Posted: July 25th, 2023

Transitioning to Practice as a Registered Nurse: NURS13144

NURS13144
UNIT TITLE: Preparation for practice as a Registered Nurse
Assessment Two – Short Answer Responses
Type: Written Assessment – Short Answer Responses
Due date: 4pm (AEST) Tuesday 3rd October 2023 (Week 12)
Weighting: 50%
Length: 1600 words (±10%)
Unit Coordinators: Natalie Browning and Chanchal Kurup
Course Learning Outcomes Assessed
1. Identify transitional challenges that you may experience in your transition from
student to registered nurse and explain the skills and strategies you may
require to manage this transition
2. Explore power differentials that can exist within healthcare organisations and
the tensions that may arise from these
3. Identify leadership roles undertaken by graduate registered nurses and discuss
the skills required to undertake these roles
4. Analyse how the knowledge of governance systems can support the graduate
registered nurse to provide safe patient care
Aim
This assessment asks you to consider four different aspects of transitioning from a
student nurse to a Registered Nurse: transitional challenges, power differentials,
leadership, and clinical governance.
Instructions
This assessment functions as a ‘choose your own adventure’. Each question provides
multiple options; you need to choose one option to respond to for each question. Each
question requires a short response of approximately 400 words (± 10%), for a total of
1600 words. Please include all four responses in a single Microsoft Word document,
ensuring that each question is written in full with your chosen topic clearly identified
followed by your response.
1) Transitional challenges are commonly encountered by many new graduate
Registered Nurses. Choose one of the transitional challenges below and outline
two skills or strategies you could use/implement to successfully navigate the
chosen transitional challenge as a graduate registered nurse in the Australian
healthcare setting. (400 words)
a. Role transition (e.g. from student to RN, AIN to RN, or EN to RN).
b. Adapting to the organisational culture of the ward/unit/facility
c. Joining a team
d. Time management
2) Choose one of the examples provided below. Briefly outline the perceived
power differential and discuss how this could impact the patient care provided
by the graduate registered nurse (400 words)
a. A graduate registered nurse needs to delegate a task to a very
experienced enrolled nurse
b. A graduate registered nurse needs to talk to the nurse unit manager
about the upcoming roster, which has the graduate registered nurse
working ten eight-hour shifts in a row.
c. A graduate registered nurse is preceptoring a second-year nursing
student and needs to talk to them about their underperformance.
d. A graduate registered nurse asks a much older Helpant-in-nursing to
help with a hoist transfer. The Helpant-in-nursing refuses and tells the
graduate registered nurse to do the hoist transfer alone.
3) Choose one of the advanced nursing roles below. Discuss two leadership skills
you can develop as a graduate registered nurse which will help to prepare you
for the chosen advanced nursing role (400 words)
a. Clinical nurse consultant/specialist
b. Nurse unit manager
c. Director of nursing of a rural hospital
d. Nurse educator
e. Nurse practitioner
4) Choose one of the National Safety and Quality Health Service Standards listed
below. Analyse how you as a new graduate registered nurse could use one
aspect of this Standard to improve patient care in a specific patient context (e.g.
orthopaedic ward, residential aged care facility, child health nursing service,
remote health clinic etc.). The importance of the chosen NSQHS standard for
the specific patient context must be justified (400 words)
a. Preventing and controlling Infections
b. Medication safety
c. Comprehensive care
d. Blood management
e. Recognising and responding to acute deterioration
Literature and references
In this assessment use at least 5 references from relevant, high-quality and
contemporary journal articles (<5 years) to support your discussion. You may also use
seminal scholarly literature, textbooks and credible websites where relevant. When
sourcing information, consider the 5 elements of a quality reference: currency,
authority, relevance, objectivity, and coverage. Grey literature sourced from the
internet must be from reputable websites such as from government, university, or peak
national bodies: for example, the Australian College of Nursing. Avoid using blogs,
even when hosted by universities and other reputable organisations, as these are not
credible sources.
Requirements
1. Use a conventional and legible size 12 font, such as Arial, Calibri, Times New
Roman or similar, with 2.0 line spacing and 2.54 cm page margins (standard
pre-set margin in Microsoft Word).
2. Include a title page with your name, student number, unit code and name,
names of unit coordinators, due date, date submitted, and word count of each
question.
3. Include page numbers on each page in a footer.
4. You may write in the first-person perspective.
5. Use formal academic language.
6. Do not use dot points or bullet points.
7. Clearly identify which topic you have chosen for each question.
8. Use Australian spelling and language conventions (e.g. organisation).
9. Use the seventh edition American Psychological Association (APA) referencing
style. The CQUniversity Academic Learning Centre has an online APA
Referencing Style Guide.
10.An introduction, conclusion, and table of contents are not required.
11.The word count is considered for each individual response. The word count
excludes the assessment questions and reference list but includes in-text
references and direct quotations.
Resources
12.You can use unit provided materials and other credible sources (e.g. journal
articles, books) to reference your argument. The quality and credibility of your
sources are important.
13.We recommend that you access your discipline specific library guide: the
Nursing and Midwifery Guide.
14.For information on academic communication please go to the Academic
Learning Centre Moodle site. The Academic Communication section has many
helpful resources including information for students with English as a second
language.
15.Submit a draft before the due date to review your Turnitin Similarity Score
before making a final submission. Instructions are available here.
Submission
Submit your assessment via the unit Moodle site in a Microsoft Word document.
Marking Criteria
Refer to the marking rubric on the Moodle site for more detail on how marks will be
assigned.

Transitioning to Practice as a Registered Nurse: Navigating Challenges and Building Leadership Skills for Quality Patient Care

The transition from a student nurse to a Registered Nurse (RN) can present various challenges in the Australian healthcare setting. This assessment aims to explore four essential aspects of this transition: transitional challenges, power differentials, leadership roles, and clinical governance. Each question offers multiple options, and the responses will discuss the chosen topics with a focus on evidence-based strategies and scholarly references.

Navigating Role Transition as a Graduate Registered Nurse
As a graduate registered nurse, transitioning from a student to an RN can be both exciting and daunting. One of the significant transitional challenges is role transition. To successfully navigate this challenge, two key skills or strategies are essential:

a. Effective Communication: Communication skills are crucial when transitioning to an RN role, as it involves interacting with patients, interdisciplinary teams, and senior healthcare professionals. Clear and assertive communication fosters mutual understanding, reduces errors, and enhances patient safety (Mitchell et al., 2016). Practicing active listening, asking clarifying questions, and seeking feedback from experienced nurses can help graduate RNs build confidence and competence in their new role.

b. Reflective Practice: Engaging in reflective practice enables graduate RNs to critically evaluate their performance, identify areas for improvement, and enhance their clinical decision-making abilities (Johns & Freshwater, 2019). Regularly reflecting on experiences and seeking guidance from mentors or preceptors can aid in the identification and resolution of challenges encountered during the transition to practice.

Impact of Power Differentials on Patient Care Provided by Graduate Registered Nurses
Power differentials can significantly impact the quality of patient care provided by graduate registered nurses. Let’s explore one example:

b. A graduate registered nurse needs to talk to the nurse unit manager about the upcoming roster, which has the graduate registered nurse working ten eight-hour shifts in a row.

Perceived Power Differential: The nurse unit manager holds a position of authority and power over the graduate registered nurse’s roster, representing a hierarchical power differential.

Impact on Patient Care: Such extended work hours may result in fatigue and burnout for the graduate RN, potentially compromising patient care and safety (Grech, 2017). Studies have shown that fatigue can impair critical thinking, decision-making abilities, and communication skills, all of which are vital for safe and effective nursing practice (Jensen et al., 2018). Additionally, long working hours can lead to decreased job satisfaction, increased stress levels, and a higher risk of medical errors (Rosta et al., 2019).

Developing Leadership Skills for Advanced Nursing Roles
Aspiring to an advanced nursing role requires the development of essential leadership skills. Let’s consider one advanced nursing role and two relevant leadership skills:

c. Director of nursing of a rural hospital

Leadership Skills:
a. Strategic Vision: Effective leaders must develop a strategic vision for the rural hospital to ensure the provision of high-quality and accessible healthcare services (Cummings et al., 2018). This involves understanding the unique needs of the rural population, collaborating with stakeholders, and developing innovative solutions to overcome challenges.

b. Adaptive Communication: Communication is a fundamental aspect of leadership, particularly in rural settings with diverse teams and limited resources (Lewenson, 2016). Adaptive communication involves tailoring messages to suit different audiences, actively listening to feedback from team members, and promoting open dialogue to foster a positive and inclusive work environment.

Improving Patient Care Through Clinical Governance and NSQHS Standards
Clinical governance and National Safety and Quality Health Service (NSQHS) Standards play a vital role in ensuring safe patient care. Let’s focus on one NSQHS Standard:

a. Preventing and controlling Infections

Specific Patient Context: An orthopaedic ward

Importance of the Chosen NSQHS Standard: Infections can lead to significant morbidity and mortality in orthopaedic patients, especially those undergoing joint replacement surgeries (Jahn et al., 2019). Preventing and controlling infections is critical in this setting to minimize post-operative complications, reduce hospital stays, and improve patient outcomes.

Using the Chosen NSQHS Standard: As a new graduate RN working in an orthopaedic ward, I can use the NSQHS Standard on preventing and controlling infections to implement evidence-based infection prevention protocols. For example, ensuring adherence to aseptic techniques during wound dressing changes and catheter insertions, educating patients and their families on hand hygiene practices, and monitoring compliance with infection control guidelines (McDanel et al., 2016). By prioritizing infection prevention strategies, patient safety and quality of care can be significantly improved in the orthopaedic ward.

Conclusion

The transition from a student nurse to a Registered Nurse involves navigating various challenges and embracing leadership roles to provide safe and effective patient care. By developing essential skills, acknowledging power differentials, building leadership capabilities, and adhering to clinical governance standards, graduate registered nurses can thrive in their new roles and contribute to the improvement of healthcare outcomes.

References:

Cummings, G. G., Olivo, S. A., Hayduk, L., & Estabrooks, C. A. (2018). Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. International Journal of Nursing Studies, 85, 19-60.

Grech, C. (2017). Fatigue and stressors in nurses undertaking shift work. British Journal of Nursing, 26(17), 978-982.

Jahn, P., Ahmad, S. S., Haddad, F. S., & Sukeik, M. (2019). Assessing the quality of patient information in total hip and knee arthroplasty. International Journal of Health Care Quality Assurance, 32(4), 654-662.

Jensen, D., Webb, C., & King, B. (2018). Nursing workload and patient care: Understanding the value of nurses, the effects of excessive workload, and how nurse leaders can respond. American Nurse Today, 13(5), 44-50.

Johns, C., & Freshwater, D. (2019). Transforming nursing through reflective practice (3rd ed.). Blackwell Publishing.

Lewenson, S. B. (2016). Capturing the multiple domains of nursing practice through a new lens: A proposal for classification. Journal of Advanced Nursing, 72(9), 2064-2069.

McDanel, J. S., Perencevich, E. N., Diekema, D. J., Herwaldt, L. A., Smith, T. C., Chrischilles, E. A., … & Winokur, P. L. (2016). Comparative effectiveness of beta-lactams versus vancomycin for treatment of methicillin-susceptible Staphylococcus aureus bloodstream infections among 122 hospitals. Clinical Infectious Diseases, 63(5), 653-659.

Mitchell, R., Parker, V., Giles, M., & Boyle, B. (2016). The ABC of health care team dynamics: Understanding complex affective, behavioral, and cognitive dynamics in interprofessional teams. Health Care Management Review, 41(3), 231-241.

Rosta, J., Aasland, O. G., & Sverdrup, E. (2019). A physician job satisfaction scale: Development and psychometric analysis. BMC Health Services

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