Critical Analysis: Graduate Nurse Transition to Professional Practice

This essay provides a critical analysis of the transition from a graduate nurse to professional practice, examining the challenges and factors that influence this crucial period. It delves into the gap between theoretical knowledge and practical experience, highlighting issues such as performance anxiety, emotional exhaustion, and the 'reality shock' faced by new nurses. The essay explores the impact of personal qualities, clinical environment challenges, and the importance of orientation programs. It discusses essential skills like communication, clinical reasoning, teamwork, and problem-solving, while also considering models like Maslach and Leiter's areas of work life to ensure effective practice. The analysis emphasizes the need for support, reflection, and the development of both clinical and non-clinical skills to facilitate a smooth transition and foster long-term success in the nursing profession. The essay references relevant studies and theories to support its arguments, ultimately concluding that while the transition can be stressful, determined nurses demonstrate mastery over time.

Running Head: GRADUATE NURSE TO PROFESSIONAL PRACTICE 1
Transition from a graduate nurse to professional practice
Student’s name
Institutional Affiliation

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Introduction
The healthcare environment is an ever changing field due to the dynamic nature of the
society (Parker, Giles, Lantry & McMillan, 2014). However, one thing that seems to remain
constant is the need for ‘work ready’ nurses (Hofler & Thomas, 2016).At the beginning of
Bachelor of nursing course, students are filled with excitement and also anticipation for the
course. The course equips them with practical skills and theoretical knowledge in preparation
for professional practice. The transition to professional practice can be a ‘stressful and
difficult shift’ for a graduate nurse(Hofler & Thomas, 2016).Half the number of new nurses
in their first year of practice become emotionally exhausted and majority of them experience
‘incivility’ at work(Laschinger et al., 2016). There is a gap between what the students are
taught to expect and what they actually experience once they commence their practice. Chang
and Daly (2015) describe this gap as a ‘reality shock’.
Critical analysis
The experiences of nurses during the very first years of professional practice have
great influence on their future career path (Parker et al., 2014).These first years of practice
can be termed as a ‘vulnerable time’ because it is during this period that nurses make
decisions that portray the intent to commit to the profession (Parker et al., 2014).The nurses
might also decide to leave their profession during this time. There are some factors which
influence the transition from a graduate nurse to a professional practice. First, the great
difference between the graduate's expectations and the actuality(Christensen, et al. 2016). The
experiences that these nurses go through are different from what they perceived initially.
Many nurses experience performance anxiety (Hofler & Thomas, 2016).The nurses
feel that their knowledge is not adequate. During the very first days of practice, they look at

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other staff who know exactly who they should talk to, what they ought to do and when to do
it and this makes them feel incapable and self doubts starts. The nurses end up wishing that
they could go back to college and learn more. Performance anxiety influences how well a
nurse demonstrates mastery.
The personal qualities of a nurse like maturity, age and motivation can also influence
the transition. A nurse who is known exactly what he or she wants to achieve in the career
will put a lot of effort to grow in the profession. A nurse’s personality will affect his or her
approach during difficult or even stressful experiences.
The new practicing nurses experience a challenge when they have to manage the
responsibilities for a number of patients simultaneously (Chang & Daly, 2015). There are
many patients in the hospital and at the end of the day, the nurses are emotionally and
physically exhausted. At times, the nurses have to work overtime and they were unprepared
for this (Laschinger & Boamar, 2016).The burn out affects their work negatively. The nurses
may disconnect from their work and colleagues (Hofler & Thomas, 2016). Burn out is a key
factor that pushes a nurse to make the decision of leaving the job or even the nursing career
(Laschinger & Boamar, 2016).
The new graduate nurses will need guidance during the beginning of their practice. He
or she will ‘not work in isolation but within an organizational environment’(Mellor &
Gregoric, 2016).
Maslach and Leiter's areas of work life model and Greenhaus et al's theory of work
life balance can be adopted to ensure that graduate nurses will work effectively once they
start professional practice(Laschinger & Boamar, 2016). Six areas of work life are
considered. First, manageable work leads. This considers a nurse's physical and emotional
capabilities this reducing burn out. Secondly, controlling overwork. This is the ability of the

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new nurses to make important decisions. Thirdly, rewards for contribution. Nurses feel
fulfilled once they achieve their expectations. Fourth, fair treatment in the working
environment. Decisions made should be impartial. Fifth, sense of community. Nurses have to
learn to work with other medical professionals to ensure better patient outcomes. Finally,
congruence between organisational and personal values. The nurses must follow the values of
their profession. Once these areas are looked into, the new nurses will be able to work
effectively (Laschinger & Boamar, 2016).
In order to ensure a smooth transition from graduate nurses to professional practice,
orientation is carried out. This is meant to prepare the nurses for their new roles (Liaw et
al.,2014; Pasila, Elo & Kääriäinen, 2017).
Discussion
There is a theory-practise gap in the nursing profession which can be as a result of
challenges of the clinical learning environment (Salifu, Gross, Salifu & Ninnoni, 2018). First,
the clinical activities are a routine and due to this, they become monotonous (Salifu, et al.
2018).The students eventually lose interest in what they are studying and this will influence
their professional practice. The students end up not taking their career seriously and as a
result, they end up feeling inadequate during their practice and might even wish to go back to
study the course. The lecturers who teach these student nurses have a high expectation on the
students regarding their competence (Salifu, et al. 2018). These lecturers assume that the
students are simply prepared enough for practice. Another challenge with the clinical
environment is that the learning outcomes during clinical placement are ‘vague’. Salifu et al
argue that these outcomes lack full details thus whatever the students are left to expect is
different from the reality.

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New graduate students experience feelings of self doubt which can be referred to as
transitional shock (Christensen, et al. 2016).This can be closely related to Imposter
Phenomenon (IP) syndrome according to Christensen et al. (2018). Transitioning nurses have
high personal expectations of what it means for them to be a registered nurse. In the working
environment, the registered nurses are presumed to be capable of their new role (Christensen,
et al., 2016). These puts pressure on the graduate nurses. They feel that they ought to know
everything. It becomes a great challenge for them to ask for clarifications in the areas where
they lack clarity because of the fear of being ridiculed.
Reflection
It is important for nurses to adopt certain clinical and non-clinical skills in order for
them to succeed in the profession. One of these skills is communication. This will facilitate
therapeutic and professional relationships. Therapeutic relationships can be described as a
key factors of all health care interactions (Kornhaber, Walsh, Duff & Walker, 2016).The
relations influence the improvement of a patient. The registered nurse on practice is required
to not only listen but also respond to the patient. This way, the patient's emotional health is
catered for. A graduate nurse should be in a position of answering all the questions, anxieties
and doubts of not only the patient but also their families. During these interactions, it is the
duty of the nurses to guide the patient’s in the right direction as they make decisions that will
have an impact on their health. The skill of clinical reasoning will be required in this situation
. A challenge that faces the relationships is that it can be viewed as a task and thus not done
effectively by the nurse (Kornhaber et al,2016).A nurse has to improve his or her
communication skills so that they can interact properly with the patients.
Clinical reasoning is acquired through reflection of past experiences (Nursing and
midwifery board of Australia, 2017). A student should reflect on the experiences during

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initial clinical placement. In the classroom setting, students always work in groups. This
teaches them how to work in groups. These teamwork skills are necessary for a graduate
nurse. He or she will have to work with other medical professionals in the career. A student
who works well with other members of his or her group will also work effectively in the
hospital setting. A student should be able to communicate with ease with others group
members and also ask questions in areas where they lack clarity. Problems may arise in the
hospital once the graduate starts working and problem solving skills will be useful. One
needs to tackle the problems on time and effectively.
Conclusion
There is a gap between what is taught during the study of nursing and the actual
experiences in the profession. As a result, graduate nurses go through stressful working
conditions at the start of their career. This has a negative impact because some of them may
decide to leave the job or career. The factors which affect the transition from a graduate nurse
to a professional practice include personal anxiety and self doubt, challenges in the clinical
education, unclear role expectations, high expectations of the student’s abilities by the
lecturers during learning, by medical professionals at the onset of practise and by the students
themselves. Orientation has been identified by different scholars as a means of ensuring
smooth transition for the students. A graduate nurse needs certain skills in order to succeed
in professional practice. Most of these skills are acquired from reflection classroom
experiences. These skills include clinical reasoning, problem solving, teamwork, research and
communication. Even though the transition from a graduate nurse to a professional practice is
stressful at first especially due to theory-practise gap, determined nurses demonstrates
mastery as they continue with their profession (Chang & Daly, 2015).

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