Are Hospitals Doing Enough to Help Newly Licensed RNs?

CalloutNewNursesVoices

Staff retention is a big issue in hospitals. There can be advantages in hiring newly licensed RNs, but some hospitals and workplaces may pay insufficient attention to helping new nurses with the challenging transition from classroom to clinical practice. In our November issue, some of these issues are brought more clearly to light by an original research article called “Hearing the Voices of Newly Licensed RNs: The Transition to Practice.”

“The first few months of employment is a crucial time in a nurse’s career,” write the authors of this small study. According to interviews with newly licensed RNs conducted by the authors, the following factors can make a big difference:

  • The quality of the preceptor—is the preceptor knowledgeable, adequately experienced, and nonjudgmental?
  • Professional growth and the development of confidence over time in terms of time-management, communication skills, and learning from experience.
  • A sense of being nurtured by the program, the preceptor, and peers.
  • The thoroughness and effectiveness of orientation.

Read the article, or listen to an author podcast on our Web site. What worked in your own transition to practice? What didn’t work? Or how do you help others with this transition? We’d love to know. —Jacob Molyneux, senior editor


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2016-11-21T13:06:00-05:00November 18th, 2013|career, nursing perspective|1 Comment
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Get the Job Done

By Marcy Phipps, RN, a regular contributor to this blog. Her essay “The Love Song of Frank” was published in the May (2012) issue of AJN.

Dietetics class for nurses, 1918/Cornell University Library/via Flickr Nursing students, 1918/Cornell University Library/via Flickr

I remember being a new nurse and having an order to place a Foley catheter in a female patient.

I was filled with dread. Urinary catheter placement was the only skill I’d failed in nursing school (I’d contaminated my sterile field), and placing a catheter in this patient was sure to be a challenge, as she was obese and unable to cooperate. It was not a one-person job, even for a far more experienced nurse.

When I asked a coworker for help, she sighed and said, “I don’t have time. This isn’t nursing school, you know. You just do the best you can and get the job done.” […]

2016-11-29T13:33:01-05:00July 8th, 2013|nursing perspective, nursing stories|3 Comments
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Passion and Fear: Signs of a Kindred Nursing Spirit

Florence Nightingale in Crimean War, from Wikipedia Commons

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Love Song of Frank,” was published in the May issue of AJN.

“It’s not that we want something bad to happen; we just want to be there when it does.”

One of my colleagues recently saw that phrase on a T-shirt, and it perfectly echoes the sentiment of the ICU nurses I work with. We’re prepared for crises, primed for instability—and the lower acuity patients who have been populating the ICU lately leave many of us restless and discontented. We start to miss the dramatic cases, the incredible saves and miracles; we miss using our skills. We do see the irony of being in the awkward position of wishing for trauma patients, yet not actually wishing ill on anyone.

I haven’t always embraced unstable patients. When I was a new nurse I simultaneously dreaded yet was drawn to the instability of the ICU. I remember the early morning drives into work, a time of quiet anticipation filled with a gnawing fear that I’d make a mistake or be inexcusably inadequate at a crucial time.  I’d pray to gods above to be good enough, to be up to the tasks of the day; I clearly recall, more than once, taking report on an unstable patient and getting physically sick. Dramatic, I know, but born […]

2016-11-21T13:09:21-05:00September 12th, 2012|career, nursing perspective|1 Comment
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On Euphemisms and Learning to Be Present

By Alicia Marie Hinton, who is a BSN student at the College of New Rochelle School of Nursing in New Rochelle, NY. This is her first post for this blog.

My senior year preceptorship was an assignment on a palliative and acute care unit at a busy medical center. When I received the assignment, I prayed that no patient of mine would die during my time on the unit. Every nursing student is afraid of their first patient death. Simulation and course work prepare students in various ways for this experience, but nothing can really prepare you for the emotions you’ll feel. Some students experience a patient death during an undergraduate nursing program, but for others it may not happen until their first year or two working as an RN. I hoped to never endure it, but knew it was inevitable.

During report, working alongside my preceptor, I listened anxiously to the status of the various patients. Since my first day on the unit, I’d practiced my therapeutic techniques and researched different cultural needs pertaining to the death of a patient. I felt culturally competent and well informed about what a nurse should do when a patient dies, but I couldn’t shake my fear. What would I say to the family? Would they […]

2016-12-09T11:57:13-05:00November 28th, 2011|career, students|7 Comments
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The Priceless Clarity of Inexperience

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Soul on the Head of a Pin,” was published in the May 2010 issue of AJN.

Heartstudy by James P. Wells, via Flickr

I was precepting a senior nursing student last week. During an idle moment, I asked her why she’d decided to go into nursing.

She shrugged, averted her eyes, and mumbled something like “I’ve just always wanted to.”

I didn’t press it, but I’m sure there’s more to it than that. I probably shouldn’t have asked, given that I cringe when posed the same question, and usually give a faltering and inadequate “I like helping people” kind of answer . . . when “that’s too personal of a question” would be more honest.

I’ve been a nurse for years, and there are certain aspects of the profession I wouldn’t attempt to broach in casual conversation. I doubt that I could have articulated my motivations when I was a student, even if I’d wanted to. That exchange, though, calls to mind one of the most defining experiences of my nursing career.

I was a senior nursing student, doing a clinical rotation in the ICU. My preceptor and I were caring for a patient who’d been in a motorcycle accident. He’d not sustained […]

2016-11-21T13:11:53-05:00September 22nd, 2011|career, Nursing, Patients, students|8 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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