Aside from this, the researcher also looked into whether or not the nursing expertise of the respondents increased as they started working. The increase in the expertise upon working in a clinic for their practice is also of vital importance. More often than not, most novice nurses tend to perceive themselves as failures due to the fact that they are not learning from their experiences and their interaction with their colleagues and other nurses.
In the same way, looking into this achievement could also help the researcher in finding out the factors that play a very big role on why the nursing expertise of a certain person increased or not. Twenty-four respondents (96%) of this particular focused interview said that their nursing expertise increased since they’ve started working as a full time nurse, one respondent (4%) who said that she was not sure on whether her expertise increased or not while no one said that their expertise was not affected at all.
When asked how their nursing expertise increased, the following responses were generated: (1) acquired a much better routine that helps them in their jobs; (2) better with assessment, which is very important in determining the best treatment for a particular patient; (3) more confident with what they are doing as they could now make sense out of what has been taught to them at school; (4) laboratory values; (5) better practice skills; (6) better in time management and thinking critically; (7) becoming more familiar with nursing practices and processes and finally (8) understanding the why behind everything.
The respondents also mentioned why their nursing expertise increased when they started working. Apparently, they were able to learn so many things just by interacting with their patients. In the same manner, asking doctors and nurses questions helped them a lot. Afterwards, the respondents were also asked who and what they consider as barriers that affected their transition into practice. The following are their responses: – Lack of Confidence – Experienced nurses who are not used to doing things the way that a respondent learned them in school.
As a result, she is having a hard time in keeping her own standard of practice. – Knowledge deficits in certain areas. The respondents note that there are times when their own pride gets in the way as they find it hard to ask for assistance from their fellow nurses. – Working is generally the barrier that affected one respondent’s transition into practice as she had to start all over again. – A respondent considers nursing clinics as barriers as her experience proved that these are not realistic and a waste of time since all they did was to accomplish paperwork and give baths.
Simply put, it did not provide them with what she called, the “real world experience. ” – Trying to get the experience of the kind of job that she wants. This respondent wanted to work in the Emergency Room. However, she was not able to get a job in a hospital. As a result, she pursues her BSN and hopes that this would solve her problem. – Their own doubts on whether they are really fit to work in a particular department as they are so scared to make a mistake. – Laziness
– The area in which they live in since one respondent felt that there the absence of big hospitals fails them to see different things. – Not enough hands on experience provided before they started practicing. – Not finding someone who they can turn to in times of need. However, there were a number of respondents who believe that there were no barriers that affected their transition into practice due to the fact that their education and their mentors prepared them for what their jobs as nurses would entail.
Table 11 and Chart 11 give a clear picture on how many respondents said that there are indeed barriers to their transition, as compared with those who said that there were none. The analysis of the different barriers that affected one’s transition may also aid the researcher in determining which factors could truly aid the novice nurses in their transition. In the same manner, the examination of these barriers could also lead to the discovery of solutions that could help in ensuring that the novice nurses could be ensured of a smooth and effective transition to practice.
Due to these nurses’ claim that their nursing experience have increased since they started working, the researcher looked into how the former expanded their knowledge with regard to understanding the concept of how to do something as compared with why to do something. Those who answered that there was indeed an expansion in their knowledge were asked to identify a pivotal moment when this particular transition occurred.
The results revealed that among the twenty five respondents, sixteen (64%) felt that they were able to expand their knowledge in understanding the concept of how to do something versus why to do something while five (20%) said that they have not expanded theirs. Meanwhile, the remaining four respondents (16%) said that they are not sure about their ability to grasp this particular concept. The answers of these respondents are summarized in both Table 12 and Chart 12. Table 12. Frequency and Percentage Breakdown: Understanding the Concept: Knowing how to do something vs. Why to do something.
Frequency Percent Valid Percent Cumulative Percent Valid Yes 16 64. 0 64. 0 64. 0 No 5 20. 0 20. 0 84. 0 Not Sure 4 16. 0 16. 0 100. 0 Total 25 100. 0 100. 0 Chart 12. Understanding the Concept: Knowing how to do something vs. Why to do something. The respondents mentioned different reasons on why they feel that their knowledge about the concept of how to do something vs. why to do something expanded. Apparently, there were some who mentioned that they could now understand what their patients need. According to one respondent, she learned the necessity of watching a person closely after his or her surgery.
At the same time, she also realized the importance of keeping an eye on someone’s urinary output. Another respondent also recounts her experience with a patient who was assigned to her. Right after the admission of this patient, she could already tell that this lady would be in surgery before her shift is over as the respondent could see it in her eyes even though the latter was not telling her anything. As a result, she was able to recommend surgery to the doctors even though the patient changed her story and as it turned out, a surgical operation is what this patient really needed.
Another respondent cited her experience with a patient who kept complaining that she could not breathe. Upon hearing her complaint, the respondent listened to her lung sounds and noticed that patient sounded okay. However, the nurse feels like there is still something wrong. Upon noticing the confusion that has befallen her and the patient, the nurse called the doctor. However, the doctor concurred with her previous findings, that there was nothing wrong with the patient despite her complaints of not being able to breathe properly.
After insisting that there is really something wrong with her patient, the doctor advised his caller to give the patient Lasix if she continues to feel like she is filling up with fluid. No sooner than she had hung up the phone, the aid came rushing to her and said that she should immediately come to her patient’s bedside who was at that time already filling up with liquid, the nurse-respondent recounts. Proving the doctors wrong was again another milestone for another respondent.
As a result, she considered to be the pivotal moment of her career when the transition from knowing how to knowing why occurred. She tells the event that happened a week after she came off orientation. Apparently, she was supposed to do some packing for the doctor. However, she realized that what he wanted was not making sense. So instead of agreeing with what he wanted, the respondent told him that she thinks that he is asking for the wrong thing. At first, the doctor thought that she was wrong but after looking down at the patient, he realized that what he needed was not really what he called for.
Instead, the suggestion of his nurse made more sense. Without a doubt, the respondents consider their ability to understand a patient’s needs without any help as their turning point in their careers. This is because they feel that they are already capable of helping their patients without having to consult the books or anyone for this matter that could only teach how to do something. Rather, being able to follow their instincts and looking closely at the patients make them understand the concept of why to do something.
On the other hand, there were also respondents who did not feel that their knowledge expanded. This is due to the fact that they still focus more in accomplishing their tasks just the way they were asked to do it rather than finding their own way of dealing the problem just like the experiences mentioned above. This is also true of the respondents who were not sure whether they were able to grasp the concept – that there was, indeed, a difference between knowing how to do something and knowing why to do something.
After looking at their experiences as nurses and after examining their ability to perform the different practices related to nursing, the focused interview then devoted time to look into how different factors affect the professional competency of its respondents. These factors included years of practice, age, ethnicity and gender. With regard to the number of years of practice in the field of nursing, Table 13 and Chart 13 present a summary of the responses. Table 13. Frequency and Percentage Breakdown: Years of Practice
Frequency Percent Valid Percent Cumulative Percent Valid One year 5 20. 0 20. 0 20. 0 Two years 8 32. 0 32. 0 52. 0 Three years 6 24. 0 24. 0 76. 0 Four years 2 8. 0 8. 0 84. 0 Five years 1 4. 0 4. 0 88. 0 More than 5 3 12. 0 12. 0 100. 0 Total 25 100. 0 100. 0 Chart 13. Years of Practice The figures above show that among the twenty five respondents, five (20%) had been practicing for a year; eight (32%) for two years, six (24%) for three years, two (8%) for four years, 1 (4%) for five years and three (12%) for more than five years.
The three respondents who worked as a nurse for more than five years were basically nursing aids before they decided to go into nursing. In the same manner, the respondents were also asked how old they were as age is another factor which is essential to the examination of professional competency. The answers are then summarized in the figures below (Table 14 and Chart 14). Table 14. Frequency and Percentage Breakdown: Age Frequency Percent Valid Percent Cumulative Percent Valid 20-29 8 32. 0 32. 0 32. 0 30-39 8 32. 0 32. 0 64. 0 40-49 8 32. 0 32. 0 96. 0 Above 50 1 4.
0 4. 0 100. 0 Total 25 100. 0 100. 0 Chart 14. Age Of the twenty five respondents, eight (32%) belong between the ages of 20-29, eight (32%) between 30-39, eight (32%) between 40-49 and finally, one (4%) is above the age of 50. Gender and Ethnicity are two factors that the researcher also gives importance for this particular study. However, the respondents of the focused interview are all Caucasian (100%) and all belong to the female gender (100%), as shown in Tables 15 and 16 as well as in Charts 15 and 16. Table 15. Frequency Percent Valid Percent Cumulative Percent
Valid Caucasian 25 100. 0 100. 0 100. 0 Others 0 0. 0 0. 0 100. 0 Total 25 100. 0 100. 0 Frequency and Percentage Breakdown: Ethnicity Chart 15. Ethnicity Table 16. Frequency and Percentage Breakdown: Gender Frequency Percent Valid Percent Cumulative Percent Valid Female 25 100. 0 100. 0 100. 0 Male 0 0. 0 0. 0 100. 0 Total 25 100. 0 100. 0 Chart 16. Gender Upon obtaining the information presented above, the researcher also made the respondents mentioned their reflections with their regard to their transition into practice. The following were their responses:
– One respondent is aware of the fact that about forty percent of new graduates fail their transition into practice due to the lack of orientation and bad attitudes on their new job. Apparently, she witnessed this happen on her classmates and considers herself very lucky. Nonetheless, she recognizes the importance of humility and admitting one’s mistakes to succeed in the field of nursing. – Having a mentor that you can call at any time of the day is very important especially whey new nurses are having a hard time in their job as there are times when they feel like no one cares.
As a result, they feel the necessity of taking up further studies in nursing so that other people would listen to them and would not just take their opinions for granted. – Self confidence is very important in one’s job as a nurse as it takes more than just knowledge from the books to succeed as a nurse. The schools should then focus more in preparing them for the ‘real world’ as hospital jobs are very different from what is being taught inside the clinics. – Nursing has to be in the heart of the practitioner. Otherwise, it will be hard for him or her to cope with the difficulties of the job.
The Respondents’ Perception of the Education they received from School After the presentation of all the responses of the twenty five nurses who participated in this study, this chapter would look into the respondents’ perception of the education they received from the nursing schools where they graduated from based on their answers to certain questions in the interview that immediately points out to this. As shown in both Table 2 and Chart 2, all the responses have undergone rigorous educational preparation either through LPN, RN or BSN.
Despite their rigorous training and educational preparation, they still believe that learning nursing is a continuous process and acquiring knowledge should not stop upon graduation. As a result, some of the respondents believe that although both LPN and RN could provide nurses with the knowledge they need for their practice; most respondents believe that it is only through one’s acquisition of a bachelor’s degree in nursing that one could enhance his or her knowledge about his or her field of practice. As a result, most of them continue on to take further studies in nursing whether formally or informally, as shown in Table 9 and Chart 9.
There were a number of respondents, who take advanced their studies informally, through subscriptions in nursing journals, attendance in conferences or workshops, interacting with fellow nurses and doctors, etc. The following words of the participants support this finding: (1) “I ask the doctors, when I have to call them questions so I understand things better. I also read a lot of nursing journals. ”(2) “I get a book and look things up. I also ask other nurses” (3) “I attended two national conferences and I read nursing journals whenever I can.
I also attend hospital in-services. ” (4) “I have attended a few workshops and subscribed to a nursing journal. ” Likewise, even those who already have a bachelor’s degree in nursing also notes how important it is to take up further studies through self study, using the different ways mentioned in the previous paragraph. The respondents also believe that there was something missing from the Education they received in school. The following words of the participants support this finding: (1) “I felt like I had the basics and basics are just that. I need to understand how to think!
I thought just answering tests questions was where it was at. What a joke. That doesn’t teach you anything about the real world! ” (2) “There needs to be more emphasis on assessment and more case studies. I think this helps you and makes you more aware of your critical thinking skills”(3) “I felt I needed more hands on experience though I learned enough through classroom teaching to pass my state boards. ” (4) I think that there is too much time spent on wasted classes. Like Nursing Management. What good did that do me? I never wanted to be a manager, just a staff nurse.
They should have taught us how to delegate… Now that would have helped. ” (5) Sometimes I felt like I understood a lot from what I was seeing in people’s homes because something would come back from a clinical experience. Then, I would feel like I have never heard of this problem before. I kept on wondering if I missed something. I never missed classes. I just felt like I was dumb in some areas. It is also because of the aforementioned sentiments that the respondents also believe that their education did not focus on the skills they needed for their transition.
Their education focused so much on what the books teach and not the training that they shall need once they take on the real world. The following sentiments also highlight this particular finding: (1) “I think the last two clinics before graduation should focus on skills and transition into practice. We should be prepared for both the NCLEX and the real world. I don’t know how that could be done, but what we do now, I think, is a waste. ” (2) “That the real world is so different from clinic. I think that we need to be prepared better in school for what is really out there.
” (3) “I think that I never got a chance to understand the role differences. I don’t think we were taught that in school, either. ” (4) “Just that I wish I would have had some experience in clinic where I could of gone with a school nurse. I think that I’m going to l like it but I am worried that I will lose a lot of skills that relate to the hospital. I only took this job because it was days. ”(5) “I would have really liked more hands on experience in school. I learn best when I actually do the procedure or give the injection.
I know that we were suppose to get more out of writing care plans (critical thinking) but it seemed to me that all we did was copy things out of a chart. I guess I still think more in the task mode. ”(6) “There isn’t the feel of the amount of responsibility in your clinical rotations in school. It doesn’t give you the experience that you need. I wish I would have had more autonomy at some point in my education. I always felt like I was being babysat. ”(7) “When I was in nursing clinics, I thought that having just two patients was a joke.
I knew we would never have those few in the real world. I guess an instructor can only handle so much. But it just seems that we need a chance to play “real”. .” (8) “When I was in nursing clinics, I thought that this is a snap. I wish there was a way that school could prepare us better for the real world. ”(9) “I wish I could have had more experience on the floor working during clinics and somehow we could get a chance to feel the real world of nursing and not that “textbook” stuff. ”(10) “If I could change one thing it would be to have more hands on care in clinic.
It just seems as if we don’t’ have enough time to learn what we need to. ” Generally, the respondents are not contented with the education they received from their nursing schools. As a result, they tend to look for other means by which they could gain a better learning experience that they need in order to function effectively as nurses in the workforce. In the same manner, due to the fact that their education is limited and their busy schedules could no longer accommodate their pursuit of higher education, they resort to journal subscriptions, conferences and workshops to fill in the spaces.