Western Sydney University: Critical Analysis of Nurse Transition Essay

This essay provides a critical analysis of the transition of new nurses and midwives to graduate practice, focusing on the development of clinical and non-clinical skills. It emphasizes the importance of implementing nursing theories, such as Benner's stages of clinical competence and Dreyfus's model of skill acquisition, to enhance the confidence, competence, and interpersonal strengths of new graduates in clinical settings. The essay discusses the need for effective transition programs, clinical competency evaluation systems, and the utilization of electronic health records to improve patient outcomes. It also highlights the importance of reflective practice and the development of non-clinical skills, such as communication and conflict resolution, to improve the overall quality of care. The conclusion underscores the significance of support systems and training to facilitate a smooth transition and improve professional development.

Critical Analysis Essay of a Case Study - Transition to Graduate Practice
Introduction
Outline
The presented study essay critically analyses the case study related to the transition of new
nurses/midwives to the graduate practice with the objective of improving their confidence,
learning methodology, competence, and interpersonal strength in the clinical practice
environment. The discussion section of the paper effectively evaluates the need for
implementing a range of significant nursing theories in the context of improving the clinical
skills and proficiency of the newly deployed registered nurses across the matrix environment.
The essay also emphasizes the requirement of utilizing relevant strategies and resources to
effectively facilitate the smooth transition of the graduate nurses to their respective job roles
in the concerned clinical settings.
Thesis Statement
The senior nurses and healthcare team members need to evaluate the grey areas highlighting
the significant issues and conflicts related to the graduate practice transition in the context of
configuring innovative support systems for the newly hired nurses and midwives in the
clinical practice environment.
Critical Analysis
The newly appointed nurses and midwives need to develop healthcare proficiency through
the consistent acquisition of the non-clinical and clinical skills in the medical facility. The
senior members of the healthcare teams must encourage and motivate the new graduate
nurses in terms of taking active participation in the professional discussions related to the
autonomous handling of a range of complex clinical scenarios (Thrysoe, Hounsgaard, Dohn,
& Wagner, 2011). This will eventually improve their technical proficiency and confidence in
the healthcare setting and help them in overcoming the 'transition shock' and 'reality shock' in
the clinical practice environment.
The presented case study describes a range of clinical skills that the newly deployed graduate
nurses and midwives need to develop and inculcate in the context of handling various types
of patient circumstances in the clinical settings (Katsoolis, 2017). These clinical skills include
the insertion of the intravenous cannula/catheters, collection of blood samples, monitoring of
vital signs, medication management, assessment of dosage requirements, handling of safety

episodes, birth management, and dealing with patient referrals. However, newly hired nurses
and midwives need to improve their confidence in terms of utilizing these clinical skills in the
context of accomplishing patient care goals (Kensington et al., 2016). The development of an
effective transition program is highly required to enhance the clinical skills of the new
graduate nurses and midwives to facilitate their transition to the graduate practice. This will
not only improve their professional growth and development but also enhance the extent of
patients’ satisfaction in the clinical practice environment.
Newly hired qualified nurses will require undertaking clinical judgment through the
systematic utilization of health information technology and scientific evidence. The
appropriateness in the clinical judgment will substantially improve the quality of health care
services and corresponding patient outcomes. The timely recognition of the patient trends
through perceptual acuity will not only improve the autonomy of the newly hired nurses but
also improve their experiential learning in the clinical setting (Benner, 2004). This will
improve the credibility of the health care interventions and patients’ trust in the
recommended treatment approaches. Eventually, the healthcare organization, as well as the
nursing teams, will experience the elevated scope of mutual development and profitability.
The nurses and midwives will need to improve their proficiency and skills in utilizing the
electronic health record and clinical evaluation tool with the objective of improving the
precision of the medical decision-making. The consistent use of the clinical evaluation tool
will not only improve the quality of the treatment approaches but also assist in improving the
clinical performance and patient care objectives in a timely manner (Hodgson, 2018). For
example, the improved clinical performance of the midwives through the strategies use of the
clinical evaluation tool will substantially improve the quality and outcomes of the abortion-
related and newborn care interventions. This will also improve the precision of IUD insertion
in the clinical setting.
The non-clinical skills that the newly appointed nursing graduates need to acquire include the
initiation of therapeutic communication, compassionate dealing with the patients, conflict-
resolution, assessment of performance constraints, resource management, and work
allocation. These skills will substantially improve the leadership quality of the new graduate
nurses and improve their situational awareness of various complex patient care scenarios
(Pires et al., 2018). Although the non-clinical skills’ will significantly improve the personal
development outcomes of the new graduate nurses; in numerous other situations, they will

also improve the overall clinical outcomes as well as the patients’ safety pattern in the
healthcare setting.
These evidence-based findings advocate the need for improving the clinical and non-clinical
skills of the newly hired graduate nurses to improve their professional autonomy, confidence,
trust on the health care system while concomitantly enhancing the overall organizational
objectives.
Discussion
The development of an appropriate clinical competency evaluation system is highly essential
to effectively improve the clinical skills and proficiency of the new graduate nurses for
facilitating their smooth transition to the graduate practice (Woeber, 2018). The clinical
practice settings and nursing educational institutes must coordinate with each other to explore
the insight and experience of the new graduate nurses in relation to their initially allocated jib
roles (Walton, Lindsay, Hales, & Rook, 2018). The systematic mitigation of the clinical
practice and graduate education gaps is highly warranted to facilitate the successful transition
of registered nurses to the graduate practice (Wiley, 2018).
The learning trajectory of professional nurses is based on Benner’s five stages of clinical
competence (NSW_Health, 2011). The newly appointed (novice nurse) enters the stage – 1 of
clinical competence immediately after acquiring a new job role. The nurse in such a scenario
constantly needs expert supervision to take significant healthcare decisions. Stage – 2 is
based on the knowledge development and acquisition of the clinical practice skills. The
advanced beginner needs a smaller number of supportive cues for the execution of the
healthcare responsibilities. Stage – 3 is associated with the acquisition of clinical competence.
The professional nurse at this stage consciously undertakes healthcare planning measures in
the absence of expert supervision. The nurse gains proficiency during stage – 4 and evaluates
the long-term patient care goals in the clinical setting. The enhancement of decision-making
skills assists the professional nurse to efficiently deliver holistic and person-centered
healthcare interventions to the patient population. The stage – 5 is based on the acquisition of
nursing expertise instilled with analytic capacity and innovative aptitude. The newly
appointed nurses, therefore, need to adapt themselves with Benner’s learning trajectory in the
context of developing clinical proficiency and leadership skills across the nursing practice
environment. The hospital setting also requires developing an appropriate infrastructure,
educational programs, and resources for the new graduate nurses in accordance with the
Benner’s novice to expert model (Thomas & Kellgren, 2017).

Similarly, Dreyfus’ model of skill acquisition is highly significant in facilitating the
continued professional development of the newly hired graduate nurses (Williams, Byrne,
Williams, & Williams, 2017). Dreyfus’ model advocates the need for designing training
courses for the new graduate nurses in accordance with the level of their confidence and
clinical competence. For example, an average level novice nurse would require understanding
the general nursing care norms under the expert supervision. The competent nurse would
require evaluating situational components of the clinical practice to gain more proficiency
and exposure for moving on to the next level. However, the expertise level for the
professional nurse would be based on the execution of intuitive actions and configuration of
patient care guidelines based on the reported clinical scenarios. Furthermore, the mastery
zone for the professional nurse/midwife would be based on the acquisition of automaticity in
the clinical practice environment.
Reflection
Koshy, Limb, Gundogan, Whitehurst, and Jafree (2017) consider reflective practice as the
most important requirement for nursing career enhancement in the healthcare sector. The
individualized assessment of ‘what has happened’ during the initial clinical placement is
highly needed to explore the scope of professional improvement. As I reflect on my nursing
care preparation, I understand that my placement in the clinical setting has equipped me with
the desired therapeutic communication skills for patient management. Being a student nurse, I
consistently attend the nurse-patient communication sessions and assist the senior nurses in
configuring therapeutic alliance with the treated patients.
My professional competence matches with the standard – 2 of the Nursing and Midwifery
Board of Australia (NMBA) practice conventions that advocates the need for collaborative
practice while safeguarding the rights, beliefs, culture, dignity, and values of the treated
patients (NMBA, 2016). My professional strength is also based on the comprehensive
assessment of the chronically ill patients in the clinical setting. This strength matches with
NMBA standard – 4 that advocates the undertaking of culturally appropriate and holistic
health assessments to improve the treatment planning strategies in the clinical practice
environment (NMBA, 2016).
I believe that I have just stepped into the ‘So what’ stage of Rolfe’s reflective model. I,
therefore, need to take assistance, advise, and guidance from experienced nurses to testify and
authenticate the adequacy of my patient assessment and therapeutic alliance skills in the

clinical setting. Furthermore, while moving into the registered nurse’s practice role I need to
develop my skills and proficiency related to the development of the nursing care plans,
assessment of the nursing practice outcomes, resolution of complex patient care issues, and
undertaking critical analysis while concomitantly maintaining a safe and responsive
healthcare environment. This will eventually accomplish my successful transition to the
graduate nursing practice.
Conclusion
The evidence-based essay signifies the need for developing an effective training and
education system in the context of improving the confidence and skills of the newly deployed
nurses across the clinical settings. The configuration of appropriate support systems is highly
needed through the utilization of Benner’s five stages of clinical competence and Dreyfus’
model of skill acquisition in the context of mitigating the grey areas and conflicts that
consistently barricade the transition of graduate nurses to the graduate practice. The
enhancement of the clinical and non-clinical skills of the newly appointed nurses is
substantially warranted to elevate the overall healthcare outcomes while concomitantly
improving the scope of professional development.

References
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