The Impact of Preceptorship on the Newly Qualified Nurses
Review of the Materials 5 3. Main themes of the literature discussing pro and cons of the preceptorship program 7 4. Results 11 4. Unfair expectations 11 4. Possible reasons for unfair expectations - Clinical environment 12 4. Design: Descriptive design was employed in the study to determine the impacts of preceptorship to the newly qualified nurses. Data sources: Some sources of data which were employed when collecting the data included catalogs in library EBSCO (2011), Dawson Era (2015), the Academic one file and 123 libraries (2010). Bibliography database of (CINAHL) which is the Cumulated Index of Nursing and Health Allied Literature of 2016, The Medline (2012), Istor and Nursing. Also, some websites which are relating to health that information was sourced from the (DoH) Department of Health and Children website (2009). Method: A qualitative and quantitative method of approach was employed.
Due to the shortage of nurse preceptors who are qualified in the health care system, this generally affects the orientation process of newly qualified nurses in the clinics negatively. This results in failure in orientation and increased nurse turnover. The rate of turnover in the first year for the newly qualified nurses is approximately 30 percent, and this increases substantially to about 57 percent in their 2nd year of experience (Shields et al. This high rate of turnover in the healthcare has been identified to cause negative impacts on the satisfaction in the job place and also the care offered to the patient. Nicol & Young, 2007). Review of the Materials The study aimed to discover the impact of preceptorship on the newly qualified nurses.
Mixed method was used during the study, the qualitative and quantitative methods. In subheadings, we have a depth discussion of the data sources which were used and the review of the methods. In the last subheading discussion of the conclusion were made and some recommendations were brought forth. Some sources of data which were employed when collecting the data included catalogs in library EBSCO (2011), Dawson Era (2015), the Academic one file and 123 libraries (2010). Quantitative studies used questionnaires. Qualitative studies used interviews which were one used focus groups while the other one used open-ended questionnaires, but no other details which are given. These 15 articles included Nurse education in Practice (2007 to present date) accessed on 29th Feb 2018, Nurse education Today (2010 to present date) which was accessed on 3rd Feb 2018, International Journal of Nursing (2011) accessed on 9th Feb 2018, Nursing Administration Quarterly (2009 to the present date) accessed on 2rd March 2018, Nursing Practitioner (2012) accessed on 17th Feb 2018, Nurse Educator (2007-present date) which was accessed on 22nd Feb 2018, Nursing Preceptor and Meaning Making (2016) accessed on 29th Feb 2018, preceptor- based orientation program (2010) which was accessed on 3rd March 2018, Preceptor matter (2009) accessed on 3rd Feb 2018, The art of preceptorship (2017) accessed 29th Feb 2018, Clinical teaching and learning within a preceptorship program (2017), The effects of nursing preceptorship on new nurses (2017), The meaning of preceptorship (2013) accessed 9th Feb 2018, National Patient Safety Agency (2013) accessed on 17th Feb 2018 and Enhancing healthcare through strengthening the new nurse and preceptor relationship (2014) accessed on 29th Feb 2018.
This chapter reviews the preceptorship history and also the current state of knowledge of newly qualified nurses on preceptorship. The literature is reviewed in the relation of six main themes (1) Need for preceptorship programmes (2) The need for feedback (3) The need for emotional support (4) Protected time for preceptorship (5) Retention of nurses who have newly qualified (6) acquisition of skills and also competence (7) Advantages to the faculty This research will focus on the major impacts of preceptorship to the newly qualified nurses. A survey done by (Allan et al. showed that hose newly qualified nurses who effectively involved with preceptorship program achieves many qualities and skills which are required in their transitional process. As a result of preceptorship programs many newly qualified nurses acquire more specialized knowledge, skills, and professional communication skills which are needed for quality care of the patients and satisfaction (Aiken al.
Preceptorship program is important to the newly qualified nurses because the preceptor supports them which enable them to share freely their fears and anxieties concerning their new roles. A research which was done by Anderson and Mark (2008) found that the rates of retention of the new nurses have increased as a result of utilizing the assistance of a preceptor in clinical transition. The study made a recommendation that the nursing profession should focus more and invest in developing and building the relationship between the preceptor and the preceptee in order to improve the retention rates of newly qualified nurses. In addition to that, Burns (2009) found that the retention rates of the new nurses are increased with the usage of assistance offered by the preceptor into practice during the transition period, also, Cater (2010) found the similar outcome which showed that the rates of turnover of the newly qualified nurses have improved greatly with the introduction of the preceptorship program.
The rates of turnover have decreased by 50 percent. Preceptors have also been identified to help the new nurses to gain and increase professional competence and confidence in practice. Finger and Gelling (2010) evaluated effective preceptor characteristics and also the altitude of the preceptors. showed that hose newly qualified nurses who effectively involved with preceptorship program achieves many qualities and skills which are required in their transitional process. As a result of preceptorship programs many newly qualified nurses acquire more specialized knowledge, skills, and professional communication skills which are needed for quality care of the patients and satisfaction (Higgins et al. p 4-6). Preceptorship program is important to the newly qualified nurses because the preceptor supports them which enable them to share freely their fears and anxieties concerning their new roles.
A study which was done by Fox and Graf (2010) found that the rates of retention of the new nurses have increased as a result of utilizing of the assist of a preceptor in the clinical practice transition. This title may be confusing as many different ones exist with sometimes similar and sometimes differing functions (Holland & Lauder 2012). However, in my Trust, these are nurses that are employed to work alongside colleagues in a particular area (usually the more specialist areas) for the purpose of education and training. My study revealed that this role seems to be valued by newly-qualified nurses as one which can effectively provide teaching and support. The need for emotional support There have been differences which have been perceived between the expectations of new nurses and the qualified preceptor.
This differences can result in the preceptor programs being ineffective when there if conflicting issues between the qualified preceptor and the newly qualified nurses (Darzi 2013). Maben et al. used mixed methods, starting with questionnaires given to senior student nurses followed by interviews with 26 of these once qualified, and quotations help illustrate the findings, although no methodology is stated. Protected time for preceptorship Some studies, including a review in Evans et al. of a study about the system of rotation which has made the new nurses feel the need to have a greater preceptor support. Qualified preceptors who have been assigned to impact clinical skills and knowledge to the newly qualified nurses do not perform this role effectively. If this period of transition is not handled well it can be very stressful for the newly qualified nurses, which can make them leave their career very early (Kramer 2008, Lauder 2012).
The programs to fully support nurses during this transition time are important because there is a shortage of nurses at the time of writing (Francis2013, Ford 2014). During this time of transition, the newly qualified nurses depend on the preceptors to ask them questions, guidance and filling the gaps of knowledge that exists. Retention of the newly qualified nurse staff The retention of newly qualified nurses and satisfaction in the job place begins with how staffs are valued in the organization. Unfortunately, it’s very clear that in many organizations in healthcare view their staff as an expense and not as an asset. According to Shields and Ward (2011 p. found that high job satisfaction related to the provision of preceptorship training. Acquisition of skills and competence Holland et al`s (2009) the preceptorship program is focussed and when new nurses follow this program they are highly skilled and are better than when in control groups.
O’Driscoll et al (2007) requested the newly qualified nurses to evaluate themselves and all of them reported that they were more confident, highly skilled and more competent after attending the preceptorship programme. Other authors have noted the benefit of having worked in one’s area as a student, though this may have been for other reasons, such as knowing the layout of the ward (Persaud 2009) and “continuity” (Burns 2009 p. Ways to address this in practice have been raised, such as a reduction in the workload of these nurses or perhaps the introduction of more PDNs (Practice Development Nurse). However, these solutions require resources so the question remains as to how and whether healthcare organizations will support this answer may lie in the provision of evidence as to the consequences of the current system.
The preceptorship adds the level of professionalism and challenges the new nurses in their new work dimension, this is my motivating them to maintain and continue upgrading their skills in clinical areas and knowledge so that they can provide a high-quality care to the patients. The new nurses acquire growth professionally and they are introduced to the real world of experiences where they apply skills in the clinical wards. In addition, the new nurses are able to meet the potential of being new employees in the health care system they are able to identify major problems which are associated with drugs and also gain knowledge of therapeutic alternatives ( Maxwell 2011). The data show that these nurses feel a sense of unfair expectations which leads the study to consider the environment in which the preceptors work and the possible risks to patient safety.
These results suggested some paramount ingredients which for the preceptorship preparation. Which are discussed below? 4. Unfair expectations Many authors have written about the different expectations that educators and practitioners have of a newly-qualified nurse (Schumaker 2007; Robinson 2009; Ryan et al. Holland (2008) argues that the only way the fitness for purpose can be developed is only when nurses are qualified and working in practice, whilst Thomka (2007) identifies that there is still a discrepancy between what managers and educators consider the term fit for purpose to mean. My participants found this stressful, which in itself has implications, but first I want to consider why this stress. Possible reasons for unfair expectations - Clinical environment The reality shock identified so long ago by Allan et al,.
who relates the relationship between the conducive and safe environment of an educational institution and the workplace reality. And now the question today becomes what is this environment? Bullock and Rochester (2014), in their study they researched the experiences of new nurses in the state of Australia. They found that the values in the workplace reflect a concern for the timely completion of tasks, and this would resonate with the experiences of some of my study participants. The question that arises is why this situation persists. An obvious answer may well be the issue of resourcing. There would, of course, be cost implications if nurses were supernumerary for longer or if another trained nurse was needed for every shift to allow for the reduction in workload for new nurses.
However, it is possible that there are some implications of not doing this which I now discuss under the heading of patient safety. Relationships The importance of relationships stood out during the research in a number of ways. The learning environment has been studied by those interested in the experiences of student nurses, for example, (Burns 2011) who made a conclusion that preceptorship program is not focused on learning. If this is true for students, whose sole purpose for being in the workplace is to learn, then it will surely be even truer of the “workforce”. I would suggest therefore that the NHS is a long way from promoting lifelong learning for all. If the reality is that the hospital setting is not a conducive environment to help in learning, perhaps this is why most of the nurses in my study talked about the role of the Practice Development Nurse (PDN).
This title may be confusing as many different ones exist with sometimes similar and sometimes differing functions (Holland & Lauder 2012). It is possible that this role could take on the receptor function. This would certainly ease the pressure on clinical staff whose primary role is patient care. Furthermore, it would also hopefully ensure that the preceptor role was being carried out by someone who had a genuine interest in teaching (Anderson 2008 p. Recommendation 5. Recommendation for research A number of recommendations for research have come out of the study. However, these solutions require resources so the question remains as to how and whether healthcare organizations will support this answer may lie in the provision of evidence as to the consequences of the current system.
A study in Taiwan reported that 50% of all medication errors were found to have been made by newly-qualified nurses, but following the introduction of a preceptorship programme this figure was reduced to 0% (Lee et al. Studies in the United States looking at the cost implications of preceptorship have demonstrated that investment in support and training for newly-qualified nurses can be extremely cost-effective (Bullock et al. Fox 2010). I would argue that similar work is needed here in the United Kingdom and may help to urge senior managers and budget holders to invest further in learning and education. Despite the fact that preceptor program offers many benefits to the new nurses it also has some drawbacks by adding to preceptors extra responsibilities and time.
Lack of support due to short staffing The preceptors indicated that the nursing administration in the hospital appointed them without consulting them or giving them a notice. This led to low confidence and deficient knowledge. The study recommended that it was important that when preceptors are being given the preceptorship program role they need to be supported well so that they can be mentally and educationally prepared for their new role. Conclusions Recommendations have been made for research, practice, and education but it is evident that these are all linked. Journal of Nursing Management. pp. Allan H. T. Smith P. Career development: the preceptorship process. Nursing and Residential Care 10 (6), pp. Bradbury-Jones C. Sambrook S. Irvine F. G. Terhaar M. Designing an outcome-focused model for orienting new graduate nurses.
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