University Nursing Program: Transition Challenges and Solutions Essay

This essay delves into the complex challenges faced by new nurses as they transition from academic settings to professional healthcare environments. It highlights the emotional journey, initial excitement, and subsequent feelings of incompetence, insecurity, and anxiety that often accompany this transition. The essay explores various difficulties, including theory-to-practice gaps, caring for complex patients, medication administration, time management, and collaboration issues. Furthermore, it examines the significance of the issue, emphasizing the impact of challenges such as role ambiguity, workplace bullying, and performance anxiety on nurses' well-being and patient care quality. The essay proposes solutions such as mentorship programs, advanced education, and shared governance to facilitate a smoother transition and foster confidence and competence. It underscores the importance of supportive environments, including anti-bullying policies, error reporting, and constructive feedback, to reduce stress and anxiety, ultimately contributing to improved patient outcomes and nurse satisfaction. The essay draws on research to support its arguments and emphasizes the need for healthcare organizations to prioritize the well-being of new nurses and create a supportive work environment.

Running head: TRANSITION IN NURSING
TRANSITION IN NURSING
Name of the student:
Name of the university:
Author note:

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Abstract:
Transition from student life to that of nursing professionals is not as smooth as thought
by many individuals aspiring to work in the healthcare industry. They face various issues during
the initial months of their joining as professional nurses in healthcare sectors. These challenges
often make them develop stress and anxiety and make them los their confidence over their
competence in nursing job. This makes them live poor quality life along with emotional
instability and improper work-life balance. Therefore, it becomes important for them to be well-
aware of the strategies that might help them to undergo a smooth transition in their career
without developing stress and anxiety. This assignment would be discussing the different
challenges faced by new nurses when they start working in professional places. This assignment
would also shed more light on the different strategies that they might undertake to help them
overcome the barriers, stress, continue their professional life smoothly, and aspire to reach the
zenith of success.

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Introduction:
The healthcare environment is ever changing. However, one of the things that never get
changed is the demand for the nurses. The need of more nursing professionals in the healthcare
sector has become important because of the lingering issues of nursing shortage felt by the
nation. Firstly, one of the reasons identified by researchers is the increase in the number of
chronic ailments among the citizens along with the increased average life expectancy of the
people of the nation (Chang, 2015). The demand for healthcare services has increased the
urgency of allocation of more nurses than before in the healthcare industry for curing this
increased number of patients. Secondly, one of the studies by Lea and Cruickshank (2015) had
also found that the clinical practices in the modern generation are under additional pressures for
operating in a lean as well as efficient manner because of the shrinking reimbursements along
with increased regulatory oversight and increased consumerism. Therefore, these forms of
pressures have demanded that the education programs need to produce nursing professionals who
would be work-ready from the very moment they flip their tassels. Every nursing professional
are expected to be ready not only with efficient knowledge and skills but also emotionally and
mentally. However, it has been seen that new nurses often face several of challenges that affect
their practices increasing risk of poor quality and unsafe care delivery to the patients (Spector et
al., 2015). Moreover, they are also seen to become burned out because of huge number of
factors that affects their job satisfaction ultimately resulting in attrition. This article would be
discussing about the different challenges that nurses face during their transition period to
healthcare industry after completing their bachelor’s degree in nursing. It would also provide
solutions to the issues faced by them so that modern day nurses can use them as guide for their
own transitions as well.

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Significance of the issue:
The nursing transition is considered as an emotional journey. In the beginning, new
nurses are seen to be full of excitements, anticipations, as well as enthusiasms for their nursing
profession. Studies have found that new nurses who became the participants in the study had told
that in the beginning, they used to be spurred on by their desire in making a positive contribution
towards the lives of patients (Zerweck et al., 2017). However, they had also revealed that
although the Bachelor of Nursing course design had equipped the student with the practical skills
and even the theoretical knowledge required for being capable nurses, they are still not enough in
truly preparing them for professional practices. Studies have stated that after a few shifts, the
initial excitement might get accompanied by the feelings of incompetence along with feelings of
insecurity, anxiety and exhaustion (Marcoux et al., 2017). It has also been seen that new graduate
nurses start questioning their own skills, values, and competence level along with their decision-
making ability. They may also feel overwhelmed by the demands of the role. A huge number of
challenges are faced by new nursing professionals like that of theory to practice gaps as well as
caring for increasingly complex patients with different multiple co-morbidities. Other
challenges that are faced by them during the initial days of their transition to healthcare industry
are medication administration, time management and even patient assessment skills. Different
types of documentation skills, issues in effective collaboration with team members, limited
proficiency in management and execution of technical skill are some of the other challenges
that new nurses face after their transition (Cherry & Jacob, 2016). Other challenges are
accountability issues, decision-making issues, shift works, and development of competency in
planning and organizing. Performance issues and bullying often makes them emotionally

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unstable. Such issues need to be handled and managed with efficiency so that new nurses can
have smooth transition and carry one their practices with confidence.
Discussion:
Ashwood et al. (2018) are of the opinion that new graduate nurses face different types of
challenges when they are transitioning to workforce. These are seen to include handling of
increased number of patients with different complex conditions and even different co
morbidities. They also suffer from lack of access towards experienced coaches and mentors
along with generational diversity in the workforce, bullying and even performance anxiety. Often
such issues are seen to occur simultaneously thereby compounding the problem (Betz et al.,
2016). Nurses are seen to develop fear, stress, and anxiety in due course of time because of these
reasons making them fatigued. They are seen to lose their self-confidence and make them feel
burned out. This affects their quality of care and prevents them from communicating effectively
with patients and their family members. As a result, patients remain unsatisfied from treatment
(Masters & Gilmour, 2018).
Studies have found out that when new nurses feel fatigued, it becomes important for
healthcare authorities to identify them and propose them with solutions to make them overcome
the burn out feelings (Demeh & Rosengren, 2015). Role ambiguity is one of the significant
contributors for developing burnouts among nurses. This makes them more disconnected from
their work as well as their colleagues and makes them to perform in ways that are more detached
(Cherry & Jacob, 2016). Hopkins et al. (2016) had stated that when nurses become detached and
stressed, they exhibit poor work performance which eventually result in severe patient safety
events.

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Studies have found that workplace bullying is one of the most significant obstructions
that make new nurses display their best talents. It also affects the appropriate socialization of the
new nurses (Cherry & Jacob, 2016). It has been seen that often, senior nurses bully the new
nurses for maintaining control of their work environment. Regan et al. (2017) are of the opinion
that organizations that do not protect any new nursing professionals from bullying are silently
promoting different types of unprofessional behaviors. Healthcare leaders have obligations in
providing a work environment that would help in contributing to the health as well as well-being
of the patients as well as staffs and address workplace bullying to provide an encouraging
environment for new nurses.
Owen (2017) had put forward an article that offers strategies in positioning the new
nursing professionals towards the success. Nurse mentoring programs need to be implemented as
it helps in increasing the intent of the individuals in staying and maintaining the retention rates.
The paper has talked about the importance of achieving competency, autonomy, and confidence
by the new nurses and for this; they suggest that organizations need to develop a structured
approach for developing mentors. Bauman et al. (2017) had proposed a mentorship model that
includes about three important phase. The first phase is the initiation phase, which would mainly
include establishment of effective communication skills for establishing interpersonal
relationships. This is then followed by collaboration phase during which the mentor and the
novice would be collaborating. Finally, during the autonomous phases, the novice is seen to gain
more independence.
Another of the study had talked about the importance of the nurses in attaining advanced
degrees for developing their clinical and non-pharmacological knowledge that align with higher
quality, confident and evidenced based healthcare services. Studies have stated that advanced

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degrees for the nursing professionals are associated with developed critical thinking skills as well
as ability for implementing translational researches. Heightened leadership capabilities along
with understanding of the different changes in the healthcare landscapes along with effective
understanding of the significance of quality care are also found to be associated with new nurses
who have undertaken advanced degrees. Mellor et al. (2017) had supported such claims and had
stated that understanding of one’s role in continuum of care, improvement of job advancement
opportunities and even improved understanding of the decision-making skills in clinical settings
are also the benefits of advanced educational programs. In such situations, leaders should help
new nurses by setting goals, clear expectations as well as implementation of procedures that
support employee achievement through higher education (Cherry & Jacob, 2016).
Another study by Clipper and Cherry (2015) had put forward another strategy for
successful transition of nursing professionals to their professional practices. The authors are of
the opinion that shared governance needs to be promoted as this helps in giving the new
healthcare professionals a better platform in discussing the issues that affect their practices. It has
been found when the new nurses are involved in making decisions that affect their practices
allowing them in effectively managing the complexities for the healthcare environment today
and coping with stress. The evidences also suggest that nurses who have active roles in making
decisions feel empowered which have positive impacts on their confidence and self-esteem
resulting in increased staff management. Inter-professional decision-making also helps in
promoting a professional atmosphere encouraging respect and thereby enhancing confidence
(Cherry & Jacob, 2016).

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Evaluation:
“Support” is one of the most important components that help in ensuring a smooth
transition period from student life to professional lives. In such arenas, preceptor programs and
mentoring are found to be excessively important as well as effective in offering support to new
nurses. Studies have found that preceptor programs are extremely helpful in ensuring more
positive outcomes in the first six months of transitioning into the position of the registered
nurses. This had been found to be helpful as it helps in reduction of the culture shock and even
integration and linking of the theory with that of the practices (Demeh & Rosengren, 2015). Such
mentoring programs also provide support to the graduates by allowing them in working closely
with another experienced nursing professional. This ultimately helps in developing the
confidence, competence and even gradually gaining autonomy in the patient care. The preceptor
or mentors would support the new professionals by guiding them in their clinical learning
procedures but also with their professional and even personal growth (Spector et al., 2015).
It can be also found that development of a supportive environment can help in smooth
transitioning of the nursing professionals from their student lives to their professional lives. A
supportive environment needs to be developed in ways so that they can provide opportunities for
the new nurses to develop their not only clinical skills but also patient management skills. This
would ensure bringing out effective outcomes of their work in practices and this would help in
encouraging further confidence and their ability. Researchers are of the opinion that being part
of the supportive environment should be allowing the new nurses in feeling comfortable in
raising any issues as well as concerns during the transition periods (Spector et al., 2015). This
helps any potential problems to be identified and managed early. This helps in reduction of the
anxiety as well as stress. Some of the examples of supportive environment would be developing

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an organizational culture where anti-bullying policies are followed, supportive environment for
reporting of errors and omissions are encouraged, open-constructive feedback sessions are
promoted and many others. Zero-tolerance policies for gender discrimination, encouragement for
participating in continuous professional development, transformational leadership and similar
others can all help in developing a supportive environment for smooth transitioning of nurses
from student to professional lives (Zerweck et al., 2017).
Proper planning is also found to be helpful for the nursing students to develop a proper
understanding and awareness of different types of the potential challenges and issues that they
may commonly face during the transition period. This had been found to be helpful in
encouraging the nurse for preemptively devising different strategies that would assist them in
their transition before the problem occurs (Demeh & Rosengren, 2015). This would help them in
making their adjustments experiences that are more positive. Many of the researchers have
evaluated the different studies and have concluded that self-care is also an important aspect for
smoother transitions. Self-care is also found to be significant during the time of transition where
they need to care for themselves which would be focused on ensuring a healthy balance between
their new role as a registered nurse and their lifestyle (Zerweck et al., 2017). The transition from
student to that of nursing professional life can prove to be a turbulent tile personally as well as
professionally and this would help in serving to only compound feelings of exhaustion and
anxiety. Mindfulness based therapies, yoga and meditations had been found to be fruitful in
helping new nurses to manage their resilience and self-regulation skills (Chang, 2015).

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Conclusion:
From the above discussion, it becomes clear that new nurses who have undergone
transition from their student life to professional lives might face various forms of challenges.
This would include developing stress and fatigue from bullying, feeling incompetent on work-
floor, burdensome shift-works, performance anxiety and similar other challenges. In such cases,
mentorship programs or preceptor programs are found to be highly beneficial. Moreover,
undertaking effective participation in advanced degrees would help in enhancing their
confidence as well as their clinical and non-pharmacological knowledge reducing their anxiety.
Moreover support programs from the organizations, anti-bullying properties, encouraging
organization culture, blame-free environment and similar others have been found to be extremely
helpful. Moreover, nurses also need to be well aware about how to take care of their own selves
in order to balance their personal and professional lives. Participating in different types of
therapies like mindfulness based therapies; yoga and meditation can help them in controlling
their self-regulation capabilities as well as help them in developing attribute of resilience. All of
them help in ensuring smooth transition from student lives to the professional lives of registered
nurses.

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nursing: What about pay?. Practice Nursing, 29(2), 83-87.
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Betz, C. L., O'Kane, L. S., Nehring, W. M., & Lobo, M. L. (2016). Systematic review: Health
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