New Graduate Nursing: transition process

ESSAY ON ISSUE ENCOUNTERED BY A GRADUATE NURSE IN TRANSITION Name of the Student: Date: INTRODUCTION (100 words) The transition process for every graduate nurse is a period characterized by transitional based issues and a variety of difficulties (Casey, et.al 2004). It is therefore important to understand the various aspects of the transition process in nursing, and the difficulties encountered by graduate registered nurses as they enter the work force (Chang & Hancock, 2005). This essay will define, describe from literature, justify selection, discuss the impact, and show how therapeutic relationships, leadership and professional boundaries as issues encountered by graduate nurses during transition, influence their transition. It will also illustrate importance of these issues later in the profession. BODY Therapeutic Relationships (604 words) Step 1 (163 words) From my critical reflections, I have chosen therapeutic relationships since nurse client relationships lay the foundation of nursing. The National Council of State Boards of nursing defines therapeutic relationships as a continuum of professional behavior that has a zone of under involvement, to a zone of helpfulness, and an extreme of over involvement (Peternelj, 2002). Justification of the selection of therapeutic relationships is that the restructuring of the health care system has resulted in the removal of elements that support therapeutic relationships. The restructuring has led to replacement of non professionals with regular health care provider, decreased support mechanism, and decreased nurse educators. This has led to the graduate nurse sense of emotional burnout, translating to decreased nurse and patient satisfaction (Aiken et al., 2001). It has also led to decreased quality of care (McGillis Hall et al., 2001). This necessitates for me as a graduate nurse to learn how to develop therapeutic relationships, so as to shield myself from the adverse outcomes. Step 2 (271 words) 5 journals used Importance of therapeutic relationships in nursing has been cited as a key to balance the emphasis on communication technical skills (Chant et al., 2002). Graduate nurses in transition ought to use their therapeutic relationships as a key attribute of relating professionally with their patients (McQueen 2000). For a nurse client relationship to be therapeutic, it must encompass: trust (Belcher & Jones, 2009), empathy, respect, professional intimacy, and power. Graduate nurses should move towards establishing trust in their patients, and keep it strong as breeched trust is had to replace. Respect entails the graduate nurses realizing the uniqueness, worth and dignity of their patients, regardless of their patients` socio economic class. Professional intimacy entails the graduate nurses` access to patients` personal health information, and performance of procedures like bathing, psychological acre, and spiritual care. Power should be used by the graduate nurse in a caring manner, should not be abused, and its main goal should be to meet the needs of the client. Empathy entails understanding, validating and reasoning with the patient, it means the graduate nurses should emotionally distance themselves from their patients for therapeutic relationships to be effective (Registered Nurses` Association of Ontario, 2006). However, research has shown that new graduate nurses face complex challenges in building therapeutic relationships with their clients. This is since they perceive themselves as not yet having the enough confidence in establish a confidential therapeutic relationship with the patient (Belcher & Jones, 2009). Consequently, some nursing procedures entail relating professional intimately with the patient; other patients suffer from extensive illnesses, challenging the new graduate nurses to provide care without sympathy which evidences emotional attachment (Moyle, 2003). Step 3 (148 words) Understanding therapeutic relationships will enhance my transition and also assist me in the future path of my career since it will enable me to take care of the patients professionally, empathising with them and not sympathising with them (Moyle, 2003). Moreover, therapeutic relationship has taught me to respect my patients regardless of their background status, for optimal patient care. Determination of appropriateness of an activity is evidenced in Appendix A. In addition, therapeutic relationships will help me as a graduate nurse to always work within the zone of helpfulness (Fischer et al., 2008) and not to be in the over involvement zone. This is since research has evidenced that majority of new graduate nurses work in the over involvement zone as they always feel it would be unprofessional not to adhere to the call of the patient, hence go beyond their means to help (Cheeks & Dunn, 2010). Leadership (625 words) Step 1 (195 words) I have chosen leadership as my second issue since graduate nurses in transition have reported encountering more responsibility and accountability for patient care, a scenario which was not anticipated (Etheridge, 2007; Duchscher, 2008). Leadership is defined as the process which involves influence, attainment of a goal, occurs in a group setting, and exists at all levels (Faugier & Woolnough, 2002). Leadership in nursing is described as an attitude that invokes behaviour, and a nurse leader is anyone who is involved in direct patient care and by continuously influencing others, improves patient care (Cook, 2001). Good leadership empowers all the staff in decision making, allowing them to work together for the benefit of the optimal care of the patient (Scott & Caress, 2005; Wong & Cummings, 2007). I justify the selection of leadership since leadership skills are needed by all nurses in their diverse capacities. Any nurse, who is looked at as an authority figure, or who others consider responsible for giving assistance, is regarded as a leader (Mahoney, 2001). For graduate nurses in transition to be good leaders, they must act as visionaries and help others plan, organise, lead, and control their activities (Jooste, 2004). Step 2 (278 words) 4 journals used It is important for leaders to empower team members by allowing them to lead in their areas of expertise. Graduate nurses as leaders should also explore barriers and manage conflicts when they arise, by working collaboratively with other team members. Consequently, by the remaining as part of the team, they will be in a position as leaders to understand their team players perspectives, hence optimal patient care (Outhwaite, 2003). Graduate nurses in transition should use the transformational leadership style since it allows for; innovation in problem solving, instilling faith and respect, treating patients as individuals, provision of challenging goals, transmission of ethical principles and values, and at the same time communicating the future vision (De Geest, et al., 2003). By the graduate nurses utilizing this leadership style, it has been reported to translate to enhance employee satisfaction and better performance, translating to higher patient satisfaction (De Geest, et al., 2003). Consequently, leadership is an important ingredient for the graduate nurse in transition since transformation leadership style promotes empowerment among nurses as they are in a position to believe in their capability to create and adopt to change (Hyett, 2003). However it is important for the graduate nurses in transition with leadership positions to ensure that they set boundaries, goals, support services and accountability for their team members (Hyett, 2003). The transitional graduate nurses with leadership positions should also balance the use of power in a democratic way, so as mot to create the impression of abuse of power. This is since it is important for the graduate transitional nurses to understand that respect and trust of the staff is very important for leadership to be successful (Welford, 2002). Step 3 (152 words) The understanding of leadership will help me as a graduate nurse during the transition process and later in my career since good leadership empowers all the staff in decision making, allowing them to work together for the benefit of the optimal care of the patient (Scott & Caress, 2005; Wong & Cummings, 2007). Moreover, the good leadership that I will exhibit during transition and later in the profession, will lead to increased morale, increased motivation, increased sense of worth, coupled with creativity and encouragement, culminating to job satisfaction among the staff I lead(Scott & Caress, 2005). Consequently, my leadership skills will influen...