Abstract
The primary objective of this study was the evaluation of the transitional factors which a nursing student has to face in the path of becoming a professional, in their transitional phase. The study primarily keeps the transitional factor of competency of the nurses in organizing and managing shifting workloads in its focal point. The severity of these factors can be minimized to a bearable extent so that the nurses can carry on with their professional lives safely while maintaining the nursing protocols. As per the findings of this study, the presence of an unfamiliar and professional environment and lack of practical knowledge are the main reasons for the transitional factors. Nursing is a job with a heavy workload and hence management of the workload is necessary. Extra workload precedes fatigue and proper nutrition, diet, and sound sleep can replenish the fatigued energy. Even the distribution of workloads while managing time also can help with minimizing the transitional factors. Supervision of the recruits and incorporating nursing supervisors can be beneficial. Minimizing the effect of transitional factors will lead to a safe working environment while increasing efficiency.
Introduction
The transitional phase of a student from institutional life to professional life poses various mental and orientation-based changes in a person. It presents with changes in responsibilities, goals, and involvement. The challenges come with various physical and mental health changes. Nurses entering the professional world encounter exhaustion and severe burnout (Epstein et al., 2020). This study discusses the necessity of planning and organizing shift workloads as a transitional factor. This considers time management, fatigue management, and management of emergency issues arising in the healthcare center. Lack of help and being in an exposed work situation with high demands hinders a nurse’s development of medical competence when working with complex patient situations, which in turn affects high-quality care and patient security negatively (Pačarić, Nemčić & Farčić, 2018). Improved aid is wished from the start to enhance nurses’ work situation and decrease the pressure and demands positioned upon them. Processing and execution of a properly planned work routine are crucial. Efficient planning of the shifts will allow each nurse to rest properly and will result in proper management of patient care (Pradas-Hernández et al., 2018). Mentally and physically fit nurses can provide proper palliative care to the patient. The report focuses on the identification of the transitional factors that a nurse faces while entering professional life.
Findings
The transient factors associated with the effectiveness in managing the shift workload, like time management, difficult work pressure, and administrating challenging care wishes are to be outlined and referred to in this section. Several related searches for articles will be added. Patricia Benner classified nurses from novice to expert, whereas newly graduated nurses fall into the category of advanced beginners (Stawicki et al., 2020). They lack any experience in the practical fields and they need to be provided with some special training so that they can efficiently manage time, complex cases, and physical and mental exhaustion. Taking these things into account, the management arranges competency-building activities to familiarize and habituate the new employees to the environment. At the start of the career, the lack of confidence, mismanagement of workload, fear, anxiety, and orientation issues arise due to insufficient knowledge of the practical field and reliance only on theoretical understandings. Management of time is often a serious issue for them. Complex case handling is also a major challenge for them as adapting to the new environment and precisely handling the situation needs time. Some evidence-based strategies might be of help to keep them mentally and physically competent. Duchscher & Windey, (2018), described shocks experienced by nurses in their transitional period into different phases. This model of transition includes four determinants, which are self-doubt, confusion, feelings of loss, and disorientation. Involvement of these factors impairs mental stability and emotional homeostasis. Four more areas are also involved with transition-related shock, which are roles, responsibilities, relationships, and knowledge. Excessive stress and anxiety in the workplace lead to fatigue and burnout which in turn results in disinterest in the job (Benjamin et al., 2021). The clinical features that are seen in newly graduated nurses are lack of concentration, lower back pain, and headaches. The self-reports of the nurses also suggest that these conditions often lead to quitting jobs for better opportunities. All these factors are also accompanied by poor communication and a lack of cooperation among senior nurses and other healthcare professionals. These lead to poor clinical decision-making for patients on their own and handling patients with complex care needs. A study on nurses found that there is a huge correlation between time administration ability and educational motivation. These instances are suggestive of mismanagement by the administration and they should promote psychological health and give education with efficiency and effort. Characteristics perceived across ninety-one studies conclude that exhausting job patterns are related to burnout in nursing. Maslach’s principle describes a psychological assessment tool that considers 22 symptoms of exhaustion and relates it to occupational burnout. The dimensions that this test considers, are depersonalization, personal accomplishments, and emotional exhaustion. It is frequently associated with work-life Surveys. As burnout is difficult to recognize and distinguish from other factors, it is hard to gather evidence that can be used to reduce exhaustion.
Analysis/Discussions
There are several reasons for which the transitional factors keep a nursing graduate from being a skilled worker. Incidents such as preparing staff, professional relationships, degree of support which is perceived, professional accountability and commitment, welfare services, and a decrease in several trained nurses potentially have contributed to nurses’ ability to cope with transitions (Broetje, Jenny & Bauer, 2020). As the study performed by Murray, Sundin & Cope, (2019), suggests, due to transition shock, nurses often feel doubt and confusion and a question about their knowledge base and skills. They often felt stressed, scared, and overwhelmed due to this. According to the self-reported finding, failure to identify clinical deterioration or missing a significant care aspect, NGNs often feel confused and panicked, and such poor ability to cope with anxiety interferes with their consciousness and concentration on current tasks or activities (Labrague & De Los Santos, 2020). The reasons which are affecting the transitional workload of nursing students are –
Support from others: – The students who have just become professionals, often do not have the experience and practical knowledge to make decisions themselves and act accordingly. In undergraduate college, students have the guidance of the professors, while in the practical field, they are on their own. Here, the higher authority and older colleagues have a role to play. It is also supported by evidence that a hospital having a supportive environment has a lesser morbidity rate. Recognition of the work of a nurse is also judged by the head nurses and their acknowledgment of performance and achievement. An issue that is responsible for such contemporary transition issues often experienced by nurses includes poor relationships with other health professionals and members of multi-disciplinary teams (Boamah, Read & Spence Laschinger, 2017). In this aspect, it can be stated that, when a nurse enters his/her professional career, some of the time, he/she experiences bullying, emotional abuse, and humiliation from senior nurses and other health professionals. Lack of cooperation in the transition phase often acts as a major barrier for them to properly communicate their issues and disruption in the work process (Boamah, Read & Spence Laschinger, 2017). The above-mentioned process significantly affects standards of patient care, which are to be discussed in the subsequent paragraph of the study.
Poor job satisfaction-Professional nurses are always liable to follow standards of practice and codes of conduct that ensure some particular guidelines and regulations to ensure safe and secure patient care (El Haddad, Moxham & Broadbent, 2017). However, it is evident that nurses who have poor job satisfaction due to high transitional shock feel withdrawn from their job roles and often make several mistakes associated with patient care procedures. Transitional shock among nurses has an inversely proportional relationship with resilience, empathy, and job satisfaction. According to the NMBA codes of conduct, a registered nurse must follow seven fundamental standards of nursing that include critical thinking and strategic analysis, proper engagement in therapeutic and professional relationships with patients and other healthcare professionals, maintaining the capability of practice, conducting a comprehensive assessment, development of patient care plan, delivery of safe, authentic and responsive standard of nursing practice and lastly, evaluation of outcomes to instruct practice of nursing (nursing midwifery board, 2021). In this regard, it can be stated that constant stress and anxiety often interfere with standard six which includes the delivery of a safe, appropriate, and responsive standard of nursing practice. In the study of (Sadeghi, Oshvandi & Moradi, 2019), it has been identified that nurses often make mistakes in providing comprehensive care and following safe medication strategies while providing care to patients with complex care needs. Lack of confidence due to poor relationships with staff often interferes with the process of developing good therapeutic relationships with patients. Strategic decision-making often requires empowerment and encouragement for nurses. However, due to having a tight schedule and poor time management skills considering transitional shock, they fail to use a creative mindset and strategic decision-making to bring positive change to patient care facilities.
Conclusion
That in this study, the author has specifically focused on some contemporary transition issues commonly experienced by nurses. The main focus was on investigating determinants and variables that are directly or indirectly associated with the impact of transitional shock or contemporary transition issues such as fatigue, poor time management, and challenges in handling complex care issues. Some major issues that were found to be directly associated with such occurrences include poor confidence, anxiety, and fear. On the other hand, other environmental or situational factors that also lead to poor resilience and adherence of nurses to their job roles and responsibilities include poor relationships with other healthcare professionals, emotional abuse, and humiliation in the workplace. All the above-mentioned issues are considered to have a significant impact on the standard of patient care they provide for patients. If nurses fail to meet their code of conduct it deteriorates the clinical outcomes of patients with complex care needs.
Recommendation
Self-care strategies – One self-care strategy that nurses need to follow is to start working on creative activities that include painting, singing, gardening, and other hobbies as per individual requirements. Nurses have to practice whatever they have learned throughout their education and try to use full of their training practically. They should attain more heights of education and also training by an enhanced education system. As evidence suggests, staying adhered to creative activities significantly helps in increasing perseverance and balance between professional life and personal life (Kester & Wei, 2018). It helps in increasing the concentration of individuals and therefore, it is anticipated that nurses will be able to cope with their stress and anxiety in the transition phase which will further help in managing time and strategic decision making. It will help them to build a strong mentality in every situation. They should be more active in performing cardio, yoga, or other physical exercises, and try to intake a good fiber diet and 4-course meals. If they face fatigue they can lessen it by dividing the workload and communicating with others.
Improvement in healthcare organization –This strategy needs to be followed by all the nurses or clinical team who are experiencing stress, anxiety, and other transitional shock-associated complications in their transition phase. Creative activities are to be followed in a residential setting after initiation or accomplishment of job hours. Evidence-based recommendations for healthcare organizations to address the transitional factor of nurse trainees or other health stuffs which are needed to arrange a resilience training session for them which will help in increasing coping skills and strategies within the workplace (Maria et al., 2020). In this program, the motivational session needs to be incorporated which will help in empowering participants to focus on their jobs and be more confident while providing care to their patients. Stakeholders like trainers, supervisors, and registered nurses need to arrange this program to ensure the emotional and psychological well-being of nursing staff as well as other healthcare professionals. Resilience training programs can be arranged in healthcare facilities at a particular time with prior instruction to all nurses who are experiencing trouble regarding transitional shock. The organization should also take the responsibility of developing a good workplace for nursing staff so that they don’t face further problems and try to make more plans to make good relationships between employees and employers which will help them in the long run in return.
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