Posted: September 10th, 2023

NURS13144 Transitional Challenges for New Graduate Nurses

UNIT CODE: NURS13144
UNIT TITLE: Preparation for practice as a Registered Nurse
Assessment Two – Short Answer Responses
Type: Written Assessment – Short Answer Responses
Due date: 4pm (AEST) Tuesday 3rd October 2023 (Week 12)
Weighting: 50%
Length: 1600 words (±10%)
Unit Coordinators: Natalie Browning and Chanchal Kurup
Course Learning Outcomes Assessed
1. Identify transitional challenges that you may experience in your transition from
student to registered nurse and explain the skills and strategies you may
require to manage this transition
2. Explore power differentials that can exist within healthcare organisations and
the tensions that may arise from these
3. Identify leadership roles undertaken by graduate registered nurses and discuss
the skills required to undertake these roles
4. Analyse how the knowledge of governance systems can support the graduate
registered nurse to provide safe patient care
Aim
This assessment asks you to consider four different aspects of transitioning from a
student nurse to a Registered Nurse: transitional challenges, power differentials,
leadership, and clinical governance.
Instructions
This assessment functions as a ‘choose your own adventure’. Each question provides
multiple options; you need to choose one option to respond to for each question. Each
question requires a short response of approximately 400 words (± 10%), for a total of
1600 words. Please include all four responses in a single Microsoft Word document,
ensuring that each question is written in full with your chosen topic clearly identified
followed by your response.
1) Transitional challenges are commonly encountered by many new graduate
Registered Nurses. Choose one of the transitional challenges below and outline
two skills or strategies you could use/implement to successfully navigate the
chosen transitional challenge as a graduate registered nurse in the Australian
healthcare setting. (400 words)
a. Role transition (e.g. from student to RN, AIN to RN, or EN to RN).
b. Adapting to the organisational culture of the ward/unit/facility
c. Joining a team
d. Time management
2) Choose one of the examples provided below. Briefly outline the perceived
power differential and discuss how this could impact the patient care provided
by the graduate registered nurse (400 words)
a. A graduate registered nurse needs to delegate a task to a very
experienced enrolled nurse
b. A graduate registered nurse needs to talk to the nurse unit manager
about the upcoming roster, which has the graduate registered nurse
working ten eight-hour shifts in a row.
c. A graduate registered nurse is preceptoring a second-year nursing
student and needs to talk to them about their underperformance.
d. A graduate registered nurse asks a much older assistant-in-nursing to
help with a hoist transfer. The assistant-in-nursing refuses and tells the
graduate registered nurse to do the hoist transfer alone.
3) Choose one of the advanced nursing roles below. Discuss two leadership skills
you can develop as a graduate registered nurse which will help to prepare you
for the chosen advanced nursing role (400 words)
a. Clinical nurse consultant/specialist
b. Nurse unit manager
c. Director of nursing of a rural hospital
d. Nurse educator
e. Nurse practitioner
4) Choose one of the National Safety and Quality Health Service Standards listed
below. Analyse how you as a new graduate registered nurse could use one
aspect of this Standard to improve patient care in a specific patient context (e.g.
orthopaedic ward, residential aged care facility, child health nursing service,
remote health clinic etc.). The importance of the chosen NSQHS standard for
the specific patient context must be justified (400 words)
a. Preventing and controlling Infections
b. Medication safety
c. Comprehensive care
d. Blood management
e. Recognising and responding to acute deterioration
Literature and references
In this assessment use at least 5 references from relevant, high-quality and
contemporary journal articles (<5 years) to support your discussion. You may also use seminal scholarly literature, textbooks and credible websites where relevant. When sourcing information, consider the 5 elements of a quality reference: currency, authority, relevance, objectivity, and coverage. Grey literature sourced from the internet must be from reputable websites such as from government, university, or peak national bodies: for example, the Australian College of Nursing. Avoid using blogs, even when hosted by universities and other reputable organisations, as these are not credible sources. Requirements 1. Use a conventional and legible size 12 font, such as Arial, Calibri, Times New Roman or similar, with 2.0 line spacing and 2.54 cm page margins (standard pre-set margin in Microsoft Word). 2. Include a title page with your name, student number, unit code and name, names of unit coordinators, due date, date submitted, and word count of each question. 3. Include page numbers on each page in a footer. 4. You may write in the first-person perspective. 5. Use formal academic language. 6. Do not use dot points or bullet points. 7. Clearly identify which topic you have chosen for each question. 8. Use Australian spelling and language conventions (e.g. organisation). 9. Use the seventh edition American Psychological Association (APA) referencing style. The CQUniversity Academic Learning Centre has an online APA Referencing Style Guide. 10.An introduction, conclusion, and table of contents are not required. 11.The word count is considered for each individual response. The word count excludes the assessment questions and reference list but includes in-text references and direct quotations. Resources 12.You can use unit provided materials and other credible sources (e.g. journal articles, books) to reference your argument. The quality and credibility of your sources are important. 13.We recommend that you access your discipline specific library guide: the Nursing and Midwifery Guide. 14.For information on academic communication please go to the Academic Learning Centre Moodle site. The Academic Communication section has many helpful resources including information for students with English as a second language. 15.Submit a draft before the due date to review your Turnitin Similarity Score before making a final submission. Instructions are available here. Submission Submit your assessment via the unit Moodle site in a Microsoft Word document. Marking Criteria Refer to the marking rubric on the Moodle site for more detail on how marks will be assigned. Transitional Challenges for New Graduate Nurses Role Transition from Student to Registered Nurse One significant transitional challenge faced by new graduate registered nurses is adapting to the role transition from student to fully qualified practitioner. Having spent years in the student role with guidance and supervision, the graduate nurse must now independently take on full responsibility for patient care (Duchscher, 2008). Two skills that can help with this role transition are developing self-awareness of strengths and limitations, and utilizing support networks. First, it is important for the graduate nurse to realistically assess their own abilities through self-reflection so they do not take on more than they can safely handle in the early months (Casey et al., 2011). Understanding personal strengths and weaknesses will allow for appropriate delegation and knowing when to ask for assistance. Second, maintaining strong connections with clinical preceptors, nurse educators, and experienced colleagues provides graduate nurses with an important support system to process experiences, debrief, and gain additional guidance as needed (Parker et al., 2014). Relying on the expertise of others helps mitigate risks to patient safety during this adjustment period. Power Differentials in Healthcare Organizations Graduate Nurse Delegating to Experienced Enrolled Nurse One power differential that can impact patient care is a situation where a graduate registered nurse needs to delegate a task to a very experienced enrolled nurse. While the enrolled nurse has greater clinical experience, the registered nurse is ultimately responsible and accountable for the care provided (Nursing and Midwifery Board of Australia, 2016). This could potentially cause tension if the enrolled nurse does not agree with the delegation or feels their expertise is being challenged. To mitigate risks to patient safety, the graduate nurse should have a respectful discussion with the enrolled nurse to explain their rationale for the delegation based on the patient's needs and goals of care (Krautscheid et al., 2017). Emphasizing teamwork and mutual respect can help minimize perceived threats to professional roles that could otherwise interfere with provision of optimal care. Open communication and understanding different perspectives are key for navigating power dynamics in a way that prioritizes the patient. Leadership Skills for Advanced Nursing Roles Nurse Practitioner One advanced nursing role that requires strong leadership abilities is that of a nurse practitioner. To help prepare for this role, two leadership skills graduate nurses can develop are clinical expertise and effective communication. Developing advanced assessment and diagnostic reasoning through further education and experience will help the graduate nurse gain the clinical knowledge and competence expected of nurse practitioners (Bryant-Lukosius et al., 2016). Leadership also involves effectively communicating and collaborating with other healthcare providers as an autonomous practitioner (Nardi & Gyurko, 2013). As a graduate, taking on additional responsibilities like preceptoring students or acting as a clinical resource for colleagues provides opportunities to hone communication and teaching abilities. Mastery of both clinical expertise and relationship-building skills will help position the graduate nurse well for leadership as a future nurse practitioner. Continued development of these competencies during the early career lays the groundwork for advanced practice. Improving Patient Care through Clinical Governance Medication Safety in an Orthopaedic Ward One National Safety and Quality Health Service Standard that could significantly improve patient care outcomes on an orthopaedic ward is medication safety. Medication errors are common, costly, and can have serious consequences for orthopaedic patients undergoing surgery and rehabilitation (Smetzer et al., 2018). As a new graduate registered nurse, I could lead a quality improvement project to enhance medication safety practices. By auditing medication charts and conducting staff interviews, opportunities for error could be identified such as similar drug names, complex regimens, and high-risk medications like anticoagulants (Hughes & Blegen, 2008). Recommendations could then be made to implement strategies like double-checks for high-alert drugs, utilizing tall-man lettering on prescriptions, and standardizing administration processes (Manias et al., 2012). Leading a project demonstrates my commitment to clinical governance and has potential for measurable impact by reducing preventable harm events from medication mistakes. In conclusion, this assessment addressed four key aspects of transitioning to professional practice through thoughtful consideration of challenges, power dynamics, leadership development, and quality improvement. Drawing from credible sources supported discussion of strategies for successful role transition, navigating relationships, advancing competencies, and enhancing patient outcomes through governance. Continued reflection on these topics will serve me well as I embark on my nursing career.

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