Critical Analysis of Clinical and Non-Clinical Challenges Faced by Transitional Nurses

This study identifies the clinical and non-clinical problems that arise in the transition phase of nursing. Management and importance of the clinical and non-clinical problems are discussed in the study. Different theoretical approaches to learning are also mentioned in the study. A self-reflection is present that depicts a personal point of view. The summary of the points is mentioned in the conclusion.

PROFESSIONAL NURSE

Table of Contents
Introduction......................................................................................................................................2
Critical analysis...............................................................................................................................2
Discussion........................................................................................................................................4
Reflection.........................................................................................................................................7
Conclusion.......................................................................................................................................7
Reference list...................................................................................................................................8
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Introduction
The transition phases of nursing are one of the most challenging parts of the profession. Nurses
have to cope with the different type of clinical and non-clinical challenges those come in this
transition phase from being a student to a graduate registered nurse. The clinical and non-clinical
skills are to be developed in a proper way to increase the efficiency of the service. It is seen that
young graduate nurses face lots of difficulties in managing the clinical and non-clinical practices
in the first year of their professional life. It is essential to perform a critical analysis of the issues
related to the transition problem of the nursing career. The study identifies the clinical and non-
clinical problems that arise in the transition phase of nursing. Management and importance of the
clinical and non-clinical problems are discussed in the study. Different theoretical approaches to
learning are also mentioned in the study. A self-reflection is present that depicts a personal point
of view. The summary of the points is mentioned in the conclusion.
Critical analysis
Clinical skills
The clinical skills are essential for delivering the proper service to the patient. In the transition
period, it is seen that nurses face a problem with clinical skills. One of the most important
clinical skills is the intravenous catheterization. According to research most of the nurses in their
transition phase have problems with starting of the intravenous channel (Fulton, 2017).
Nevertheless, through proper capacity building training, it can be mastered by the nurses.
Delivering intravenous injection is another key clinical skill that lacks in the nurses who are in
their transition zone. However, transition shock can be one reason for the poor performances of
the nurses. Other essential clinical skills are the fundamental concepts of pharmacology and its
application according to the situation analysis of the patient (Gonzol & Newby, 2013).
According to the researchers, it is seen that the nurse in the transition phases have difficulties in
situation analysis and setting proper doses of medicine for the patients (Özlü, Z., & Yildirim,
2018). On the other hand, if the proper support is given to the transition nurses they can acquire
proper knowledge and implement them in a proper way.
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Importance of clinical skills in nursing
The clinical skills are the most important skill that should be possessed by the nurse. It helps in
proper nursing care of the patient. However, to implement the nursing care in a proper way the
clinical skills like intravenous catheterization assessment of vital statistics, performing proper
intravenous channels are essential (Gonzol & Newby, 2013). These skills play a pivotal role in
the delivery of proper nursing care to patients. On the other hand situational analysis and clear
concept of pharmacology help in delivering proper medication to the patient in times of
emergency service (Özlü, Z., & Yildirim, 2018). Performing Percutaneous endoscopic
gastrostomy, tracheotomy is the major clinical skills of the present in the nursing care setting.
On the contrary, these skills have to develop through proper capacity building training and
experience.
Non-clinical skills
The Non-clinical skills like communication, workload distribution and management should be
present in the nurses. According to the researchers, it is seen that nurses in the transition phase
lack communication and workload management skills (AdibHajbaghery & RezaeiShahsavarloo,
2014) On the other hand the most important non-clinical skills are the team effort or team
nursing used in the profession. If the communication skill of the nurse in the team is not up to the
mark it can cause a fatal result (AdibHajbaghery & RezaeiShahsavarloo, 2014). Nevertheless
through proper communication training verbal and non-verbal communication can be developed.
There is a huge amount of workload in the nursing care setting that should be properly
distributed by the top management (Jalal et al., 2014). However, the top management has to take
the initiative to develop the communication skills of the nurses through a proper capacity
building program.
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Management of clinical and non-clinical skills
In the transition phase, proper capacity building training should be provided to the nurses for
holistic development of the clinical and non-clinical skills. During the first few months of the
transition period, additional support should be given to the nurse (Negarandeh, 2014). The
experienced and professional nurses should be train the new nurses so that they can develop the
clinical and non-clinical skills.
Discussion
Banner’s 5 stages to become a professional model
The nurses and midwifery require developing their interpersonal skills to cop up with the
transition problems in their initial years of nursing practices. As per Benner’s theory nurses need
to pass five clinical levels with potential (Stutz, 2013). The five potential stages are a novice,
advanced beginner, competent, proficient and expert.
Stage 1: Novice
It is a situation where the nurses or the midwives have no practical nursing experiences. They
remain incapable to manage the clinical challenges and transition problems (Coxon, Bisits&
Sandall, 2015). The nursing staffs generally remain less confident. Moreover, nursing staffs
remain ignorant to characterize the safe practices. this is the stage when the nurses and midwives
require clinical advice from their senior members. They require a constant verbal and physical
response form, their senior to understand the clinical issues.
Stage 2: Advanced beginner
Advance beginner is a stage when the nursing care staffs become a little clinically potential to
handle the clinical issues. The level of nursing performance gets better at this stage. The nurses
start getting prior experiences in critical clinical situations (Dyer & Latendresse, 2016). They
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become potential enough to handle the practice area with effective nursing skills. However, the
nurses and midwives still require verbal and physical assistance from the senior nursing
members but lesser than the novice stage. This is a knowledge developing stage for the nursing
staffs.
Stage 3: Competent
Competence signifies the potential existence of nurse’s in particular clinical practices for two or
more years. The nurses become more proactive trot heir clinical approach due to the existence of
their clinical experiences (Coxon, Bisits & Sandall, 2015). The nurses become potential enough
to describe their efficiency focusing on the key competency level. The clinical actions of the
nursing staffs become more matured. They require the least assistance from their senior clinical
staffs for clinical advice. The nurses become capable of demonstrating the several clinical plans
based on their analytical skills and ethical clinical consciousness. Several clinical plans enhance
the nursing capabilities of the nursing staffs to provide quality care to the patients with suitable
intervention procedure.
Stage 4: Proficient
The proficient nurses are capable enough to understand all the clinical issues. They become
efficient in managing the situations wholly rather than partly. The proficiency helps then uses to
develop their capability to set long terms intervention goals. The proficient nurses have a wide
range of experiences and they can plan for any clinical situation (Dyer & Latendresse, 2016).
They have the efficiency to provide quality care to the patient with a professional outlook. This
stage enables the nursing staffs to attain the clinical decision-making process and capable to
handle the pressure situation.
Stage 5: The Expert
The expert stage is the final stage for the nursing staffs and midwives. The nurses become
potential enough to tackle the clinical issue, involve in the decision-making process, a situational
analysis of the clinical condition of the patient and provide quality care (Miah, 2013). Here, the
nurses develop their transition level into the expert level. The wide ranges of experiences have
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been beneficial for them to provide flexible care practices with professionalism. Additionally,
they become proficient in developing ethical consideration overcoming the transition level.
Transition theory
The transition theory of nursing can be segregated into three stages doing, being and knowing.
Doing stage
The nurses have no experience in this stage. This is the first three and four months of the nursing
stage. They are unable to resolve clinical problems (Schmied& Bick, 2014). The nurses are
hired for temporary basis but a full-time job. None of the nurses has registered the nursing
certificate in this stage. They try to learn new sets of clinical issues and responsibilities. this
stage can be segregated into learning, performing, concealing, adjusting and accommodating.
Being stage
This is the initial learning stage for the nurses and the midwives. This stage enables the nursing
staffs to understand the recurrent features of clinical experiences (Miah, 2013). This stage is 5 to
8 months of the initial nursing stage. The nurses and midwiferies start developing their nursing
capabilities and clinical skills. This stage can be segregated into five steps; searching, examining,
doubting, questioning and revealing.
Knowing stage
The proficient stage is the advanced experienced stage for nursing caregivers. They develop their
potential capability to handle the clinical issues (Berardo, 2017). This is the final phase of the
graduate nursing learning process. The new nursing graduates start continuing two recovers the
second phase of the nursing learning process. Additionally, the nursing staffs experience a
supportive relationship with their friends, family and colleagues. This is a stage when the nurses
and midwives are ready to provide quality care at any time (Schmied& Bick, 2014). This is a
little-stressed stage when they feel a little problem in coming up the new clinical environment.
However, the situation gets easy through experiences. This stage can be segregated into five sub-
stages separating, recovering, exploring, critiquing and accepting.
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Reflection
I think it is essential to develop the clinical and non-clinical skills for the holistic development of
the nurses. (Cook, 2016). According to the Rolfe model, the main content of the case is
described. I think the lack of clinical and non-clinical knowledge is the main problems of the
Transitional nurses.
According to the Rolfe model, the consequences of the problems are analyzed. However, it is
natural to be in a state of shock for the transitional nurses. Thorough proper support and capacity
building training the transitional nurses can develop proper clinical and non-clinical skills. In my
opinion, to combat the fear anxiety and shock of the transition nurses, it is very much important
to make proper capacity building training program. Nevertheless in my opinion excessive
workload is another prime problem for transitional nurses. Workload should be distributed
properly among transitional nurses through systematic management.
According to Rolfe reflection model, the final phase is the analysis of the present scenario. I
think that if the proper implementation of the support and capacity building training program is
done it will have a positive impact on the transition nurses. On the other hand, it is essential to
manage the workload of the nurses in a proper way so that holistic development of the nurses in
the transition phase can be possible. I think it will enhance the quality of service in the nursing
care setting.
Conclusion
The study has focused on the issues that the nursing care staffs and midwives use to face in their
clinical practices. The transitory issue is the biggest issue that the nursing staffs use to face
during their care plans. In order to develop the care plans to cop up with the transitory period, the
study has discussed two clinical and non-clinical skills. Moreover, Dreyfus and Banner's model
are used to analyze the developmental stage of the nursing care staffs from the transition period.
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The effective maintenance of Dreyfus's model and Banner's model can be beneficial for the
nursing staffs for a healthy outcome.
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