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Investing in latest nurse graduates matters for our future

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10 months ago

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Yr after 12 months we hear that latest nursing graduates will not be able to enter practice. The numbers are clear; over the past 3 years, the NCLEX pass rate for RNs has decreased from 88.2% in 2019 to 79.9% in 2022 (NCSBN, 2022). Moreover, only 23% of nurse graduates demonstrated entry-level competencies and profession readiness (Kavanaugh and Szweda, 2017). The NCSBN concluded that the present NCLEX examination didn’t adequately assess clinical judgment. Clinical judgment is defined as the method by which nurses make decisions based on nursing knowledge, evidence, theories, other disciplinary knowledge, critical considering, and clinical reasoning (AACN, 2023). Starting in April 2023, NCSBN will release the next-generation NCLEX exam, which streamlines clinical assessment testing.

Clinical assessment: an important element of competence

Practicing nurses expect the nurse working next to them to be competent, confident and in a position to count on their support in an emergency – essentially able to practice. The reality is that latest nurses will not be ready for practice because they will not be fully competent; they’re beginners. Being competent in nursing means with the ability to provide complete patient care in any situation by integrating knowledge, clinical judgment, skills, values, and attitudes to perform activities defined by their scope of practice (ANA, 2018). Clinical judgment is a component of competency; it does not imply someone is competent. Based on Benner’s novice to expert model, student nurses start on the novice level, meaning they haven’t any work experience, and progress to the expert level where they’ll recognize patient problems, begin to make use of clinical judgment, and learn to prioritize what to deal with first in patient care situations (Benner, 2020). True competence is achieved only after 2-3 years of experience as a nurse. Today, healthcare organizations are facing an experience shortage as lots of their most experienced nurses are retiring or leaving the hospital staff.

Healthcare organizations must facilitate the acquisition of competencies

Once a nursing graduate passes the NCLEX exam and begins practicing, the work begins with improving competencies. Practitioners must accept that graduate nurses won’t be competent; It’s the responsibility of health care organizations to get them thus far through comprehensive orientation programs, nurse residency programs, mentoring, coaching and experience monitoring. Healthcare organizations must provide a sturdy preceptor program and offer latest graduates structure, resource support, and training as they progress through orientation. Although there’s a push for brand spanking new nurse graduates to develop into independent and competent as quickly as possible, the outcomes of pushing too quickly will be disastrous. The turnover rate of graduate nurses in a single 12 months ranges from 18% to 33% and increases within the second 12 months (Blegan et al., 2017; Flinkman, Isopahkala-Bouret, and Salanterä, 2013). Newly graduated nurses leave after they don’t feel they’re supported within the transition from beginner to competent nurse. Healthcare organizations that supply nurse residency programs experience significantly lower staff attrition rates than those that supply standard orientation programs (Knighten, 2022).

This partnership between academia and practice ensures the success of nursing graduates

It is obvious that academia or practice alone cannot ensure nurse competence; it needs to be a partnership. Healthcare organizations that collaborate with academia in formal academic/practice partnerships, through which students spend more clinical time within the healthcare organization and are supervised by teachers and school with dual academic/practice positions, have demonstrated success in higher preparing graduates and stopping worker attrition (Kennedy, 2020 ). Our healthcare organizations often struggle with the prices of longer, more comprehensive graduate nurse orientation or nurse residency programs. Return on investment should be considered when initiating and maintaining these programs. The typical cost to fill a nurse unoccupied is $46,100; if a company can retain a brand new graduate and facilitate their skilled development from beginner to competent and ultimately expert clinician, the fee savings will likely be significant (NSI, 2022).

Investing in graduate nurses matters for our future

The Next Generation NCLEX exam is step one toward ensuring that latest nurses are on target to becoming competent. Nevertheless, experienced nurses and healthcare organizations need to alter their approach to nurse graduates. It will be important to acknowledge that latest nursing graduates are learning to exercise clinical judgment, but it surely is the role of the organization and other nurses to facilitate their development from beginner to competent nurse. We’d like to know that investing in latest nursing graduates will allow us to construct a pipeline of competent nurses, and the following time you end up in an emergency situation, you’ll be able to make sure that the nurse working next to you is competent, confident and has your support.

American Association of Colleges of Nursing (AACN). (2023). Fundamentals: Clinical Assessment Concepts. https://www.aacnnursing.org/Essentials/Concepts/Clinical-Judgement

American Nurses Association (ANA). (2018). ANA Leadership: Competency Model. https://www.nursingworld.org/~4a0a2e/globalassets/docs/ce/177626-ana-leadership-booklet-new-final.pdf

Benner, P. (2020, August 1). Nursing. https://nursology.net/teorie-pielęgniarki/od-nowicjusza-do-eksperta/

Blegen, M. A., Spector, N., Lynn, M. R., Barnsteiner, J., & Ulrich, B. T. (2017). Newly Licensed RN Retention: Hospital and Nurse Characteristics. , (10), 508–514. https://doi.org/10.1097/NNA.0000000000000523

Flinkman, M., Isopahkala-Bouret, U., and Salanterä, S. (2013). Young registered nurses’ intention to depart the occupation and early profession turnover: A qualitative case study. , , 916061. https://doi.org/10.1155/2013/916061

Kavanagh, J. M., and Szweda, C. (2017). The competency crisis: A strategic and ethical imperative for assessing the clinical reasoning of latest graduate nurses. , (2), 57–62. https://doi.org/10.1097/01.NEP.0000000000000112

Kennedy, S. (facilitator). (2020, November 5). [Webinar]. American journal of nursing. https://journals.lww.com/ajnonline/Pages/video.aspx?autoPlay=false&v=156

Knighten M. L. (2022). Latest nurse residency programs: advantages and return on investment. , (2), 185–190. https://doi.org/10.1097/NAQ.0000000000000522

Nursing Solutions, Inc. (NSI). (2022). 2022 National Health Care and RN Workforce Retention Report. https://www.nsinursingsolutions.com/Documents/Library/NSI_National_Health_Care_Retention_Report.pdf

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