Modern tasks assigned to the nurse make this profession multifaceted and technologically complex. If, in accordance with the laws of dialectics, our society is now entering a new round of development of the attitude towards diseases, i.e., focusing on their prevention, it is necessary to accordingly form and develop a methodology for nursing in order to manage the health of not only healthy or sick people, but also society from the standpoint of public health.
In particular, the methodology of nursing diagnosis should be based on the mandatory principles of evidence-based medicine, providing the possibility of proving (or refuting) certain decisions and formalizing both the development of decisions for certain standard situations and the decision-making process in non-standard cases. In general, the successful solution of the tasks facing healthcare is largely dependent on the competence of nurse personnel, their professionalism, creative activity, and competency. Thus, a systemic consideration of hard and soft skills and knowledge of graduate nurses, as well as leadership requirements and potential challenges, seems to be necessary.
Implications of Graduate Nurse Work in Today’s Healthcare Environment
Necessary Skills, Knowledge and Attitudes
At the present stage of medical science and practice development, the role of a nurse has significantly increased. According to available estimates, nurses make up the majority of medical personnel (up to 70%) and provide up to 80% of the direct patient care (Black, 2019). The main burden on the implementation of a huge variety of practical patient care lies namely on nurses. While specialists-doctors are increasingly moving into ‘technological’ specialties, namely the nurse becomes the expression of the human side of medicine and healthcare.
First of all, new nurses should be well aware of nursing process stages, be able to apply the elements of the nursing process in practice, know the features of the course of various diseases and the principles of nursing diagnosis, as well as be able to help the patient and assist the doctor in performing the procedures. In addition, nurses should have certain personal qualities that will help them cope with a variety of tasks, often very difficult ones. In particular, it should be noted that the basic principle in the organization of nursing is to pay priority attention to the personality of the patient. The nurse becomes patient’s ‘instructor,’ confidently abandoning the prevailing opinion that the less the patient in severe condition will do something himself, the better.
She motivates rehabilitation, prevention, and a healthy lifestyle (Pertiwi & Hariyati, 2019). Thus, helping the patient, she at the same time encourages him to be independent as much as he is capable of.
A Personal Communication with a Nurse Leader
A nurse leader specifically emphasized that it is necessary that nurses with a large amount of specialized knowledge acquired during study are not “mechanical executors” of doctor’s prescriptions, because this mode of work determines the low self-esteem of nurses as workers in the professional hierarchy. Meanwhile, the head nurses often point out the low level of training of graduates. One can hear from the head nurses that graduates have to be provided additional training at the workplace, or even have to be retrained. On the one hand, this is not unusual as each organization has its own standards and rules of work, starting with the appointment of the patient and ending with his discharge, and there is, after all, own internal corporate culture.
However, on the other hand, of course, this is due to problems in the quality of training. There can be several nursing educational institutions in one city, and they all teach students differently. According to the nurse leader, one of the directions for improving the training of nursing staff is a greater level of integration of higher medical schools and secondary medical institutions like colleges.
The Issues and Challenges Faced by New Nurses upon Entering the Workforce
Lack of sufficient communication skills, critical analysis, creative thinking, a scientific approach to acquiring new knowledge and skills, in particular, insufficient knowledge of evidence-based medicine methods and practical experience in this area are the main problems and challenges of new nurses entering the workforce. The situation is aggravated by the reluctance of a sufficiently large number of managers to recognize the right for managerial positions for nurses, because due to the prevailing patriarchal stereotypes, rigidity and inflexibility of mind, such leaders are accustomed to the mode that “the doctor is the main one over the nurse” (Ingvarsson et al., 2019). In this case, nurses cease to respect themselves, and their work does not bring well-deserved joy and satisfaction to them.
Special studies indicate that the majority of respondents ‑ nursing students ‑ would like to work with a mentor at first (Gimbel et al., 2017). In this fact, a certain pattern is seen: any young specialist, regardless of specialty, at the initial stage of entry into labor activity simply needs a mentor to support, guide, train, and protect him. The mentoring program seems to be the most effective at the adaptation stage when mastering the profession by a young nurse.
Conclusion
It is becoming increasingly apparent that under the conditions of socio-economic and administrative reform, the strategy for the development of nursing should be consistent with the changing paradigm of medicine, be socially acceptable and at the same time guarantee the high quality of medical care to the population. In the new model, a nurse with multilevel training background can play the role of a leader, actively participating in the rational organization of the medical diagnostic process, a creative person who systematizes and individualizes patient care, an active member of the medical team who correctly and independently provides assistance to patients using modern technologies of the nursing process.
Accordingly, the process of adaptation of graduate nurses should contribute to the formation of a positive attitude of young nursing professionals towards the organization, its unit and the assigned work tasks. This is a prerequisite for the provision of highly qualified nursing care and reducing staff turnover.
References
Black, D. (2019). Managing new grad nurses: The nurse managers guide to hiring, managing and getting new grad nurses to outperform. Davavi Media Group.
Gimbel, S. P., Kohler, P., Mitchell, A., & Emami, A. (2017). Creating academic structures to promote nursing’s role in global health policy. International Nursing Review, 64, 117-125.
Ingvarsson, E., Verho, J., & Rosengren, K. (2019). Managing uncertainty in nursing ‑ newly graduated nurses’ experiences of introduction to the nursing profession. International Archives of Nursing and Health Care, 5(1), 1-8.
Pertiwi, R. I. & Hariyati, T. S. (2019). Effective orientation programs for new graduate nurses: A systematic review. Enfermeria Clinica, 29(S2), 612-618.