Posted by: ayrshirehealth | July 6, 2012

Getting your first year off to a flying start. By @mz_kimb

Newly qualified nurses

According to Shirely (2009) as a newly qualified nurse your priorities lie in socialising into your own new role, making the right choices, identifying your strengths and building your confidence.  Through the literature there appears to be significant disagreement about the level of support available to nurses new to the profession.  Deasy et al (2011) found that there exists a poor level of support, whereas Shirely found there were good resources to support newly qualified nurses, conversely suggesting that resources were lacking to support long term career development.

Scottish resources

As a Scottish nurse I have been able to benefit from NHS Education for Scotland (NES)’s Flying Start programme, a web based learning resource to help newly qualified nurses make the transition from student to registered nurse.  In addition they have recently launched The Effective Practitioner, a web based resource, which, following Flying Start supports nurses throughout their career.  Early Clinical Career Fellowships was one of Scotland’s lead areas under Modernising Nursing Careers, it supports a cohort of newly qualified nurses to continue their education to Masters level – admission onto the programme is after a gruelling selection process (naturally!) run by NES.

The literature suggests that, while these resources are available in Scotland, this is not the case everywhere.  From my experience so far I would encourage all nurses to look outside their local areas to find these resources as they are most definitely out there.

From my first year in practice I would suggest that the safe transition to competent registered nurse is not all about the individual practitioner and the literary/educational resources available to them. To enable a newly qualified nurse to flourish and develop it requires an organisation that truly recognises staff as ‘assets’ (Hampel et at 2010), however it also requires supportive teams within that organisation, sensitive to the learning needs of new team members; this allows the new nurse to feel safe and able to ask questions (Peason 2009).  In my case, many many questions!

Mentorship

Mentorship from great practitioners has been invaluable to me through this first year. This mentorship not only gave me the confidence in the application of clinical skills learnt throughout my training, but it also provided inspiration and direction –  an perspective supported by Tracy & Nicholl (2006).  Hughes (2005) suggests that a good mentor will help you reflect and encourage self-reflection as a tool to help you develop.  I would suggest, from my first year in practice, that it also enhances the impact and application of education/learning in clinical practice.

At a time when your mind is full of what you have just been taught and what you are now learning I’ve found it’s essential to utilise opportunities to embed positive influences on your practice, this is after all a key stage of my development. You learn from role models you see around you in clinical practice.   Critically I think a mentor can also help you negotiate what is expected of you throughout this first year.

Gerrish’s 2000 article discussed her own 1998 and 2000 findings, regarding the fitness to practice of new nurses qualifying ; she found that the nurses themselves perceived that they were given too much responsibility and felt stressed by this accountability and responsibility, a finding supported by Shirely (2009). Gerrish also found however that overall it was believed by services that nurses where not ready to fully fulfil the role of registered nurse (how many of us newly qualified’s have heard that! – an interesting and unanswered dichotomy considering that 50% of our development/learning happens in the practice setting and 100% of our sign off as being ready to enter the register).  There exists therefore incongruence in that we are felt not to be ready but often given too much responsibility – illustrating the indispensible role of the mentor!  Additionally as every nurse knows, the Code (NMC 2008) requires you to work within your competence, in other words, it’s ok not to know it all!

Learning in practice

Findings from a study by Taris and Feij (2004) resonated with my experience of coming into the profession. They studied the impact of demand (in my case raised expectations and increased complexity of caseload) and control (increased autonomy) upon learning capacity.  The study showed that a combination of high demand and high control can provide an opportune learning environment, superior to a low control, low demand position. They also found that gently lowering demand can increase learning capacity. I read this research as a reminder to keep the balance of demand at the right level for me, while remember to keep advancing my practice and expecting more from myself.

The study also showed that strain can inhibit learning – another reminder to moderate/control the level of demand placed upon me.  A competent mentor is well placed to help support this moderation process.

Interestingly they also showed that learning does not inhibit strain, as a nurse I believe this to be an important point as it shows that academia, while important, is not enough in itself, it is a reminder of the importance of clinical supervision and seeking the support of your mentor.

Getting off to a flying start

My hope in writing this blog is that it may be of value to one of my newly qualified colleagues, there are resources out there to support us and it’s ok to come across challenges in developing our skills.However I also hope it is of value to mentors and those responsible for supporting newly qualified colleagues in embedding newly developed skills into our routine practice – your support and guidance is invaluable in getting us off to a flying start.

References used in this blog:

Deasy, C., Doody, O  & Tuohy, D. (2011) An exploratory study of role transition from student to registered nurse (general, mental health and intellectual disability) in Ireland. Nurse Education in Practice. Volume 11, Issue 2 , Pages 109-113

Hampel, S., Procter, N & Deuter, K. (2010) A model of succession planning for mental health nurse practitioners. International Journal of Mental Health Nursing. Vol. 19, Issue 4, pages 278–286

Hughes, E. (2005) Nurses’ perceptions of continuing professional development. Nursing Standard

Nursing & Midwifery Council (2008) The Code: Standards of conduct, performance and ethics for nurses and midwives. NMC London

Pearson, H. (2009) Transition from nursing student to staff nurse: a personal reflection. Paediatric Nursing. 2009 Apr; 21(3):30-2.

Shirley, M (2009) Building an Extraordinary Career in Nursing: Promise, Momentum, and Harvest. The Journal of Continuing Education in Nursing. Vol. 40 Issue 9 pages.394-400

Taris, T & Feij, J (2004) Learning and strain among newcomers: A three-wave study on the effects of job demands and job control. The Journal of Psychology Vol 138 No 6 pp 543-563

Tracey, C & Nicholl, H (2006) Mentoring and networking. Nurse Management Vol 12 No 10 pp 28-32

Next week’s blog comes from @austynsnowden.

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Responses

  1. Really enjoyed your blog….and great to hear about your understanding of the importance of accessing and using the excellent resources available to support consolidation of learning – but also how good mentorship is crucial in enabling this process for newly qualified staff.

    • Thank you. I really appreciate all the nurses that helped me through my first year and continue to do so! Hope one day I can help someone like they have.

  2. Great blog Kim.
    A fantastic insight into the first year. Supportive people and organisations are key to this in my view combined with an individuals desire to develop

    • Absolutely, the desire to develop is strengthened by those supportive people and organisations too. Thanks for the comment!

  3. Have you found resonance for your enthusiasm and reflections within other disciplines within the teams you have worked with – medical, AHP, psychology for example ? My question comes from an interest in common elements of professional identity among clinical professions (which are often de-emphasised for various reasons).

    • The question of professional identity is an intriguing one. The reasons and extent to which each profession feels the need to ‘defend’ their identity is perhaps worthy of a future blog (?) – and subsequent discussion. I’m sure Mz_kimb will respond regarding her own experience.

  4. Indeed, could make an interesting future blog topic…. and in something I am sure that there are thousands of things already written about; and we’ll all have our particular experiences to share.


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