Susan Dyess

The First Year of Practice: New Graduate Nurses’ Transition and Learning Needs

Although the phenomenon of reality shock has been acknowledged as part of the new graduate nurse transition for decades, there is evidence to suggest that the problems with the transition into practice are more serious today. This article presents findings about the new graduate nurse transition and learning needs from qualitative research conducted in a community-based novice nurse transition program. The new graduate nurse transition and learning needs are examined through the eyes of new graduates and the nursing leaders and preceptors who work with them. Recommendations are offered for continuing education initiatives that can be designed to meet these needs.

A Methodological Review of Faith-Based Health Promotion Literature: Advancing the Science to Expand Delivery of Diabetes Education to Black Americans

Non-traditional avenues, such as faith-based organizations (FBOs), must be explored to expand delivery of diabetes self-management education (DSME) to benefit Black Americans with type 2 diabetes (T2D). The purpose of this study was to methodologically review the faith-based health promotion literature relevant to Blacks with T2D. A total of 14 intervention studies were identified for inclusion in the review. These studies detailed features of methods employed to affect health outcomes that DSME similarly targets. Analysis of the faith-based studies’ methodological features indicated most studies used (1) collaborative research approaches, (2) pre-experimental designs, (3) similar recruitment and retention strategies, and (4) culturally sensitive, behaviorally oriented interventions with incorporation of social support to achieve positive health outcomes in Black Americans. Findings indicate FBOs may be a promising avenue for delivering DSME to Black Americans. Informed by the findings, a focused discussion on advancing the science of faith-based interventions to expand delivery of DSME to Black Americans with diabetes is provided.

Faith: a concept analysis

AIM This paper reports a concept analysis of faith. BACKGROUND There are numerous scholars who consider spirituality and religiosity as they relate to health and nursing. Faith is often implied as linked to these concepts but deserves distinct exploration. In addition, as nursing practice conducted within communities of faith continues to emerge, concept clarification of faith is warranted. METHOD Qualitative analysis deliberately considered the concept of faith within the lens of Margaret Newmans health as expanding consciousness. Data sources used included a secondary analysis of stories collected within a study conducted in 2008, two specific reconstructed stories, the identification of attributes noted within these various stories and selected philosophical literature from 1950 to 2009. FINDINGS  A definition was identified from the analysis; faith is an evolving pattern of believing, that grounds and guides authentic living and gives meaning in the present moment of inter-relating. Four key attributes of faith were also identified as focusing on beliefs, foundational meaning for life, living authentically in accordance with beliefs, and interrelating with self, others and/or Divine. CONCLUSION Although a seemingly universal concept, faith was defined individually. Faith appeared to be broader than spiritual practices and religious ritual and became the very foundation that enabled human beings to make sense of their world and circumstances. More work is needed to understand how faith community nursing can expand the traditional understanding of denominationally defined faith community practices and how nurses can support faith for individuals with whom they encounter within all nursing practice.

Transition support for the newly licensed nurse: a programme that made a difference

AIM To describe and evaluate a collaborative programme that supports newly licensed registered nurses (RNs). BACKGROUND New RN transition is recognized globally as a challenge. Nurse managers desire successful programmes that support transition into professional practice. One community developed and implemented an on-going programme that supported the new RNs transition and leadership development. METHODS One hundred and nine newly licensed nurses participated in a 10-month programme. Quantitative data were collected and analysed. The present study reports on the evaluation of the programme. RESULTS Skill acquisition occurred, retention improved, and transition was supported. Leadership development and psychosocial and technical skills sets improved for participants involved with the programme. CONCLUSIONS AND IMPLICATIONS FOR NURSING MANAGEMENT The results of the present study suggest that transition support is valuable. Enhanced retention, improved transition and leadership development were noted. Newly licensed RNs gained leadership, patient care and professionalism skills, and were supported with their transition. The results demonstrate that Nurse Managers need to consider opportunities to offer their newly licensed nurses a programme that is targeted for transition support and leadership development.

Succession planning for the future through an academic-practice partnership: a nursing administration master's program for emerging nurse leaders.

A global nursing leadership shortage is projected by the end of this decade. There is an urgent need to begin developing emerging nurse leaders now. This article describes the work of an academic-practice partnership collaborative of nurse leaders. The goal of the partnership is to develop and promote an innovative enhanced nursing administration masters program targeted to young emerging nurse leaders, who have not yet moved into formal leadership roles. An action research design is being used in program development and evaluation. Qualities needed by emerging leaders identified through research included a need to be politically astute, competency with business skills required of nurse leaders today, comfort with ambiguity, use of a caring approach, and leadership from a posture of innovation. The current curriculum was revised to include clinical immersion with a nurse leader from the first semester in the program, a change from all online to online/hybrid courses, innovative assignments, and a strong mentorship component. Eighteen young emerging nurse leaders began the program in January 2012. Early outcomes are positive. The emerging nurse leaders may be uniquely positioned, given the right skills sets, to be nurse leaders in the new age.

Developing the leadership skills of new graduates to influence practice environments: a novice nurse leadership program.

The authors of the recently published Institute of Medicine on the Future of Nursing report emphasized the importance of preparing nurses to lead change to advance health care in the United States. Other scholars linked practice environments to safe quality care. In order for nurses to fully actualize this role in practice environments, they need to possess leadership skills sets that identify and respond to challenges faced. New nurses are no exception. This article presents a program with a 5-year track record that is designed to support transition and enhance the skill sets of leadership for new nurses in their first year of practice. Qualitative and quantitative evaluation measurements at baseline and postprogram provided data for evaluation of the first 4 cohorts in the program. Evaluative outcomes presented indicate that new nurses gained leadership and translational research skills that contributed to their ability to influence practice environments. Nonetheless, practice environments continue to need improvement and ongoing leadership from all levels of nursing must be upheld.

Guidance for using mixed methods design in nursing practice research

The mixed methods approach purposefully combines both quantitative and qualitative techniques, enabling a multi-faceted understanding of nursing phenomena. The purpose of this article is to introduce three mixed methods designs (parallel; sequential; conversion) and highlight interpretive processes that occur with the synthesis of qualitative and quantitative findings. Real world examples of research studies conducted by the authors will demonstrate the processes leading to the merger of data. The examples include: research questions; data collection procedures and analysis with a focus on synthesizing findings. Based on experience with mixed methods studied, the authors introduce two synthesis patterns (complementary; contrasting), considering application for practice and implications for research.

Support for Caring and Resiliency Among Successful Nurse Leaders

Health care practice settings are replete with competing priorities for nurse leaders who are responsible to the staff, the organization, and the patients and their families. In the midst of the competing priorities, there is a mandate for successful nursing leadership that is patient centered. To support the continuance of nurse leader success and avoid discouragement and attrition, a caring and resilient model for leadership may be necessary. This article considers the practices of nurse leaders that support caring, resiliency, and, ultimately, their success. Successful navigation toward patient-centered solutions through the intentional and inextricably linked living caring and resiliency was enhanced with practices of self-care, accountability, and reflection. Within each of the 3 intentional practices, a primary process emerged that revealed how nurse leaders actualize their caring and resiliency. The practices and mutually supportive processes are discussed. Useful questions are provided to guide any nurse leader who is contemplating practices of self-care, accountability, and reflection for supporting caring and resiliency.

Sustaining health in faith community nursing practice: emerging processes that support the development of a middle-range theory.

This article reveals processes that support theoretical development for holistic nursing in the context of a faith community. The emerging processes enhance the articulation of the holistically focused practice, add clarity to faith community nursing activities and outcomes, and contribute to theoretical clarification and development. Theoretical clarity is essential to guide faith community nursing practice, research, and education because there is tremendous potential for the specialty practice to contribute to the health of a community across the continuum of caring and because to date there has been no unifying model for this practice proposed. A lack of a theoretical basis can result in disparate and disconnected approaches to studying, testing, and promoting the practice.

New Graduate Transition into Practice During Turbulent Economic Times

the last thing most new graduates expected to worry about when they entered their nursing programs was finding employment when they graduated. although it is true that a serious nursing shortage is still anticipated within a decade (Buerhaus, auerbach, & staiger, 2009), new graduates today across the country are experiencing difficulty securing their first job. the economic downturn over the past 2 years has quickly changed what was once a wide open job market for new graduates. experienced nurses in the workforce are delaying retirement and working more hours (Buerhaus et al., 2009). Hospitals are under enormous financial pressure due to the increasing number of uninsured and underinsured patients (american Hospital association, 2009). in many geographic areas, hospitals have significantly reduced hiring. With the availability of experienced nurses, nurse leaders are more cautious about employing new graduates when they do have vacancies. Historically, the highest turnover in nursing staff occurs in the new graduate group (robert Wood Johnson Foundation, 2009). this turnover often comes after a considerable investment in the orientation of a new graduate to the clinical setting. the employment situation in California serves as a good example of the reversal in hiring trends. Nursepatient staffing ratios were initially passed in 1999 and fully implemented in 2005. initially, hospitals struggled to maintain nurse staffing to meet the ratios. the employment picture has shifted, and the California institute for Nursing and Healthcare (2009) now estimates that 40% of new graduates will be unable to find employment in the state. Not surprisingly, many new graduates are becoming discouraged about their career choice. Nurse educators play a crucial role in helping these newest members of the profession maintain their optimism and stay engaged in the profession. the advice and support that nursing faculty provide students and graduates can make a significant difference in a successful employment search. student development of job-seeking skills should begin with their first clinical rotation. Nurse leaders tell us that every clinical rotation should be viewed as a job audition. While in their rotations, students are observed for their appearance, knowledge, clinical skills, communication, and engagement in their work. employers are seeking to recruit and retain high performers (Hanson & Hanson, 2007; Hausknecht, rodda, & Howard, 2009). it may be necessary for faculty to clearly define for students what it means to be a high performer in today’s environment and incorporate activities into classes that promote these behaviors. Faculty should look for opportunities to have students engage with nurse leaders during their clinical rotations. Faculty can encourage this interaction with assignments. an interview assignment with the nurse leader in a unit where a student does a senior practicum experience can provide insight into the expectations that leaders have when hiring new staff. it can also strategically give students an opportunity to talk one to one with the leader and create a positive impression. Historically, students have been urged not to work during their nursing programs. Faculty may need to reconsider this recommendation. in the current job market, employers often give preference in hiring to students who have worked in the organization in unlicensed assistive positions. Volunteer and intern experiences can also provide students with an opportunity to demonstrate their knowledge, skills, and abilities to potential employers. students should be taught to be strategic in selecting senior practicum experiences so they are able to demonstrate their clinical acumen and caring know-how. although students may want to be assigned to experiences in specific specialty areas, they should consider clinical areas where employers are most likely to place new graduates. Networking is a critical skill in a tight employment market. Faculty can help introduce students to the importance of networking during their nursing program by encouraging students to attend professional organization events to meet nurses in the community. local, regional, and international links to professional nursing organizations offer students connections to nurses in practice and potential volunteer prospects and expose them to the importance of professional advocacy early in their careers. Membership and involvement in the National student Nurses’ association (NsNa) should be encouraged. the mission of NsNa is to facilitate the entrance of students