New Graduate Nurse's Role in Leading a Quality Improvement Initiative

This report examines the role of a newly graduated nurse in leading a quality improvement initiative within a healthcare setting, specifically focusing on social media obligations and patient safety as outlined by the Nursing and Midwifery Board of Australia (NMBA). The paper explores the importance of adhering to social media guidelines to maintain patient confidentiality, professionalism, and avoid breaches that could compromise patient safety. It then delves into the leadership role of the new graduate nurse, emphasizing the importance of teamwork, effective communication, and the ability to delegate responsibilities. The report identifies several challenges faced by new graduate nurses, including insufficient workplace support, bullying, and transitional shock. Furthermore, it proposes strategies to mitigate these challenges, such as implementing mentorship programs and residency programs, enforcing zero-tolerance policies against bullying, and promoting awareness campaigns. The conclusion highlights the significance of evidence-based approaches and organizational support in aiding new graduate nurses in their transition and ensuring patient safety and professional integrity.

Running Head: NEW GRADUATE NURSE IN LEADING A QUALITY IMPROVEMENT
INITIATIVE
NEW GRADUATE NURSE IN LEADING A QUALITY IMPROVEMENT INITIATIVE
Name of the student
Name of the University
Author Note

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Table of Contents
Introduction................................................................................................................................2
Task 1: Importance of social media obligations in patient safety..............................................2
Task 2: Role of the new graduate nurse in leading a team.........................................................3
Task 3: Challenges that may arise in team leading....................................................................4
Task 4: Strategies to tackle the challenges.................................................................................5
Conclusion..................................................................................................................................6
References..................................................................................................................................8

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Introduction
The conversion from a nursing student to a newly graduated nurse comprises of
challenges and receiving hands-on experience about clinical practice and guidelines.
Teamwork and collaborations between peers as well as other healthcare professionals involve
effective communication among the variety of teams and efficient time management to
deliver safe patient care, which often poses as perplexing to the new graduate nurse leading to
poor professional performances. In this context, the new nurse should learn and understand
their role in the workplace and the different consequences it entails. The purpose of this paper
is to assess the new graduate nurse’s role in leading an initiative of quality upgrade related to
social media obligations as a nurse in the clinical setting, examine the team leader roles that
should be exhibited by the new nurse and lay down strategies to be implemented for the
challenges that may arise.
Task 1: Importance of social media obligations in patient safety
According to NMBA, the social media guidance meant for every nurse and midwife
registered under them is to guide them towards appropriately implementing the professional
code of conduct and ethics to ensure patient safety and better outcomes in their clinical
practice (Nursingmidwiferyboard.gov.au, 2020).
With the increasing applications of social media tools in the clinical setup, it is
imperative to learn and understand the implications it holds on the nurse’s usage of this
platform. All the nurses must abide by social media obligations to maintain patient
confidentiality and privacy, compliance to professionalism and its boundaries, formal and
respectful communication standards with patients and their families, and to refrain from
falsely representing misleading or unreliable information as well as advertising only true and
accurate claims that can be supported by satisfactory evidence (Hao & Gao, 2017). The use

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of internet tools may give rise to any nursing malpractice. Inappropriate social media use can
lead to harmful results in the patient and the profession, precisely due to the varying
dynamics of confidentiality standards and the allowance for materials to be virtually
publicized by others.
Consequences of such activity may involve a confidentiality breach, violation of
professional conduct related to patient-nurse boundaries, offensive acts or defamation of the
patients and their families, or unintentional disclosure of personal data and information over
the public platforms of social media, which can be accessed by anyone (Rozenblum et al.,
2015). The extent to which these possess a threat to patient safety depends on the revelation
and magnitude of the information and its indefinite exposure or rapid circulation. Therefore,
it is crucial that every nurse in the transitioning phase, remain vigilant and aware of what they
publish or represent online, irrespective of the nature of the site or the language used (Scruth
et al., 2015).
Task 2: Role of the new graduate nurse in leading a team
To this context, it is essential to note that leadership qualities in the clinical practice
are critical to patient outcomes, as almost always, it is linked to the implementation of
innovative healthcare strategies and results in cooperation between employees and peers, and
enhanced teambuilding strategies. The roles of the nursing team leader involve personal
contribution in patient care and safety, ensuring effective communication between team
members and others, maintaining an environment which enforces harmony amongst the team,
appropriate usage of nursing skills and applying acquired skills learned from practice
wherever relevant, abilities to accurately delegate work responsibilities and capacity to take
on the duty and accountability within the team and workplace (Pfaff et al., 2014).

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Nurses new to the profession seldom perceive their ability to perform clinical
procedures as an epitome of professionalism. However, they must realize and adhere to the
three vital necessities of nursing that are, to lead, manage, and follow, while performing at
the point of care (Yoder-Wise, 2014). With a shift from the traditional hierarchy model of
command and control, nursing leadership now revolves around teambuilding and
collaborative efforts where interpersonal skills are the chief requisites to deliver patient-
centered care (Malone, 2016). In this approach, the new graduate nurse must develop a
comprehensive team project where the liabilities are evenly distributed to the other team
members, and must also leverage clinical aptitude to ensure that professional standards and
ethics are being followed by others.
Task 3: Challenges that may arise in team leading
There are several challenging situations that the new nurse may have to encounter
while building the team project, facilitating workplace duties and additional responsibilities
(Roberts & Grubb, 2014). The first and foremost challenge is due to the insufficient support
within the workplace that results in non-compliance and feelings of overburdening. It is
natural for new nurses to experience stressful episodes at work and fatigue during this switch
of roles (Chang & Daly, 2016). They are always under the radar to maintain professionalism,
manage interpersonal relationships as well as lead the interprofessional team project (Freeling
& Parker, 2015). Without supportive relationships, trainee nurses face exhaustion and feel
overwhelmed due to the excessive duties, which significantly give rise to anxiety and attrition
(Whitehead et al., 2016). Secondly, workplace bullying, incivility, or horizontal violence are
factors that affect new nurses. These are pervasive issues that interfere with their performance
building and socialization. Nurses often bully new nurses for maintaining control over the
operations or for displaying superiority. Violence from the patient family or other healthcare
professionals also causes distress to the new nurses (Leong & Crossman, 2016).

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‘Transitional shock’ is faced by many new graduates who recognize their preliminary
professional adjustment as feelings of angst, self-doubt, shortfall, and insecurity it produces.
This is typically due to the incapabilities of the organization to utilize and leverage the skills
of experienced staff as mentors to integrate the new graduates into the operational setup
successfully (Kim et al., 2017).
Task 4: Strategies to tackle the challenges
The multitude of challenges faced by the new nurses often coincides with overlapping
instances. Therefore it is crucial to enforce and undertake appropriate strategies that can
effectively address these challenges and pave a way towards mitigating them. The primary
strategy that could be implemented is to introduce preparatory programs that will mentor the
new graduates in being able to transition from academia to clinical nursing practice
successfully. Such programs not only smoothen the transition process but increases the
nurses' intention to continue as well. For this purpose, organizations need to bring forth
initiatives that will develop efficient mentors. A structured approach will help the nurses
achieve competency, poise, and autonomy of their profession. Existing literature substantiates
that new nurses become more competent after the implementation of such an education
program where they are provided sufficient training and supervised (Kumaran & Carney,
2014). The “Morton-Cooper and Palmer mentorship model” establish few phases through
which new nurses should be integrated into the workplace. The first phase begins with
acquiring active communication skills to nurture and develop interpersonal connections.
After that, is the phase where the mentor and the new graduate work in collaboration as a
team to initiate and maintain interpersonal skills. In the final autonomous phase, more
independence and authority is given to the novice nurse to gain control over their operations
and start clinical practice based on their judgment and capabilities without any supervision.
Residency programs are another established method of reducing turnover of new nurses while

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helping them to become more competent in practice with adequate training (Hofler &
Thomas, 2016).
Organizations must also actively manage bullying and violent incidents towards
transitioning nurses (Quinlan et al., 2014). All the health care leaders must provide a
workplace that is free of such incivility, that affects the workflow and threatens the mental
and physical wellbeing of the professionals. By addressing the bullying concerns of new
nurses, they ensure better standards of practice and indirectly increase patient safety.
Evidence provides support that by enforcing nursing leaders who will look into the
prevalence of bullying and take necessary actions to prevent them, distress among new nurses
can be effectively reduced. Such acts help in nurse retention rates as well as maintain
professional integrity. Employing a zero-tolerance policy toward bullying and legal
framework in the workplace establishes strict regulations, thereby helping in reducing the
violence and incivility. Besides, there must be thorough awareness campaigns to address the
importance of a bullying free work environment. There is evidence that through a method of
cognitive reappraisal, it is possible to reduce the adverse consequences of workplace bullying
(Wilkins, 2014). The new nurses can modify their perceptions about the bullying actions such
that it improves their self-assurance and provides them with certainty in their ability to tackle
the bullying effects. Thus, there should be a promotion of destressing activities arranged for
the nurses to deal with bullying in a holistic manner that helps them to stay motivated in
adapting to the new environment.
Conclusion
Having evaluated the role of a new graduate nurse in operating as a team leader in the
workplace and assessing the multitude of challenges that may arise, it can be deduced that
implementation of rightful strategies with evidence based approach is the most useful way to

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manage the impending burden faced by novice nurses during transitioning from a student
nurse into the professional workflow. There must be an increased focus on initiatives that
identify their challenges correctly and work on them proficiently to maintain patient safety,
care, and professional integrity. Organizations must have the structure to address
inadequacies and promptly work towards reducing the non-compliant behavior from new
nurses. Nursing managers and leaders should take actions as key mediators in combating the
challenges and develop programs and policies to enhance the work culture and provide a
sustainable platform to the transitioning nurses.

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