Individuals who have recently completed accredited courses and are eligible to register as a nurse in Australia are often referred to as not being ‘work-ready’ by clinically based colleagues. This project identified the level of competence that can be reasonably expected of a newly registered nurse (RN) graduating in Australia. The research was undertaken using the necessary skills identified by Crookes and Brown in 2010.

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What level of competency do experienced nurses expect from a newly graduated registered nurse? Results of an Australian modified Delphi study

Aim To determine how extended orientation enhances the work readiness of new graduate nurses as they transitioned to their professional role in a specialty care hospital. Background Given increased complexity of care and high-patient acuity, there is concern about the work readiness of new graduate nurses in specialty areas. Design Qualitative exploratory study using an inductive approach. Methods An integrative literature review was conducted to abstract characteristics of work readiness among new graduate nurses. Semistructured interviews were conducted with 41 participants from a large paediatric specialty hospital in Ontario, Canada, in 2014. The sample of nurses was stratified and included nurse managers, new graduates, and preceptors. Interview texts were interpreted using thematic analysis. Results A framework for enhancing work readiness of new graduates transitioning to specialty care was developed from the interview and literature findings. Interview data demonstrate an extended orientation that includes mentorship, a gradual increase in clinical responsibilities, and involvement in the professional role during the early stages of a nurse's career can enhance work readiness of new graduates. Four key areas of work readiness were identified in the literature: personal characteristics, clinical characteristics, relational characteristics, and organizational acuity. Conclusion Based on the study results, new graduate nurses can be an integral part of the team in specialty care provided certain conditions are met during their transition to practice. Our study gives further evidence that extended orientation enhances new graduates' work readiness as they transit to their professional role.

Work readiness, transition, and integration: The challenge of specialty practice.

Aims and objectives

To assess changes in perceptions of confidence and preparedness for practice of preregistration nursing students before and after the introduction of a capstone subject, and factors associated with perceptions of preparedness.

Background

Preregistration nursing student 'readiness' or 'preparedness' for practice has been highlighted in the literature in recent years, along with employer concerns that university graduate nurses are not work ready. Few studies have examined Australian preregistration nursing students' perceptions of preparedness for clinical practice following their final clinical placement or assessed whether preregistration student nurses' perceptions of preparedness change as the result of undertaking a capstone subject.

Design

A capstone subject was introduced at a regional northern Australian university in 2013. Perceptions of preparedness were assessed in two different cohorts of final year nursing students; one of which undertook a capstone subject.

Methods

Two separate cohorts of third year nursing students were surveyed regarding their perceptions of preparedness for practice at the conclusion of their final 240 hour clinical placement. The 2012 cohort did not experience a capstone subject, whereas the 2013 cohort were the first nursing students to experience the new capstone subject.

Results

Both cohorts were uncomfortable performing invasive procedures and reported low levels of confidence in the area of professional identity. An overall trend of decreasing confidence as patient assignment size increased was observed for both cohorts, and higher confidence was associated with previous health care experience. Perceptions of preparedness for practice did not increase significantly following the introduction of a capstone subject.

Conclusions

Although Australian undergraduate nursing student report feeling prepared for practice there are areas of knowledge, skills and patient care in which confidence is low. The results of this study highlight the importance of experience in building confidence and competence.

Relevance to clinical practice

This study highlights that while final year nursing students report feeling prepared for practice there are areas where additional support can be provided. It is recommended that nurse educators and health care facilities tailor their programs to provide support focused on the areas highlighted by this study.

Preregistration student nurses' self-reported preparedness for practice before and after the introduction of a capstone subject.

Although in recent decades reforms to undergraduate nursing and midwifery education have increasingly been guided by the concept of competency-based curriculum in a drive to produce competent graduates in the African context, the topic remains poorly researched in-depth. The related issues and challenges need to be explored in the interest of evidence-based practice. This article stems from a systematic review of qualitative literature on the design and implementation of competency-based curriculum. Data was inductively analyzed using constant comparison. The two categories that emerged were: (i) the need for a paradigm shift to competency-based curriculum; and (ii) the associated issues and challenges, such as a shift from informative to transformative learning, lack or limited of involvement of key stakeholders in curriculum development, focus on hospital-oriented education, lack of preparation of educators, and inappropriate resources. While ongoing reform of nursing and midwifery education continues, much still needs to be done – in particular, extensive financial investment to increase the capacity of educators, mentors and infrastructure, and the development of collaborative frameworks between nursing and midwifery and higher educational councils.

Issues and challenges of curriculum reform to competency-based curricula in Africa: A meta-synthesis.

New Graduate Nurses’ Readiness to Practise: A Narrative Literature Review

Background : Employers and educators of nurse s expect that, upon graduation, they will have acquired a basic set of scientific knowledge, clinical skills and professional attitudes. In Swaziland, however, these expectations remain unmet. Methods : We explored the perceptions of stakeholders in nurs ing education of how new graduates cope and perform at service entry and the factors influencing their clinical competence. From 31 purposively recruited participants, audio-recorded focus group discussions were held with registered nurses and semi-structured interviews with lecturers and nurse managers. Data were analyzed thematically. Results: Results showed that although the graduates indicated their willingness to learn and become autonomous in their practice, stakeholders felt that most new graduates were not ready for practice upon graduation. Factors contributing to this discrepancy were associated with inadequate preparation and lack of support upon service entry. Conclusions: Stakeholders’ perceptions of the new graduates not being ready for practice call for the collaboration of academia, service and the regulatory body in establishing quality assurance mechanisms for clinical education and in providing structured support for new graduates at service entry to enhance easier and safer transition.

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Thabile Shabangu

Papers

New graduates’ readiness for practice in Swaziland: An exploration of stakeholders’ perspectives