurses self esteem, promote teamwork and unity, and increase patient care Image retrieved November 15, 2016 from: https://www.google.com/search?q=nurse+leader&source=lnms&tbm=isch&sa=X&ved=0ahUKEwiZsoenlqzQAhUW12MKHe5QAU4Q_AUICCgB#tbm=isch&q=nursing&imgrc=HFoNPmGqb0oehM%3A

Image retrieved November 20, 2016 from: https://www.google.com/search?q=john+quincy+adams-+if+your+actions+inspire+others+to+dream+more&source=lnms&tbm=isch&sa=X&ved=0ahUKEwiliMSJzbjQAhUB7iYKHUdNC2QQ_AUICCgB&biw=1366&bih=659#imgrc=xT8YejMFvjBRcM%3A

References Andrews, D. R. (2013). Expectations of millennial nurse graduates transitioning into practice. Nursing Administration Quarterly, 37(2), 152. Billings, D. M. (2016). ‘Flipping’ the classroom. AJN, American Journal of Nursing, 116(9), 52-56. doi:10.1097/01.NAJ.0000494696.86240.35 Dyess, S. & Sherman, R. (2009). The first year of practice: New graduate learning needs and transition experiences. Journal of continuing education in nursing. 40 (9), 403- 409. How to effectively manage recent college grads. (2015, October 02). Retrieved November 15, 2016, from http://www.situationmanagementsystems.com/blog /index.php/leadership/how-to-effectively-manage-recent-college-grads/

References Cont. Marquis, B. L. & Huston, C.J. (2015). Leadership roles and management functions in nursing: Theory and application (8th Edition). Hagerstown, MD. Lippincott Williams & Wilkins. Mellor, P., & Gregoric, C. (2016). Ways of being: Preparing nursing students for transition to professional practice. Journal of Continuing Education in Nursing, 47(7), 330-340. doi:10.3928/00220124-20160616-10 Sherman, R. (2011, December 19). What new graduates need from their nurse leaders. Retrieved November 15, 2016, from http://www.emergingrnleader.com/what-new- graduates-need-from-their-nurse-leaders/ Van Patten, R. R. (2014). Mentorship, preceptors, and debriefing: Quintessential support for new nursing graduates in transition