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Mentoring New GraduatesAntoinette McNeil, BSN, RN, CCRNWashington Adventist UniversityAdvancing the Profession of NursingNURS 515Nkechi Ileka, DNP(c), MSN, RN, CCRN, CMDNFebruary 21, 2012Mentoring New GraduatesTable of ContentsAbstractIntroductionLiterature reviewRecommendationsConclusionsReferencesAbstractThe nursing shortage is not going away. With a decrease in nursing instructors nursing schools are downsizing. Recognizing that nursing students are not getting a useful clinical experience due to lack of nursing instructors, hospitals need to have a strong orientation program for the novice nurse. Having the experience nurse as a mentor to the novice/new graduate in their orientation will help the nurse make the transition from novice to advance novice. The orientation process for the new graduate must help transition them to the next level in nursing.IntroductionNursing students who are now new graduates are known as novice nurses. Their experience as a new graduate in the hospital is a frightening experience. They realize that they are now responsible for the patients that are assigned to them and they do not have the luxury of spending a lot of time with their patients depending on the unit that they work on. Hospitals need to have a productive orientation program for the new graduate/novice nurse. Having mentors who should be your most experience nurse who have good communication and teaching skills should be their preceptors. The orientation program and the preceptor/mentor helps determine whether or not your mentee/novice nurse will grow in the organization or leave it.Literature ReviewMany new graduates are considered novice nurses and their transition from student to practicing nurse is a frightful one. Turnover for the new graduate is very high. The reason for the turnover is their transition is stressful and their expectations are unrealistic (Grochow, 2008). Their orientation experience will determine if they stay at their first organization or will they leave. The first year of a new graduate nurse is stressful and their confidence building is important during this time period (Morrow, 2009). Not being confident in caring for patients can lead to errors in care and discouragement in practice. New graduates are not confident due to they have not developed good critical thinking skills. A novice nurse has learned the basics to pass the nursing boards but now they need to enter the next phase.What constitute a novice nurse? A novice nurse is one who has no experience in the area that they are working in (Eigsti, 2009). Some nurses are considered Advance beginners due to they have some work experience in caring for patients (Eigsti, 2009). When is a nurse competent? A nurse becomes competent after 2-3 years of practice and is able to assess long-term goals for a patient (Eigsti, 2009). Looking at another view, a new nurse does not become competent for 18 months to 2 years (Schoessler & Waldo, 2006).What constitutes a mentor? A mentor is a nurse who can counsel, teach, coach, and supports members of the team (LaFleur & White, 2010). The mentor also is the novice/advance beginner’s preceptor. It really is imperative that the mentor can actually teach a new nurse and has experience in the field of nursing (Wolak, McCann, Queen, Madigan, & Letvak, 2009). There are many nurses who have been practicing nursing for many years but they cannot teach. The criteria for nurse preceptors are their work history, good communication skills, and have an interest in staff development (Kollman et al., 2007).The nursing shortage has caused hospitals to employ new graduates in areas that they normally would not. The school of thought is that new graduates need at least one year experience working on a medical surgical unit before working in an Intensive Care Unit (ICU), Neonate Intensive Care Unit (NICU), and Labor and Delivery (L&D). Nursing managers are hiring new graduates in critical care units due to the units needs and to prevent the predicted nursing shortage (Kollman et al., 2007).Critical thinking is very important in nursing. Since critical thinking in a very important aspect to nursing, nursing schools are recognizing this and are incorporating critical thinking skill as part of their curriculum (Bob, 2009). A hospital recognized that critical thinking is crucial to nursing but to have classes on it was not profitable. The answer to their problem was to have critical thinking sessions before taking on their assignments which help prepared them in their assignment (Bob, 2009).Nurse retention is vital to institutions. When a facility recognizes that new graduates are vital and realizing what causes nurses to remain or to leave reveals that the organization cares for its new nurses. When an organization invest resources for it nurses demonstrates that they want to empower their nurses especially their new graduates to do their work more effectively (Wolak et al., 2009). One way to empower new nurses are to have mentors to work with them (Nedd, Nash, Galindo-Ciocon, & Belgrave, 2006).It is imperative that organizations take time to invest in retaining their new graduates. Investing in resources such as money, equipment and materials are some of the tools that are needed to retain nurses (Nedd et al., 2006). Revamping orientation programs to fit the needs of the new graduates reveals that organizations has come to the realization that transition from student to practicing nurse is stressful for the new graduate. Orientation for new graduates/novice nurses has been 12 weeks, in which the nurse is to care for one patient the first week or two then they are given another patient if in an ICU or 2 if on a medical surgical floor. The preceptor and novice nurse are to care for these patients but how much teaching is done especially if the team is very busy. Having a program where the novice nurse clinical and didactic education time extended is more beneficial for them (Eigsti, 2009).The orientation program should promote the following: confidence in skill performance; improving critical thinking and clinical knowledge; foster independence; prioritizing; improve relationship with peers; and improve communication with physicians (Prouix & Bourcier, 2008). By promoting a beneficial orientation program along with a good mentoring program foster retention in the organization.Having an educator working with the new graduates and following their progress is beneficial for them also. Having someone to talk with regarding their concerns regarding the care that they are giving lets them know that there is someone for them to aid in their transition from new grad to practicing nurse. Having the support and knowledge that the mentors provide is useful in helping them develop their own skill set (LaFleur & White, 2010).Knowing that the first year of a new graduate is stressful and their desire to transition from student to professional nurse educational resources must be made available to them. Promoting new graduates to belong to a nursing organization makes available for them to read journals to enhance their knowledge. Journals offer continuing education which is aimed at improving the knowledge, skills, or attitudes of nurses (Marzlin, 2011).The Standards of Professional Performance as stated by the American Nurses Association says nurses have a responsibility for attaining the knowledge and competencies that reflect current practice especially for their clinical area of practice (Marzlin, 2011). Encourage novice nurses to do continuing education and to go to seminars to have a better understanding of their area of practice. The nurse educator and the mentor have a responsibility to share this information with the novice nurse to aid in making them confident in their skills.“Critical thinking involves purposeful thinking, reflection, active reasoning, challenging of assumptions and beliefs, application of standards, and a spirit of inquiry” (Marzlin, 2011, p. 45). Knowing that knowledge in the foundation for clinical judgment, reasoning, and thinking, which are concepts in decision-making in nursing mentors, should promote continuing education to the novice nurse (Marzlin, 2011).New graduates have support for 3 to 4 months and then they are left to the wolves. New graduates would benefit from longer-term support which will aid in their development of clinical judgment (Dyess & Sherman, 2009). Knowing that novices are having a tough time during their first year, demonstrate their need of emotional and professional support from their mentor who in the beginning for some was their preceptor’s. Novice nurses cannot handle emergencies properly, due to the fact that they lack the skill and the confidence to advise patients and their families (Komaratat & Oumtanee, 2009). Some institutions have made changes in how they retain novice nurses, by offering a sign-on bonus for a two year commitment and offering a competitive salary. They also have clinical time in their unit, clinical observation time outside their unit and didactic time in a classroom. Classes are held two day a week which is for 8 hours (Eigsti, 2009). By having an educator work with new graduates for the first 2 weeks allowed preceptors to take patients, was cost effective.The Advance Practice nurse has the responsibility to ensure that the novice nurse has a productive orientation in their area of practice. They have the opportunity to take advantage of teachable moments and can be the resource for the new nurses (Wathen, 2009). Nursing leadership know that they are responsible for making sure that the new nurse has what is needed to have a good learning experience during their orientation.The nursing leader is to create a culture that has a diversity-sensitive orientation, recruit and retain a diverse workforce (Rundio & Wilson, 2010). Much is expected of the nurse leader, thus he/she must have a good nurse educator, mentors, and preceptors to work with the novice/new graduate as they transition to a professional nurse from a student. A nursing leader is to create a culture of respect, caring and dignity for all employees. This will help lead to a sense of belong to the organization. Leaders are to promote and environment of learning that leads to growth and development for their staff, this helps to empower them (Shirey, 2007).Many may feel that a novice nurse should not work in ICU’s but with the shortage many ICU’s are being drenched with new graduates. Careful screening of candidates should be done before accepting just any new graduate in the ICU. When it is determined that a novice nurse is not making it, evaluate whether it is the novice nurse or the preceptor. A poor mentor is a barrier to learning for the novice/new munication is vital for any organization to function. Novice nurses need clear and precise communication for direction in caring for their patients. They also need to learn to be comfortable with their communications skills delegating and giving hand-off reports (Prouix & Bourcier, 2008). Goals are to be set daily and weekly with the novice nurse. Feedback is vital for the new graduate; this is the way they know how well they are doing. Setting goals for the new graduate is the structure that they need during their orientation. Each week there should be a focus that they are to strive in achieving. The long term goal is to help them prepare for certification in their area of practice. By helping the new graduate achieve their short-term goals and providing a healthy work environment promotes retention in the organization. The Advance Practice nurse is vital in promoting weekly goals for the new graduate.RecommendationsThe old way of orienting new graduates are out and planning a more constructive program for them has proven to be beneficial. Planning out an orientation program that does not over whelm the novice nurse is what is needed. Many new graduates have no experience versus the advance beginner who has some experience in patient care. There are many stages in the nursing continuum which starts with the novice and after a few years of experience the expert nurse. Investing in proper resources for the new graduate and providing a healthy work environment leads to retention of nurses. ConclusionRecognizing that the new nurse is scared yet excited about being a nurse, one must be careful not to over whelm them and drive them away. Changing the orientation process where the new graduate is building off what they learning in nursing school will empower them. By retaining new graduates in the organization at least for two years or more is cost effective. Learning not to eat our young but to nurture them is a responsibility of all nurses but the advance practice nurses can oversee the orientation process to ensure that they are receiving what they need to function properly. Providing educational resources for them demonstrates that the leaders and the educators have an interest in their learning.ReferencesBob, P. S. (2009, November/December). Critical-Thinking Program for the Novice Nurse. Journal For Nurses In Staff Development, 25(6), 292-298.Dyess, S. M., & Sherman, R. O. (2009, September). The First Year of Practice: New Graduate Nurses’ Transition and Learning Needs. The Journal of Continuing Education in Nursing, 40(9), 403-410.Eigsti, J. E. (2009, July/August). Graduate Nurses’ Perceptions of a Critical Care Nurse Internship Program. Journal For Nurses In Staff Development, 25(4), 191-198.Grochow, D. (2008, March). From novice to expert: Transitioning graduate nurses. Nursing Management, 10-11.Kollman, S., Liedl, C., Johnson, L., Elwood, T., Mundy, L., & Shue, J. (2007, December). Rookies of the Year: Successfully Orienting New Graduate Registered Nurses to the Cardiovascular Surgical Intensive Care Unit. Critical Care Nursing Clinics of North America, 19(4), 417-426.Komaratat, S., & Oumtanee, A. (2009, October). Using a Mentorship Model to Prepare Newly Graduated Nursses for Competency. The Journal of Continuing Education in Nursing, 40(10), 475-480.LaFleur, A. K., & White, B. J. (2010, November/December). Appreciating Mentorship The Benefits of Being a Mentor. Professional Case Management, 15(6), 305-311.Marzlin, K. (2011, January/Febuary). Structuring Continuing Education to Change Practice. Dimensions of Critical Care Nursing, 30(1), 41-52.Morrow, S. (2009, April). New graduate transitions: leaving the nest, joining the flight. Journal of Nursing Management, 17(3), 278-287.Nedd, N., Nash, M., Galindo-Ciocon, D., & Belgrave, G. (2006, January-March). Guided Growth Intervention From Novice to Expert Through a Mentoring Program. Journal of Nursing Care Quality, 21(1), 20-23.Prouix, D. M., & Bourcier, B. J. (2008, August). Graduate Nurses in the Intensive Care Unit: An Orientation Model. Critical Care Nurse, 28(4), 44-52.Rundio, A., & Wilson, V. (2010). Nursing Review and Resource Manuel Nurse Executive (1st ed.). Silver Spring, MD: American Nurses Credentialing Center .Schoessler, M., & Waldo, M. (2006, March/April). The First 18 Months in Practice. Journal For Nurses In Staff Development, 22(2), 47-52.Shirey, M. R. (2007, April). Competencies and Tips for Effective Leadership. JONA, 37(4), 167-170.Wathen, E. (2009). The Transition into Nursing Practice. In G. Roux, & J. A. Halstsead, Issues and Trends in Nursing: Essential Knowledge for Today and Tomorrow (pp. 503-537). Sudbury, MA: Jones and Bartlett.Wolak, E., McCann, M., Queen, S., Madigan, C., & Letvak, S. (2009, ). Perceptions Within a Mentorship Program. Clinical Nurse Specialist, 22(2), 61-67. ................
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