Evaluation of a Nursing Practicum Focused on the Needs of Senior Nursing Students Preparation for Transition into the RN Role

1
Evaluation of a Nursing Practicum Focused on the
Needs of Senior Nursing Students Preparation for
Transition into the RN Role

• Willena Nemeth MN., RN
• Debbie Brennick MN., RN
• WINN Conference
• December, 2011

2
Literature Review

• Validates what we have thought for the past 2
  decades
• Nsg students expectations of the graduate yr
  versus the reality of practice are two different
  entities
• (Heslop, McIntyre Ives, 2001)
• The majority of graduate nurses felt unready
  lacking in practice
• (Heslop, McIntyre Ives, 2001 Morrow, 2009)
• The theory-practice divide is a concern for
  graduating nurses (Heslop, McIntyre Ives,
  2001)

3
Literature Review (cont)

• First few months are the most challenging
• Many experience
• Fear of failure
• Fear of total responsibility
• Fear of making mistakes
• Organizational support can create a positive or
  traumatic transition (Morrow, 2009).

4
Literature Review (cont)

• Boychuk Duchscher describes Transition Shock
  as the early stage of role adjustment of a
  graduate nurse
• Transition Shock Model describes the impact of
• Relationships
• Roles
• Responsibilities
• Knowledge
• Performance
• (Boychuk Duchscher, 2009)

5
Anecdotal Feedback What students are telling us.

• Im so glad this was implementedI learned so
  much from my preceptor
• This...experience was much more conducive to
  learning than the Mon/Tues approach
• The insight received from the past 9 wks is
  invaluable I will not be as overwhelmed with my
  new job
• I gained so much and feel more prepared to
  graduate and begin working

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The Catalyst for Changing the 4th Year Nursing
Practicum

• To enhance nursing students self-efficacy and
  their ability to meet the CNA Entry-level
  Registered Nurse Competencies.

7
CBU Nursing Practicum (Final Term)

• Past Practice
• Courses conclude in April
• Two 6 week rotations (12 hrs/wk) with a
  nursing educator
• Consolidated practice
• 48 hrs and
• 96 hrs
• Preceptor/preceptee model

• Current Practice
• Course conclude in Feb
• One 6 week rotation (12 hrs/wk) with a nursing
  educator
• Consolidated practice
• 60 hrs and
• 348 hrs
• 40 hrs CRNE preparation
• Preceptor/preceptee model

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Nursing Practice Placement Self determined

• Individualized based on the learning needs of the
  nursing student as he/she transitions to the role
  of the registered nurse (RN)
• Competency Evaluation Plan incorporating
• Reflective practice (FRAME TM Method) CRNNS, 2008
  
• Self-directed learning
• Critical thinking
• Evaluation

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Evaluating the Nursing Practicum 4 - 8 -12
months post CRNE

• Impact analysis
• Did the intervention improve the transition from
  nursing student to the role of the RN?
• Outcome analysis was the goal attained.
• Did the enhanced practicum help bridge the gap
  between theory and practice?
• What are strongest aspects of the program?
• What are the weakest aspects of the program?

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Qualitative Feedback Student and Preceptor
Perspective will be Sought

• Student Perspective
• The week long RN prep was the reason I passed
  the CRNE
• Made a big difference in meeting the people you
  are working with
• I took full of advantage of wearing the white
  uniform (nsg student) I asked every question and
  asked to go in on every procedure
• Enhanced Communication with peers, nurses,
  physicians, families and patients
• I watched how nurses approached families and I
  took a bit from each one

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Round Table Questions

• What are the barriers to the successful
  implementation of the new practicum?
• What adaptations/considerations should be made to
  enhance the new practicum?

12
References

• Boychuk Duchsher, J. (2009). Transition shock
  The initial stage of role adaptation for newly
  graduated registered nurses. Journal of Advanced
  Nursing 65(5),1103-1113. doi10.1111/j.1365-2648.
  2008.04898.x
• College of Registered Nurses of Nova Scotia
  (2008). FRAME TM Halifax, NS Author.
• Heslop, L., McIntyre, M. Ives, G. (2001).
  Undergraduate student nurses expectations and
  their self-reported preparedness for the graduate
  year role. Journal of Advanced Nursing, 36(5),
  626-634.
• Morrow, S. (2009). New graduate transition
  Leaving the nest, joining the flight. Journal of
  Nursing Management 17, 278-287.