Sample on Case Study Analysis: Graduate RN Transition
Case Study Analysis: Graduate RN Transition
Nurses play a vital role in providing health care in the contemporary world. They are expected to provide patients with high-quality and compassionate care while maintaining a healthy work-life balance (Daly & Jackson, 2020). Transitioning from being a student to a registered nurse (RN) can be tough. It is, therefore, important for nurses to have access to support during this time (Smith et al., 2022). This includes access to evidence-based resources and strategies that can help them to build resilience, cope with stress, and maintain a healthy work-life balance (Chang & Daly, 2019). This essay seeks to evaluate the case study of Harry, a graduate RN who seems to be having difficulty during his clinical shift. The focus of the essay will be on whether or not the graduate RN fulfilled his responsibilities and roles during his shift and make suggestions for how the shift might have been done differently. Furthermore, evidence-based methods that may be used to assist the graduate RN through his transition period will be discussed.
Role and responsibilities of the RN
As the World Health Organization postulates, the role of nurses has evolved in response to changes in healthcare needs and advances in technology (WHO, 2019). In Australia, the Nursing and Midwifery Board of Australia (NMBA) is the nurse regulator and sets out the standards that all registered nurses must meet to practice safely and effectively (Australian Commission on Safety and Quality in Health Care, 2021b). These standards are based on the International Council of Nurses Code of Ethics for Nurses and include provisions for professional conduct, communication and collaboration, and continuing professional development. The NMBA Standards also require nurses to understand their practice’s legal and regulatory framework (Australian Commission on Safety and Quality in Health Care, 2021b).
In order to meet their role and responsibilities, nurses must have the skills, knowledge, and attitudes required for the effective and safe provision of care. They must also utilize technology and teamwork skills effectively (Baumann et al., 2018). However, Harry did not take the time to orient himself to his new surroundings or introduce himself to the other healthcare team members. This meant that he was not able to effectively communicate and collaborate with others during his shift (Whitmore et al., 2019). This is evident when the patient is unable to find the patient’s notes and has to ask the other team members for help.
Additionally, he does not utilize technology effectively during his shift. He is seen not to have completed filling the patient’s notes on the COWS machine (Computer on wheels machine) by the end of his shift. This prevented the next nurse from accessing that information and could have led to a delay in care (Nursing and Midwifery Board of Australia, 2016).
The Nursing and Midwifery Board Australia (NMBA) Registered Nurse Practice Standards (2016) state that nurses are expected to provide safe, high-quality, and compassionate care. They are also expected to maintain a healthy work-life balance. Harry appears to be struggling to meet these standards in the case studies. For example, he is anxious about his shift and does not feel he has provided adequate care for his patients. He is also frustrated with staying late to finish his patient notes. These examples suggest that Harry is struggling to cope with the demands of the RN role (Nichols, 2019).
However, there are some instances where Harry meets the standards of the NMBA. For example, he is able to reflect on his shift and identify areas where he could improve. He is also willing to ask for advice from his nurse preceptor. These examples suggest that Harry has the potential to be a successful RN if he is given the right support and resources (Nursing and Midwifery Board of Australia, 2018).
Similarly, the ACSQHC Australian Commission on Safety and Quality in Health Care (2021a) states that nurses are responsible for providing safe, high-quality care. In order to do this, they must be competent and have the necessary skills, knowledge, and attitudes. Harry does not appear to have the necessary skills or knowledge to complete his shift effectively. For example, he is unfamiliar with the computer system and struggles to find Mrs. Williams’ records. He also fails to attend to Mrs. Williams’ pain medication, which is an important consideration in providing palliative care. Consequently, it could be argued that Harry did not meet his role and responsibilities as an RN during his shift (Australian Commission on Safety and Quality in Health Care, 2021a).
However, it is important to consider that Harry is a graduate RN who is still in the process of transitioning from student to registered nurse. As such, he may not have had the opportunity to develop the necessary skills and knowledge to complete his shift effectively (Ashley et al., 2018). It is also important to note that Harry did show compassion towards Mrs. Williams and her family. For example, he listened to their concerns and offered them support. Consequently, while Harry may not have met all of his roles and responsibilities as an RN during his shift, he displayed some of the important skills and qualities required for the role (Stanley, Bennett, & James, 2022).
Recommendations
There are various recommendations that Harry could have considered that would have aided him in completing his shift differently. Firstly, Harry could have used the technology available to him, such as the COWS machine. This would have helped him to keep track of his patients’ records and ensured that he had all the necessary information to hand (Duckett & Willcox, 2015). Additionally, Harry could have sought advice from his nurse preceptor or another experienced RN before commencing his shift. This would have helped him better understand his role and responsibilities and the expectations of the job (Voss et al., 2022).
Additionally, it would have allowed him to document Mrs. Williams’ care on time effectively. It would have also allowed him to handle the records in an organized way, which would have prevented the next nurse from showing an attitude toward him. This would have enabled him to complete his shift in a more efficient and effective manner (Spector et al., 2015).
Secondly, Harry could have been more organized during his shift. For example, he could have ensured he had all the necessary supplies before starting his rounds. Additionally, he could have taken breaks when needed in order to avoid getting overwhelmed (Forrester & Griffiths, 2014). For instance, from the case study, it is evident that Harry became overwhelmed when trying to stop Mr. Sommersby from wandering outside the hospital wards. He could have sought assistance at this point or taken a break to clear his head. This would have prevented him from becoming overwhelmed and helped him manage his time better. Furthermore, it would have also allowed him to effectively monitor Mrs. Williams, whom he failed to monitor for 3 hours.
Thirdly, Harry could have been more assertive when communicating with the other healthcare team members. For example, he could have asked questions if he was unsure about something. Additionally, he could have been more proactive in seeking advice from the more experienced members of the team (Hatzenbuhler & Klein, 2019). This would have helped him to better understand his role and responsibilities, as well as the expectations of the job. Furthermore, it would have also allowed him to build positive relationships with the other members of the healthcare team (Collyer, Willis, & Keleher, 2019).
Evidence-based strategies for a graduate transitioning RN
There are a number of Evidence-based strategies that could be made to improve the care provided by Harry. Firstly, he could be given more support and resources to help him transition from student to registered nurse. This could include more opportunities to shadow experienced nurses, as well as access to online resources or a mentor (Duffy, 2019). Additionally, Harry could be encouraged to attend workshops or courses to develop his skills and knowledge. As Murray, Sundin, and Cope (2019) postulate, workshops would have the advantage of being interactive, allowing Harry to ask questions and receive feedback. They would also provide him with the opportunity to meet another new graduate RNs and learn from their experiences. In addition, Harry must be given clear expectations and guidance on his role and responsibilities as a registered nurse (Murray, Sundin, & Cope, 2019). This could be done through regular meetings with his manager and having access to written resources that outline his role. Moreover, Harry must receive feedback on his performance to help him identify areas for improvement (Duffy, 2019).
Secondly, the hospital could consider implementing a handover process for new graduate RNs (Eckerson, 2018). This would involve an experienced nurse providing a detailed overview of the shift to the new graduate RN. According to Eckerson (2018), this would ensure that the new graduate RN is aware of their responsibilities and knows what to expect. Additionally, the handover process would provide the new graduate RN with an opportunity to ask questions and seek clarification on any points that they are unsure about (Lesher et al., 2021). This would help reduce the likelihood of errors or mistakes during the shift.
Ultimately. It is important to note that Harry’s success as a registered nurse will ultimately depend on his willingness to learn and grow in his role. He should be encouraged to take advantage of the resources and support available to him to improve his skills and knowledge. Additionally, he should be given time to adjust to his new role and responsibilities. With time and support, Harry can develop into a competent and confident registered nurse.
Conclusion
Harry is a graduate RN who has recently transitioned from student to registered nurse. During his first shift, Harry struggled to complete his tasks and responsibilities effectively. This was partly due to the fact that he was not familiar with the technology available to him and the lack of guidance and support he received. Several evidence-based strategies could be implemented to help Harry transition from student to registered nurse. These include providing him with more support and resource and increasing his understanding of technology in the workplace.
Additionally, Harry could be given more information on palliative care and pain management. Ultimately, these strategies would help Harry to be a more successful RN. Nonetheless, it is crucial to remember that Harry is a graduate RN who is still in the process of transitioning from student to registered nurse. As such, he may not have had the opportunity to develop the necessary skills and knowledge to complete his shift effectively. However, with the right support and resources, Harry has the potential to be a successful RN.
References
Ashley, C., Brown, A., Halcomb, E., & Peters, K. (2018). Registered nurses transitioning from acute care to primary healthcare employment: A qualitative insight into nurses’ experiences. Journal of clinical nursing, 27(3-4), pp. 661–668.
Australian Commission on Safety and Quality in Health Care. (2021a). Australian Commission on Safety and Quality in Health Care. Safetyandquality.gov.au. https://www.safetyandquality.gov.au/publication-year/2021
Australian Commission on Safety and Quality in Health Care. (2021b). National Safety and Quality Health Service Standards Second edition -2021. Australian Commission on Safety and Quality in Health Care. https://www.safetyandquality.gov.au/sites/default/files/2021-05/national_safety_and_quality_health_service_nsqhs_standards_second_edition_-_updated_may_2021.pdf
Baumann, A., Hunsberger, M., Crea‐Arsenio, M., & Akhtar‐Danesh, N. (2018). Policy to practice: Investment in transitioning new graduate nurses to the workplace. Journal of Nursing Management, 26(4), 373–381.
Chang, E., & Daly, J. (2019). Transitions in Nursing eBook: Preparing for Professional Practice. Elsevier Health Sciences.
Collyer, F., Willis, K., & Keleher, H. (2019). The private health sector and private health insurance. Understanding the Australian Health Care System, 37.
Daly, J., & Jackson, D. (2020). Contexts of nursing: An introduction. Elsevier Health Sciences.
Duckett, S., & Willcox, S. (2015). The Australian health care system (No. Ed. 5). Oxford University Press.
Duffy, M. E. (2019). Concerted Management Support in New Graduate RNs: What’s It All About?
Eckerson, C. M. (2018). The impact of nurse residency programs in the United States on improving retention and satisfaction of new nurse hires: An evidence-based literature review. Nurse education today, 71, 84-90.
Forrester, K., & Griffiths, D. (2014). Essentials of Law for Health Professionals-eBook. Elsevier Health Sciences.
Hatzenbuhler, N. J., & Klein, J. E. (2019). Educational preparation for clinical practice: Reflections of newly graduated RNs. Nurse Educator, 44(2), 93-97.
Lesher, B. B., Witt, J. M., Woodard, R. M., & Haberman, A. B. (2021). New graduate RN perinatal internship. The Journal of Continuing Education in Nursing, 52(1), 47-52.
Murray, M., Sundin, D., & Cope, V. (2019). New graduate nurses’ clinical safety knowledge by the numbers. Journal of Nursing Management, 27(7), 1384-1390.
Nichols, E. M. (2019). Transitioning from nursing student to registered nurse.
Nursing and Midwifery Board of Australia. (2016). Registered nurse standards for practice. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professionalstandards/registered-nurse-standards-for-practice.aspx
Nursing and Midwifery Board of Australia. (2018). Code of conduct for nurses. http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements.aspx
Smith, C. J., DesRoches, S. L., Street, N. W., & Hyatt, J. (2022). New graduate registered nurses: Risk mitigation strategies to ensure safety and successful transition to practice. Journal of Healthcare Risk Management, 42(1), 24-30.
Spector, N., Blegen, M. A., Silvestre, J., Barnsteiner, J., Lynn, M. R., Ulrich, B., … & Alexander, M. (2015). Transition to practice study in hospital settings. Journal of Nursing Regulation, 5(4), 24-38.
Stanley, D., Bennett, C., & James, A. H. (Eds.). (2022). Clinical leadership in nursing and healthcare. John Wiley & Sons.
Voss, J. G., Alfes, C. M., Clark, A., Lilly, K. D., & Moore, S. (2022). Why mentoring matters for new graduates transitioning to practice: Implications for nurse leaders. Nurse Leader.
Whitmore, C., Baxter, P. E., Kaasalainen, S., & Ploeg, J. (2019). The Similarities and Differences in Transition to Practice Experiences for New-Graduate RNs and Practical Nurses in Long-term Care. JONA: The Journal of Nursing Administration, 49(12), 586-590.
World Health Organization. (2019). Global action plan on physical activity 2018-2030: more active people for a healthier world. World Health Organization.