New Graduate Nurses Confidence levels
Introduction & Practice Question
New nurse graduates need to be equipped with essential communication skills and a high confidence level to deliver quality medical care. Nurses are the core of communication in their work environments. They are the link between patient and healthcare professionals. To this end, new nurses are expected to exercise efficient flow of information between patients, physicians and other healthcare providers. Historically in their profession, physicians have been dominant over the subservient new graduate nurses (Norris, New & Hinsberg, 2019). This is equally based on the difference between the training of the physicians and nurses. When healthcare professionals such as nurses fail to communicate effectively, then patients’ safety becomes at risk. Lack of effective communication may lead to misinterpretation of information and generally give room for medical errors which may lead to severe injury or death. This research focuses on the literature review on the new nurses’ confidence levels communicating with physicians.
The study is guided by a specifically designed PICOT question that elaborates on the content. The PICOT questions below will be used to identify population problem, possible intervention plans, control, forecast outcome and the duration needed to effect the change. Based on the topic of the study (P) represents the new graduate nurses low confidence level, (I) indicates intervention plans such as strict policies against harassments of new nurse, (C) control measures would include implementing organizational enhance efficient and effective communication, (O) outcome expected is improved communication and increased confidence level among the new graduate nurses and finally (T) which denotes the period taken by new nurses to adapt to the health care system.
Review of Literature
Research shows that new nurses find it difficult communicating at their place of work. (Amudha, Hamidah, Annamma, & Ananth, 2018). Nurses have complementary duties in providing medical care for patients. One of the primary roles is to pass relevant information to patients and interested parties. The ability to pass such information relies on their confidence level. There are various factors impacting communication between new nurses and other professionals at their place of work.
One of the factors leading to communication barriers between new nurses and other professionals is the lack of knowledge in the speciality area. Mitchell (2015) states that many new nurses usually have limited knowledge of different health matters; for example, they may have a lack of knowledge with regards to a specific drug. This may affect effective communication between new nurses and physicians, leading to communication breakdown among healthcare professionals. There is a general agreement among healthcare professionals that there is a need for new nurses to improve their knowledge in related disciplines to improve their communication with others.
Competence of new graduate nurses is another factor to be considered. New nurses have often perceived that they were treated differently with physicians and other healthcare professionals as compared to old nurses (Ulrich et al.,2010). Being ignored and not fitting in the environment of work is a common feeling among new graduate places. This is because many new nurses are considered to be incompetent and not up to the task before them. There is a need to give new nurses time to learn and gain the required competence in their work.
There is also the issue of theoretical experience versus practical experience by the new nurses. It is without a doubt that new graduate nurses have a lot of academic knowledge from their training while in school but hardly has the practical experience in their field. New graduate nurses always have a problem of communicating with physicians as they do not have the expertise in their area. This is compounded with the healthcare practice environment where the new nurse graduates have to struggle to be at par with their more experienced nurses. On the brighter side, a new graduate nurse should work to ensure that their theoretical experience is vast enough to cover up for their lack of knowledge.
New graduate nurses equally have a hard time being tasked with dealing with non- nursing work. This may also affect their communication with other health professionals considering that most new graduate nurses consider non-nursing duties to be demeaning to them. Ortiz (2016) stated in her work that, non- nursing work might equally be a difficult task to the new nurses considering that they do not like doing it. One such duty includes helping with the admission process, which is clerical work. It is essential to assign new graduate nurses work which is in line with their qualification. This will go a long in ensuring that new graduate nurses have esteem in their work, thus improving their communication at the workplace.
Appraisal and Synthesis
Another issue affecting the communication of new graduate nurses with other health care professionals is their perception of being unappreciated. Generally, new graduate nurses feel that other health care professionals and patients did not appreciate their work. This is despite new graduate nurses being forced to sacrifice their meal hours to finish up with duties allocated to them (Blanzola, Lindeman, & King, 2004). The feeling of not being appreciated may interfere with the confidence of the new graduate nurses in their duties. This may negatively impact on the communication between the nurses and other health care professionals. There is a need to make new graduate nurses appreciated to improve the working relationship.
The issue of overworking may also affect communication by new graduate nurses at their place of work. The ratio of nurses to patients in any particular health institution, usually indicate that generally, health workers are overworked (Herron, Powers, Mullen, & Burkhart, 2019). This gets much worse for new graduate nurses who are forced to undertake double shifts to keep up with the pressure at work. Most graduate nurses are overworked in the guise of being baptized by fire into the profession. Overworking is equally compounded by the problem of staff shortage in almost all healthcare departments, thus applying to the nurses too. New graduate nurses are forced to endure long working hours without complaining, as complaining would show that they are weaklings. This may affect the communication by new graduate nurses as they expected to suffer in silence, thus also affecting their communication in their general duties.
Cohort Study
New graduate nurses equally get scared off by the personality traits of most of the physicians. Herron, Powers, Mullen, & Burkhart, (2019) state in their book that some healthcare professionals are rigorous, and instead of teaching new graduate nurses, they scold them. While some senior health professionals are rough and berate the nurses, this is likely to lead to a frosty relationship between the nurses and such senior healthcare professional. A frosty relationship can affect communication in the workplaces as the nurses would fear to have any meaningful conversation with their seniors.
It is a common observation that many doctors have bad handwriting. Many times the physicians’ handwriting is not legible, and the new graduate nurses fail to understand the instruction written to them by the doctors (Baumann, Hunsberger, Crea‐Arsenio, & Akhtar‐Danesh, 2018). At times when the new nurses try to find out from the physician the information that was being conveyed to them, they are referred to the senior nurses. This, compounded by the almost certain frosty relationship between new graduate nurses and other healthcare professionals, the nurses would most certainly assume the information. The assumption usually leads to distortion of the intended message and may lead to mistakes occurring at the place of work. There is a need to have a good relationship at the workplace and the senior doctors writing readable instructions to the nurses.
Surveys
In a move to investigate the level of new nurses confidence level, the study reviewed some of the surveys previous done by American Nurses Association. According to the survey, 60 new nurse graduates were chosen as the sample. Among them were 30 male and 30 female. The participants were given various questions concerning challenges they face in the hospitals at their new post. Approximately 68% of the participants agreed that it is challenging to align with the health care system requirements.
Prior experience of new graduate nurses with other healthcare professional may equally determine their communication is going forward. A good example is where the nurse had experienced insults and had been bullied by other healthcare professionals, and it will affect their interaction. Such actions may lead to a breakdown of communication between the new graduate nurses and their senior professional staff. It is therefore crucial for the senior professional team in healthcare institutions to handle new graduate staff well to enable them to integrate into their workplace seamlessly.
Qualitative Studies
The other leading cause of the breakdown of communication between new graduate nurses and other senior professional staff is the issue of sexual harassment at workplaces. Statics have shown that cases of sexual harassment of new employees are prevalent (Herron, Powers, Mullen, & Burkhart, 2019). To this extent, new graduate nurses who have suffered sexual harassment, find it challenging to communicate with such perpetrators. Sexual harassment will also lead to erosion of work ethics at the workplace. It is essential to have policies against sexual harassments to protect all employees, including the new nurses. Such policies would make it possible for the victims to speak out when they suffer sexual harassment and have the assurance that the perpetrators will be punished according to the law.
Literature Reviews
Their difference in training also causes the difficulty of communication between new graduate nurses and physicians. Medical training is based on scientific methods, which favour objective data over subjective opinion and evidence gathered rather than individual anecdote (Hussein et al., 2017). On the other hand, nursing has its foundation conversely in religious beliefs and areas of covalence. Nurse’s education is focused more on the physical and psychological aspects, thus meeting the patient’s needs. Further, nursing emphasizes empathy and nurturing. The new graduate nurses need to understand the difference in orientation between them and the physicians to enable them to communicate effectively.
Another critical factor affecting communication is attitude. The attitude and behaviour of healthcare professional decide the effectiveness of communication. Wilson (2018) stated that new graduate nurses must have the right attitude to communicate with other professional staff effectively. This equally applies to senior healthcare professionals. Having a bad attitude from any of the healthcare providers would affect the quality of communication at the workplace. All healthcare professionals need to have the right attitude and behaviour for effective communication at the workplace.
Synthesis
Three synthesis statements can be derived from the above discussions. First is that new graduate nurses lack experience in their work (Mitchell, 2015). Second, new graduate nurses have difficulties in communicating with other professional healthcare workers (Ortiz, 2016). Lastly, the confidence in new nurses can be built by having a welcoming working environment at the healthcare institutions (Wilson, 2018).
Conclusion
In conclusion, nurse’s confidence enhance their ability to communicate which is a key driver for the success of the healthcare system. This literature review has concentrated on the sources outlining the factors inhibiting effective communication between new graduate nurses and other healthcare professionals. Different factors have been considered from the above discussion with suggestions being given on how to adequately make adjustments to enhance communication between graduate new nurses and other professional healthcare workers. Effective and proper communication among professional healthcare workers leads to team collaboration which is essential in healthcare services. On the other hand, the effects of non-effective communication between the new graduate nurses and other professional may lead to severe injuries or even death. To this end, communication in healthcare institutions has to be effective to minimize the room for error in such institutions.
Reference
Amudha, P., Hamidah, H., Annamma, K., & Ananth, N. (2018). Effective Communication between Nurses and Doctors: Barriers as Perceived by Nurses. Journal of Nursing and Care, 7(3).
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.
Blanzola, C., Lindeman, R., & King, M. L. (2004). Nurse internship pathway to clinical comfort, confidence, and competency. Journal for Nurses in Professional Development, 20(1), 27-37.
Herron, E. K., Powers, K., Mullen, L., & Burkhart, B. (2019). Best practices of formal new graduate transition programs: An integrative review. International journal of nursing studies.
Herron, E. K., Powers, K., Mullen, L., & Burkhart, B. (2019). Effect of case study versus video simulation on nursing students’ satisfaction, self-confidence, and knowledge: A quasi-experimental study. Nurse education today, 79, 129-134.
Hussein, R., Everett, B., Ramjan, L. M., Hu, W., & Salamonson, Y. (2017). New graduate nurses‘ experiences in a clinical speciality: a follow up study of newcomer perceptions of transitional support. BMC nursing, 16(1), 42.
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Mitchell, J. (2015). Electronic documentation: Assessment of newly graduated nurses‘ competency and confidence level. Online Journal of Nursing Informatics, 19(2).
Norris, H., New, K., & Hinsberg, F. (2019). Patient Deterioration Simulation Education and New Graduate Nurses’ Self-Confidence and Competence: A Pilot Study. Journal for nurses in professional development, 35(6), 330-336.
Ortiz, J. (2016). New graduate nurses’ experiences about lack of professional confidence. Nurse education in practice, 19, 19-24.
Ulrich, B., Krozek, C., Early, S., Ashlock, C. H., Africa, L. M., & Carman, M. L. (2010). Improving retention, confidence, and competence of new graduate nurses: Results from a 10-year longitudinal database. Nursing economics, 28(6), 363.
Wilson, P. (2018). Nurse Confidence Levels in Malignant Hyperthermia Simulation. Gardner-Webb University.