Assignment: Transition Experiences of Nurses as Students and New Graduate Nurses

Assignment: Transition Experiences of Nurses as Students and New Graduate Nurses ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Assignment: Transition Experiences of Nurses as Students and New Graduate Nurses I need an explanation for this Health & Medical question to help me study. Assignment: Transition Experiences of Nurses as Students and New Graduate Nurses You will be answering the Research Design and the Sample and along with all their questions in that section ONLY from the Qualitative Critique document. These answers you would find in the article i attached below. Answers must be in own words and worth 10 points so answer the question throughly. group_6_nurse_residency_program_qual.pdf nsg_3036_qualitative_critique.docx Journal of Professional Nursing 36 (2020) 69–75 Contents lists available at ScienceDirect Journal of Professional Nursing journal homepage: www.elsevier.com/locate/jpnu Transition experiences of nurses as students and new graduate nurses in a collaborative nurse residency program T Melinda M. Wildermutha, , Ann Weltinb, Andrea Simmonsb ? a b Trinity College of Nursing & Health Sciences, 2122 25th Avenue, Rock Island, IL, USA Clarke University, 1550 Clarke Drive, Dubuque, IA, USA ARTICLE INFO ABSTRACT Keywords: Nurse residency program Preceptor New graduate nurses Transition Clinical immersion experience Orientation Background: A small Midwestern college of nursing and an affiliate hospital partnered to design a nurse residency program where students are extended pre-hire job offers in a practice area of their choice and are then partnered with a preceptor who they will work with in a clinical immersion experience during the last semester of their nursing program and in their orientation period as new nurses. Purpose: The purpose of this qualitative, phenomenological study was to explore the lived experiences of a cohort of nurses as students and new graduate nurses during transition in this collaborative nurse residency program. Method: A transcendental phenomenological qualitative approach using Meleis’ Transition Experience Theory as a theoretical framework is used for this study. Results: Themes of feeling overwhelmed, supported, and confident were identified. Assignment: Transition Experiences of Nurses as Students and New Graduate Nurses A finding unique to the literature and this nurse residency program model is a theme of overwhelming support. Conclusions: This information can be used to improve the nurse residency program and its outcomes and also further the advancement of nursing knowledge of the transition experience of new nurses. Introduction The transition experience from student nurse to new graduate nurse is both exciting and challenging. Intrapersonal, interpersonal, and organizational factors can positively and negatively influence the transition experience (Dwyer & Revell, 2016). The extent to which these factors positively or negatively influence the transition experience determines the outcome of the transition. A desirable outcome is successful transition into practice in which new graduate nurses are engaged, satisfied, feel empowered, have a high level of organizational commitment, and are confident (Dwyer & Revell, 2016; Steen, Gould, Raingruber, & Hill, 2011). This ultimately leads to retention of new graduate nurses (Twibell & St. Pierre, 2012). An undesirable outcome is one in which new graduate nurses feel emotionally exhausted, unable to meet the demands of the job, unable to provide safe care, and unsupported (Laschinger, Grau, Finegan, & Wilk, 2012; Twibell & St. Pierre, 2012; Unruh & Nooney, 2011). Assignment: Transition Experiences of Nurses as Students and New Graduate Nurses This ultimately leads to new graduate nurse turnover (Twibell & St. Pierre, 2012). Nurse residency programs are a key strategy to support positive and successful transition into practice. A small Midwestern college of nursing and an affiliate hospital partnered to design a nurse residency ? program that begins with student nurses in a clinical immersion experience during their final semester of nursing school and continues through entry into practice. Students are extended pre-hire job offers in a practice area of their choice and are then partnered with a preceptor who they will work with in their clinical immersion experience and in their orientation period as new nurses. Purpose The purpose of this phenomenological study is to explore the lived experiences of a cohort of nurses as students and new graduate nurses during transition in this collaborative nurse residency program. Through understanding transition experience, properties of transition and factors that facilitate and/or inhibit transition can be identified. This information can be used to improve the nurse residency program and its outcomes of new nurse satisfaction, retention, and clinical competence, and also further the advancement of nursing knowledge of the transition experience of new nurses. Corresponding author at: 503 Richmond Hill Drive, Geneseo, IL 61254, USA. E-mail address: [email protected] (M.M. Wildermuth). https://doi.org/10.1016/j.profnurs.2019.06.006 Received 10 November 2018; Received in revised form 2 June 2019; Accepted 7 June 2019 8755-7223/ © 2019 Elsevier Inc. All rights reserved. Journal of Professional Nursing 36 (2020) 69–75 M.M. Wildermuth, et al. Theoretical framework being in a desired position (Bratt & Felzer, 2012); experiencing authentic leadership (Read & Laschinger, 2015); possessing advanced social skills (Niitsuma, Katsuki, Sakuma, & Sato, 2012); preceptor support (Thomas et al., 2012); a good orientation program (Park & Jones, 2010); supportive professional practice environments (Laschinger et al., 2012); healthy practice environments (Kramer, Halfer, Maguire, & Schmalenberg, 2012); and empowerment (Wing, Regan, & Laschinger, 2015). Assignment: Transition Experiences of Nurses as Students and New Graduate Nurses Internships have also been shown to be facilitators of transition specifically through knowing the unit staff and routines (Steen et al., 2011). Psychological capital (PsyCap) is an important facilitator of transition first identified by Luthans and studied extensively in the context of new graduate nurse transition by Laschinger. PsyCap is defined as: Transition is defined as “a passage from one fairly stable state to another fairly stable state, and is a process triggered by a change” (Meleis, 2010, p. 11). Individuals typically proceed through stages, achieving milestones and experiencing defining moments that foster the development of a new identity. Meleis considers transition to be a central concept in nursing and the transition experience a middle-range theory. Transitions have five essential properties: awareness, engagement, change and difference, time span, and critical points and events (Meleis, 2010). Awareness involves knowing that a transition is occurring. Levels of awareness vary between individuals experiencing transition; additionally transitions can occur without awareness. Engagement is the degree to which the individual is involved in the process. The level of awareness influences the level of engagement and engagement cannot occur without awareness. Just as levels of awareness vary, levels of engagement vary. Change and difference are integral to transition but they are not interchangeable and not always related to transition. Change can bring about transition, and transition can bring about change, but not all change is related to transition. Assignment: Transition Experiences of Nurses as Students and New Graduate Nurses Difference can be viewed as the disjuncture between expectations and reality. How an individual perceives difference can sometimes result in change and affects the way in which individuals deal with change. Time span is the period of transition which has no defined boundaries of beginning and end points, but flows and moves over time. Critical points and events can be specific and identifiable or they can be subtle. They mark periods of transition which are affected by levels of awareness, engagement, change and difference. Symptoms can also be related to transition, such as anxiety and uncertainty (Meleis, 2010). Transition can be facilitated or inhibited by personal, community, or societal conditions (Meleis, 2010). Personal conditions include meanings, cultural beliefs and attitudes, socioeconomic status, and preparation and knowledge. Community conditions include resources and support from both family and friends and trusted health care providers. Societal conditions include stigma and stereotype. The outcome of the transition is dependent on the extent to which these conditions facilitate or inhibit transition. Health and perceived well-being is the desirable outcome of transition. Patterns of response include process indicators and outcome indicators (Meleis, 2010). Process indicators inherent to a desirable outcome include the need to feel and stay connected, interacting with others within the same transition, location and being situated which involves comparing the old with the new and in turn creating new meanings and perspectives, and developing confidence and coping. Assignment: Transition Experiences of Nurses as Students and New Graduate Nurses Outcome indicators include mastery of new skills needed to manage new situations and environments, and development of a fluid, dynamic identity. The Transition Experience theory applies to new graduate nurses as they transition from students to practicing nurses and can inform the outcome of this transition through identification of conditions that inhibit or facilitate transition and patterns of response. An individual’s positive psychological state of development that is characterized by: (1) having confidence (efficacy) to take on and put in the necessary effort to succeed at challenging tasks; (2) making a positive attribution (optimism) about succeeding now and in the future; (3) persevering toward goals and, when necessary, redirecting paths to goals (hope) in order to succeed; and (4) when beset by problems and adversity, sustaining and bouncing back and even beyond (resilience) to attain success (Youssef-Morgan and Luthans, 2015, p. 181). PsyCap has been found to be associated with authentic leadership and may provide a protective effect for new graduate nurses against burnout (Laschinger et al., 2016). Preceptors with authentic leadership skills can help to build PsyCap within new graduate nurses which in turn can sustain them in times of stress and enables them to use proactive strategies to solve problems (Laschinger et al., 2016). Studies have also identified inhibitors to transition. Unruh and Nooney (2011) identified one of the few demographic inhibitors as level of education; the higher the level of education the higher the perception of job difficulties and the lower the perception of job control. Incivility and workplace bullying are strongly related to emotional exhaustion and poor mental health in new graduate nurses (Laschinger et al., 2012; Wing et al., 2015).Assignment: Transition Experiences of Nurses as Students and New Graduate Nurses Lack of unit resources, increased workload and numbers of patients, not having worked 12 h shifts or as a member of the team, and inexperience with working with physicians were identified as inhibitors to transition by Thomas et al. (2012). While internship can be a facilitator of transition it can also serve as an inhibitor of transition. New graduate nurses working on the same unit they interned on felt more pressure from management to perform compared to nurses who did not intern on the same unit (Steen et al., 2011). A large study by Laschinger et al. (2016) investigated factors influencing new graduate nurses’ successful transition into their full professional role in Canadian hospitals. They found that cynicism is a significant negative predictor in new nurses’ job career satisfaction and turnover intentions. Cynicism and emotional exhaustion are both components of burnout, and cynicism had the strongest relationship with all of the outcomes (Laschinger et al., 2016). Just as PsyCap has been identified as a facilitator of transition, when PsyCap reservoirs are low cynicism develops (Laschinger et al., 2016). Patterns of response to transition can be either positive or negative. Process indicators inherent to a positive outcome cited in the literature include mastery of environment (Steen et al., 2011); feeling valued by colleagues, patients, and supervisors (Clark & Springer, 2012); confidence in performing nursing tasks and interacting with patients and families (Steen et al., 2011); work engagement, enhanced performance, and retention (Laschinger et al., 2012); positive relationships at work, a sense of belonging and fitting in (Read & Laschinger, 2015; Thomas et al., 2012); and empowerment and organizational commitment (Wing et al., 2015). Negative process indicators include burnout (Laschinger et al., 2012, 2016; Wing et al., 2015); intention to leave (Laschinger et al., 2012, 2016; Wing et al., 2015); and poor mental health (Laschinger et al., 2012; Wing et al., 2015). Assignment: Transition Experiences of Nurses as Students and New Graduate Nurses Kumaran and Carney (2014) identified positive patterns as initial feelings of excitement, Literature review Previous studies have shown that new graduate nurses experience a myriad of feelings and emotions during the transition period. Thomas, Bertram, and Allen (2012) identified that new nurses feel overwhelmed, frustrated, stressed, rushed, unsupported, and fearful of physicians or making a mistake. Clark and Springer (2012, p. e4) describe a theme called “rhythm in the chaos” and identify feelings of being unable to keep up with the pace. Clark and Springer (2012, p. e4) also identify a theme of “feeling valued” with subthemes of being valued by the team, making a difference in patients’ lives, gaining experience and expertise, and working with supportive preceptors. Many studies have identified facilitators of transition including 70 Journal of Professional Nursing 36 (2020) 69–75 M.M. Wildermuth, et al. visibility as a team member, and mounting confidence as new nurses with negative patterns of anxiety, stress, and the burden of responsibility which eventually was recognized as a positive pattern of professional responsibility. Nurse residency programs are a key strategy to support positive and successful transition into practice. Recommended by the National Academy of Medicine (formerly Institute of Medicine), National Council of State Boards of Nursing, and the Commission on Collegiate Nursing Education, key components of nurse residency programs include clinical coaching by a dedicated preceptor, evidence based classroom curricula with direct linkage to clinical experiences, high fidelity simulation, experiences in organizational committees; support of peers and nurse leaders, and professional socialization and opportunities for development (Twibell & St. Pierre, 2012). Assignment: Transition Experiences of Nurses as Students and New Graduate Nurses The primary goal of nurse residency programs is to provide support for new nurses so that they can develop clinical skills to provide safe, competent care. A successful transition, however, requires development in additional areas such as communication, professionalism, dealing with incivility, teamwork, change, stress management, and adapting to the role of a professional nurse (Clark & Springer, 2012). Nurse residency programs can significantly reduce turnover and burnout and can also positively impact nurse competencies, job satisfaction, self-confidence and group cohesion (Pittman, Herrera, Bass, & Thompson, 2013). While there is much research on new nurse transition and nurse residency programs, most research has been conducted post-licensure as nurses have entered into practice. Few qualitative studies have captured the lived transition experiences of nurses as students and as new graduate nurses. The collaborative nurse residency program is a unique model. It is important to address transition experiences of new graduate nurses in different contexts to fully understand the essence and meaning of the transition experience. collaborative nurse residency program cohort were invited by letter and email to participate in this study. Inclusion criteria included participation in the clinical immersion experience and in orientation on the same unit. Nurses in this sample had been in practice for one year and had just completed the nurse residency program. Nine responded to the invitation and participated in interviews.Assignment: Transition Experiences of Nurses as Students and New Graduate Nurses The sample was a convenience sample determined by the number of nurses willing to participate in the study. Protection of human subjects Institutional Review Board approval was obtained from the affiliate hospital where the nurses were employed as well as the academic organization where the researcher was completing doctoral work. The Institutional Review Board from the affiliate hospital specifically asked how the identity of the nurses would be protected and how the comments would be used. The consent form stated that names would not be used but with permission anonymous quotations may be used which would be general in nature and would not specifically identify the nurse. Because nurses were employed at the affiliate hospital it would be important for them to feel that participation in the study would not jeopardize their position. Interviews were conducted in private and were taped and stored in a password protected file. Data collection The principle researcher interviewed all of the subjects. The interviews lasted from 45 to 90 min. They were all face to face in a private room at the college of nursing which was identified in the invitation to interview and the consent form. One question was asked during the interviews: “What are your transition experiences as a student and a new graduate nurse in the collaborative nurse residency program?” Participants were allowed to simply talk about their transition experiences without the addition of any new questions from the researcher. Assignment: Transition Experiences of Nurses as Students and New Graduate Nurses Questions such as “I want to make sure I understand what you have just said” and open ended questions such as “tell me more” were used to clarify and facilitate conversation. Methodology Research question The research question is “What are the transition experiences of nurses as students and new graduate nurses in a collaborative nurse residency program?” Data analysis Research design Interview transcriptions were highlighted for significant statements (horizonalization) and a list of nonrepetitive, nonoverlapping statements was developed. Significant statements were grouped into themes. Textual descriptions of what the participants experienced (textual description) and how the experience happened (structural description) were written. Finally, both the textual description and structural description were used to develop a composite description of the phenomenon (Creswell, 2013). A qualitative, transcendental phenomenological approach was chosen because understanding the lived experiences of nurses in transition can help to define the meaning and essence of transition, which in turn informs nursing practice in the development of strategies to support new nurses in transition. Based on Husserl’s theory that human consciousness actively constitutes objects of experience, Moustakas (1994) describes this type of phenomenology as viewing the phenomenon with a fresh perspective and open mind, resulting in the acquisition of new knowledge derived from the essence of experiences. This method also “places emphasis on bracketing out preconceptions and developing universal structures based on what people experience and how” (Creswell, 1994, p. 54) Because the researcher was involved in the administration of the collaborative nurse residency program, this approach was used because there was unique potential for preconceptions that could result in bias. Assignment: Transition Experiences of Nurses as Students and New Graduate Nurses It was important for the researcher to reflect extensively on her thoughts, feelings, and experiences with transition in nurse residency programs in writing and bracket these in order to identify biases and evaluate openness to engage in conversation with others about their transition experience (Creswell, 2013, p. 80). Validation strategies Clarifying researcher bias The researcher reflected extensively on thoughts, feelings, and experiences with transition in nurse residency programs using bracketing to identify biases. Prolonged engagement The researcher has established a relationship with participants through administration of the academic portion of the nurse residency program and has built trust through engagement and support. Triangulation and crystallization Triangulation was completed through the use of a variety of data sources, investigator review, comparison with Meleis’ theory and information from the literature, and method triangulation. The researcher used also used journaling, which has connections to the arts and Sample Fifteen new graduate nurses who are members of the first 71 Journal of Professional Nursing 36 (2020) 69–75 M.M … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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