Nursing: a Reflective Paper on Challenges Encountered

Nursing is an exciting profession, but with the levels of interest, there is still a sheer level of challenges that are encountered in the nursing environment. Thus, by writing a nursing reflective essay, I would identify the strategies that are applicable and variable to be applied when challenges are encountered as I change from the trained nurse to a Graduate nurse. These are the strategies that are important when it comes to self-management in a nursing environment. Further, while developing these strategies for discussion, the focus will also be diverted to the indication and use of personal experience in placements. A literature review as supporting evidence will also be utilized.

General Overview

Nursing work is quite a broad service which is conducted on a range of patients with varying levels of medical urgency and complication. It involves many different fields of work specialising in different roles who collectively as a ‘nurse’ look after people of varying age levels based on their health and illness. A registered nurse provides care to their patients based on the practice that is best for the situation. They follow standards and evidence to successfully reinforce practice and they are a part of a multidisciplinary health care team. In particular, the nurse can be seen to do the following roles but are certainly not limited to:

• Patient advocate
• Unsupervised clinical practice
• Supervision and mentorship/ preceptorship
• Interaction/ liaison within the team
• Counselling
• Accurate and timely documentation.

These roles are just a broad overlook as to what nurses do in their jobs but depending on the organisation and the age group they work with, the roles can vary greatly. A Nurse is required to demonstrate competence in the delivery of care as followed by the national board of standards and codes, registration requirements, educational preparation, context of care and the relevant legislation. People of all ages and different cultural groups will be cared for by registered nurses.

Challenges in medical and medication supervision

While undertaking a nursing program as a first-year student, there were challenges in self-management which were encountered. A typical first-year nurse is faced with the problem of fear which comes due to the changing situations from a theoretical understanding of the concepts of practical experiences and implementation of the academic knowledge. As graduate nurses face these challenges, healthcare institutions and nursing training schools have an ultimate goal which is to ensure that all healthcare professionals achieve the self-medication goals (Levett-Jones, T, 2013., p 36). Self-medication management goal is focused and elevated from standard four of the Australian Commission that deals with Safety and Quality in Health Care. While on placement at the General Hospital In Alabama, there were fears that I developed which include having a shadow of a doubt that at any given time while in practice, I will make the administration errors. The reason why I had the concern is that the medical errors that are made by Graduate nurses are usually linked with the conclusion that the graduate nurse has an inadequate training in nursing and also that the nurse lacks an experience in clinical matters (Levett-Jones, T, 2013., 95). Graduate nurses who make medical errors are often treated as a concern as medical errors can be severe to the point that it leads to the death of patients in the organization. Graduate nurses also who make medical errors are subjected to a disciplinary action, and in some cases, they are usually deregistered. These are the reasons as to why I had fear when placed in the hospital as a graduate nurse.

Another challenge noted include the un supervision in medication during the time that I was placed as a graduate nurse. A new nurse who has just graduated from the nursing school needs to be trained and guided to ensure that the nurse fits appropriately in the new environment and learns the ropes that are to be scaled up the ladder (Levett-Jones, T & Brourgeois, S, 2011., p 77). The reason for the need to have guidance is because a new graduate nurse is usually faced with challenges and feelings of lack of a self-confidence and in extreme cases confusion when the organization culture is diverse. Supervision often takes place when the nurse is still undertaking his or her studies, but once they graduate to a graduate nurse, supervision is not available. The new graduate nurse will often feel isolated and low self-esteem as there is no guideline regarding a supervisor who will advise the nurse to either conduct the medication or change the medication (Ott, J, & Ross, C. 2014., p. 74). Furthermore, what usually takes place is a series of medical errors that the graduate nurse is prone to make. These errors are because the nurse is stressed and has anxiety levels which hinder him or her from performing active duties according to the theoretical training and skills impacted.

Difficulties in the pharmaceutical knowledge

Another identified challenge that I encountered and also which a majority of graduate nurses usually encounter include the lack of a pharmaceutical knowledge. In the university, nurses are trained on pharmacy knowledge, but the linkage of the knowledge with diagnosis usually take place at the time when the nurse is placed as a graduate nurse (Levett-Jones, T, 2013., p 40). Therefore, the conduction of evidence-based research and the availability of evidence-based practices have limited nursing profession by the graduate nurses. Proper placement can allow the linkage of pharmaceutical knowledge to diagnosis which will help in boosting the clinical experience of the graduate nurse.

Improvement strategies to tackle these identified challenges

Adherence to the policies and procedures

The strategies to use include the adherence to the nursing policies and procedures that are in line with the placement practice. The strategy helps in the achievement of a safe medication management program. Thus, when these policies are communicated to the graduate nurse, it will be easy for the individual to know the location of devices in the organization and also ensure that all these procedures are correctly followed. The graduate nurse who ha these understandings will be able to make proper delivery and safe medication management. Policies will also define a proper strategy to follow by the graduate nurse (Levett-Jones, T & Brourgeois, S, 2011. p 85). These strategies include the process where the graduate nurses will seek clarification when they are faced with challenges especially issues to do with unknown medications. Monthly Index of Medical Specialities should also be applied as part of the strategies that should be followed. The importance of MIMS is that they provide proper descriptions in details where the nurses will be able to understand contradictions that might arise when a particular medication is administered and also learn on the side effects that might originate from these medications.

Use of technology

Implementation of technology in the nursing environment will also help with the mitigation of medical errors that graduate nurses are prone to make. Technology plays a vital role in healthcare organizations. Among these roles include the improvement of efficiency in the workplace environment and ease of nurses working duties (Ostini, F, & Bonner, A. 2012., p 102). Therefore, when graduate nurses are trained on how to use different kinds of technology, they will gain skills that they can be depended on to minimize the stress especially on medication which might also lead to medical errors. Further, technology is stated to be beneficial to the point that it has a chance of promoting self-governance among the trained graduate nurse and it will boost the professional development. Technology can also help the graduate nurse to be able to make a comparison and conduct monitoring and evaluation. Monitoring and evaluation technologies will help in decision making which minimizes medical errors that nurses can cause. Through these systems, it will be easier for the graduate nurse to be able to learn on the progress of the patient and where there are challenges, strategies will be developed and implemented quickly. Further, technology can help a graduate nurse to be able to check on the patient identification which is against the procedures which encompass medication rights and administration. Through these strategies, there will be an achievement of the health care and consumer safety in healthcare organizations.

Development of proper plans and prioritization

Another strategy to overcome these challenges is for the healthcare institution to develop proper plans and conduct prioritization on the graduate nurses. Prioritization will lead to the proper care and guidance of graduate nurses to allow for a smooth transition between training theoretically as a nurse placement as a graduate nurse in a health care institution or a hospital. In prioritization, I selected it as a strategy as the managers and supervisors in these institutions will be present to provide guidelines and directions to the graduate nurses regarding what they are required to do and how they can be able to settle as new nurses (Ostini, F, & Bonner, A. 2012., p 47). Further, I selected the strategy because it is easy for the organizations to delegate duties to the nurses according to their capabilities. A nurse will be able to handle duties according to their capabilities which will also minimize stress levels and medical errors that might arise in the organizations.

Conclusion

In conclusion, it should be noted that different strategies are identified and selected as an option in the nursing organization. These strategies help the organization and a graduate nurse not only to overcome challenges that he or she faces as a graduate nurse but also it allows for the nurses to settle appropriately in the new placement environments. Consider the mistakes of fear and medical errors where a graduate nurse who has been placed in a new healthcare organization is capable of and prone to making. These challenges are detrimental, and there are strategies that an organization can implement and use to make sure that they address these challenges. As noted above, the strategies include the establishment of placement programs where the graduate nurses will be prioritized and supervised until the time when they are safe and can conduct management care without making any medical errors. Furthermore, there is also a recommendation that there is a need to implement the technology. Technology helps in the minimizing medical errors and allowing the nurses to improve their efficiency especially graduate nurses. In these reflective essay, these strategies need to be implemented. It will generate positive impacts to the graduate nurse, the nursing organization and also patients who seek medical services from these institutions.

Works Cited

1. Works Cited
2. Levett-Jones, T., & Bourgeois, S. (2011). The clinical placement: An essential guide for nursing students. Elsevier Health Sciences.
3. Ott, J., & Ross, C. (2014). The Role of Supervision in Mediation Errors. The Journal for Nurse Practitioners, 10(2), 74-78.
4. Australian Commission on Safety and Quality in Health Care. (2012). National safety and quality health service standards. Retrieved from https://www.safetyandquality.gov.au/sites/default/files/migrated/National-Safety-and-Quality-Health-Service-Standards-second-edition.pdf
5. Burke, M. A., & Dufault, M. A. (2018). Building resilience in nursing students: An integrative review. Journal of nursing education, 57(12), 699-706.
6. Casey, D., Burke, E., Houghton, C., & O’Donoghue, D. (2018). Physiotherapy students’ perceptions of their readiness to work as newly qualified professionals. Physiotherapy Practice and Research, 39(2), 121-128.
7. Dieterly, D. L., & Schafer, J. C. (2016). Nursing students' experiences of bullying and incivility in clinical settings: a qualitative study. Journal of Nursing Education, 55(7), 365-370.
8. Hafsteinsdottir, T. B., Beckstrand, R. L., & Bond, A. E. (2019). Transition shock in new graduate nurses: A theoretical yet realistic framework. Nursing Forum, 54(2), 250-256.
9. Kelly, J., & Ahern, K. (2018). Nursing student anxiety in simulation settings: A mixed-methods study. Clinical Simulation in Nursing, 19, 34-41.
10. National Council of State Boards of Nursing. (2015). Delegation: Concepts and decision-making process. Retrieved from https://www.ncsbn.org/Delegation_consensus_final.pdf