Facilitating Early Practice Development in Nursing Using Novice to Expert Theory
1 Facilitating Early Practice Development in Nursing Using Novice to Expert Theory Authors: Barbara Haag-Heitman, RN, MS, MA and Sara Schedler, RN, BSN April 10, 2004 © Barb Haag-Heitman - who grants permission for printing one copy for personal use. Abstract The first years of nursing practice constitute a critical period for professional practice development. Organizations are implementing programs to support nurses during this vulnerable time. This case study uses narrative accounts of practice to illustrate common concerns and characteristics of practice during these first years of development along the novice to expert trajectory. Also presented are examples of supportive interventions and practice strategies to facilitate clinical practice. Introduction The early years of nursing practice hold unique opportunities and challenges for the individual nurse learning the art and science of nursing and for organizations to support their development. The shift from new graduate to the RN role is perhaps the most stressful and crucial part of the transition into professional practice (Godinez, Schweiger, Gruver, & Ryan, 1999). Once off formal orientation, RNs in their first years of practice reveal a sharp decline in the support and guidance from experienced nurses (Hurst & Koplin-Baucum, 2003). New graduate nurses express concerns about staff not appreciating where they are in practice and worry that staff have unrealistic expectations of them in relation to their abilities (Evans, 2001). To ease this transition, many organizations have implemented nurse mentoring programs to support new practitioners during this transition phase (Beecroft, Kunzman,
2 & Krozek, 2001; Hurst & Koplin-Baucum, 2003; McHugh, Duprat, & Clifford, 1996; Owens et al., 2001; Strauss, 1997; Trevitt, Grealish, & Reaby, 2001). However, few organizations implement programs to promote life long learning and full organizational understanding and support for clinical practice development outside
2 & Krozek, 2001; Hurst & Koplin-Baucum, 2003; McHugh, Duprat, & Clifford, 1996; Owens et al., 2001; Strauss, 1997; Trevitt, Grealish, & Reaby, 2001). However, few organizations implement programs to promote life long learning and full organizational understanding and support for clinical practice development outside
References: ANA. (2004). Scope and standards for nurse administrators, Washington, DC. Beecroft, P., Kunzman, L., & Krozek, C. (2001). RN internship: outcomes of a one-year pilot program. Journal of Nursing Administration, 31(12), 575-582. Benner, P. (1984). From novice to expert. Menlo Park, California: Addison-Wesley. Benner, P. (Ed.). (1994). Interpretive phenomenology : embodiment, caring and ethics in health and illness. Thousand Oaks, CA: Sage. Benner, P., Hooper-Kyriakidis, P., & Stannard, D. (1999). Clinical wisdom and interventions in critical care : a thinking in action approach. Philadelphia: W. B. Saunders. Benner, P., Tanner, C. A., & Chelsa, C. A. (1996). Expertise in nursing practice: caring, clinical judgment and ethics. New York: Springer. Delaney, C. (2003). Walking a fine line: graduate nurses ' transition experiences during orientation. Journal of Nursing Education, 42(10), 437-443. Dreyfus, H. L. (2001). On the internet. New York: Routledge. Evans, K. (2001). Expectation of newly qualified nurses. Nursing Standard, 15(41), 3338. Godinez, G., Schweiger, J., Gruver, J., & Ryan, P. (1999). Role transition from graduate to staff nurse: a qualitative analysis. Journal for Nurses in Staff Development, 15, 97-110. Haag-Heitman, B. (1999). Clinical practice development using novice to expert theory. Gaithersburg, MD: Aspen. 14 Halfer, D. (2003). GN perceptions of the work environment/job satisfaction. Paper presented at the Seventh Annual Magnet Conference, Houston, TX. Hurst, S., & Koplin-Baucum, S. (2003). Role acquisition, socialization and retention: unique aspects of a mentoring program. Journal for Nurses in Staff Development, 19(4), 176-180. Marshall, B. L., Jones, S. H., & Synder, G. (2001). A program design to promote clinical judgment. Journal for Nurses in Staff Development, 17(2), 78-84. McHugh, M., Duprat, L., & Clifford, J. (1996). Enhancing support for the graduate nurse. American Journal of Nursing, 96(6), 57-92. Owens, D., Turjanica, M. A., Scanion, M., Sandhusen, A. E., Williamson, M., Herber, C., & Facteau, L. (2001). New graduate RN internship program: a colloborative approach for system-wide integration. Journal for Nurses in Staff Development, 17(3), 144-150. Strauss, J. (1997). An OR nurse internship program that focuses on retention. AORN, 66(3), 455-463. Thomka, L. A. (2001). Graduate nurses ' experiences of interactions with professional nursing staff during transition to the professional role. Journal of Continuing Education in Nursing, 32(1), 15-19. Trevitt, C., Grealish, L., & Reaby, L. (2001). Students in transit: using a self-directed preceptorship package to smooth the journey. Journal of Nursing Education, 40(5), 225-228.