A novice nurse is someone who lacks experience and operates by closely following the rules and orders of others. The transition from the comforts of the academic world to being part of the workforce is most challenging to the life of a fresh graduate. Professional confidence is an essential trait that one must possess to provide the best and quality care to patients. However, being a new and inexperienced makes you doubt yourself and question your skills and capabilities. “Am I doing the right thing?”, “Did I accomplish what I should be doing?”, “Am I providing the best care for my patient?”. These are the questions that run through a nurses head. A feeling of assurance and believing in one’s ability may appear to be a challenge especially for a fresh graduate. This paper will discuss the various experiences, challenges, interventions and resolutions nurses must do to gain professional confidence.
The transition from being a student to a working registered nurse is a struggle and a major stressor. Putting into practice everything you have learned in school is a struggle for most individuals. According to Kramer’s Theory of Reality Shock (1974) who coined the term Reality shock, “the transition process is divided into four phases: honeymoon phase which is a period of excitement with the enthusiasm to learn, followed by shock phase which is the most vulnerable stage”. During this time, the job responsibilities begin to sink in and the nurse is in a negative state and at risk to leave, quit or burnout. Next is the recovery phase wherein it begins to shift the positive side. The nurse is able to look at all sides and realize the job realities are eased with them at ease with their roles and responsibilities and with a more open outlook, and lastly, resolution phase where the nurse can see the role in perspective and fully contributes to the profession. (Guinan, 2016, Kramer 1974). A study reveals the seven key themes that provided an understanding of new graduate nurses’ experiences on what accounted for their lack of professional confidence. These are communication is vital at work, making mistakes, difficulty to separate school learnings and practice, independence, ability to build relationships, positive feedback is important, and gaining experience. (Ortiz, 2016). These various factors greatly affect an individual’s daily work. The shortage of nurses in the United States is making it more difficult for nurses because this resulted in rapid transition into the workforce (Mesmer, 2004). Additionally, the amount of workload, socialization with health care members and bullying results in burnout of most new nurses (Floyd, 2015). These conditions have a great impact on nurses and as a consequence they develop high levels of stress, anxiety and low self-confidence.
Identifying these concerns and addressing would significantly aid the nurse to gain knowledge, confidence and skills. The role of the academe is critical. Providing knowledge and skills, at the same time, exposing students to simulation and clinical setting situations helps them prepare to enter the workforce. Conducting orientation programs can definitely influence the new graduates by decreasing turnover, providing social support, and by preparing more skilled nurses (Chappell, 2014). Providing nurses information with work policies and regulations through lectures and seminars, laying out practical guidelines on the job, and as a professional contributes to the development of self-confidence. The National Council of State Boards of Nursing (2018) provided guidelines to nursing boundaries. This offers new nurses’ knowledge how to act professionally in dealing with patients, the implications of professional boundaries, the consequences if that boundary is crossed, professional sexual misconduct, and including the use of social media. Furthermore, the American Nurses Association, framed the Code of Ethics for nurses which laid out the responsibilities of nurses and the importance accountability for every action they make, as well as promoting professional growth and preservation of the integrity and moral values. It is imperative that that the nurse is aware of the Nurse Practice Act of each state which defines the scope of practice in full detail and a source of legality issues for nurses. the importance of knowing HIPAA, Health Insurance Portability and Accountability Act regulations for the protection of patient’s confidentiality.
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Ultimately, the nurse’s transition into the workforce pose a great challenge for novice nurses. The struggle of putting all learnings into practice is a major stressor to most nurses. providing new nurses with knowledge, information, seminars, lectures and guidance will help them improve their skills and capabilities. This issue is very relevant for our nurses today because they are responsible and accountable for their client’s life. Failure to do so will imply unfavorable consequences. That is the reason why education, experience, guidance and support is important to hone your skills and capabilities and gain professional confidence.
