Exploring the Reality and Preparing for the Shock: Using the experiences of graduates – Helen Convey RN, MA – Lecturer in the School of Healthcare, University of Leeds
Graduation days are some of my favourite days of the academic year. It’s lovely to share in the celebrations and to hear about the experiences of our newly qualified nurse (NQN) graduates who are now in practice. At graduation NQNs often tell me that their first few weeks and months in practice as registrants are much harder than they anticipated; the literature reflects this and the experience of transition as a challenging time is well documented.
This time of transition to practice is a change; NQNs might feel detached from familiar arrangements and support systems and they may find that they have new needs and feel unsure about how to meet these. NQNs may experience reality shock, where they find that they are not prepared for a role or situation that they have worked to be prepared for. Given the research evidence and my anecdotal experience I explored learning and teaching approaches to support BSc Adult Nursing students in their transition from student to registrant.
One of the approaches that I explored was the use of stories from NQNs. This resource from Patient Voices https://www.patientvoices.org.uk/un.htm was a useful starting point. I thought that acquiring and using stories from our own graduates would be a powerful way to help our learners to identify with the phenomenon. I sourced stories for use in facilitated tutorials via graduate gatekeepers, using email and social media. No specific formula was requested, just a willingness to share experiences of transition for the purposes of facilitating learning.
Some NQNs were happy to be identified whilst others preferred to remain anonymous. They provided long narratives or brief snapshots (which were presented in the tutorial as quotations) and all of the responses were valuable. The challenges that NQNs talked about were; having a new sense of responsibility and feeling doubtful whilst making clinical decisions; feeling under pressure to work quickly; needing an awareness of their ability so that they could deliver competent care and needing to use the skills to influence change in practice.
Every NQN story provided a solution to the challenge and an evaluation of its effectiveness. Solutions included; sharing worries with senior staff or preceptors; ‘standing your ground’ regarding competency and using negotiation skills to effect change. NQNs described growing in confidence, understanding of the role and an emerging feeling of knowing and understanding.
Learners found using the stories beneficial and expressed thanks to the NQNs for providing them. In evaluation the percentage of learners agreeing or strongly agreeing that these resources had helped them to think about the experience of transition were 83% for the quotations and 84% for the narratives (N= 104).
Using this approach does require sensitive facilitation so that all experiences of transition can be seen as positive learning opportunities. I continue to request and collect stories and there is potential for this approach to be used by other professional groups. If you would like to know more about my project and the other learning and teaching approaches that I use to support transition please contact me firstname.lastname@example.org