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Inquiry Paper on Challenges Facing Novice Nurses

InquiryPaper on Challenges Facing Novice Nurses

InquiryPaper on Challenges Facing Novice Nurses

Thehealthcare sector is characterized by several factors which ensureenhanced patient outcome and quality of services. Central to thissector are nurses who determine the success of the medical facilitythrough improving patient quality outcome. However, there existseveral challenges to achieving this objective. These problemsrevolve around the new nurses who often find it challenging tointegrate with the medical facility culture. Notably, professionalismis required in the medical sector which nurses gain throughexperience, continuous learning, and development. An important aspectto consider is that novice nurses face the challenge of increasedworkload which results in stress and dissatisfaction. In this regard,this paper aims at providing a clear insight into challenges faced bynovice nurses which in turn affects their work quality and patientsafety. Further, this paper provides descriptive analyses of thisproblem using PICOT format. A discussion on the proposed change whileintegrating it with nursing theory is also provided. Finally is adiscussion on the prompts to consider in this study through aliterature review and some of the recommendations to enhance such asituation in future.

TheClinical Problem

Inevery organization, it is expected, there will be new employeesregularly who must effectively integrate with the culture of themedical facility. This in itself is a challenge, both physically andpsychologically. In most cases these challenges are centered onaspects such as increased workload yet less experience, poorcommunication which affects their interaction with other healthcareproviders, dealing with patient’s emotional demands and inadequateresources affecting their performance (Della, 2016). Communicationhas been noted as the foundation of effective interaction within anorganization. This especially applies to the health care sector whereinstructions are primary expectations. New nurses and especiallythose from learning institutions rarely have adequate experience.This implies that they must depend on instructions from thesupervisors. The manner in which these instructions are conveyed hasan impact on their work. Use of commanding tones and non-verbal cuesdetermine how these nurses take the instruction. In this regard, itis imperative to consider effective communication that does notinsinuate command, superiority, and discrimination.

Workloadis also a major factor affecting novice nurses. The increase inworkload results in stressing these nurses since they must alsodeliver quality services. Interaction with patients is also anotherfactor that affects new nurses. This is attributed to less experiencein handling patient’s demands (Della, 2016). As a result of thisstress, most of the new nurses express their dissatisfaction throughquitting their job and reduced work morale. While valuating andaddressing stress affiliated with increased workload in neurologynovice nurse, the PICOT format can be used. ‘P’ representspatient, problem or population where an increase in stress level innovice nurses results in reduced work satisfaction while to thepatients, it reduces their quality. ‘I’ represent theintervention I am advocating which is the improved resources and useof a float nurse. ‘C’ indicates comparison where performing thetask is dependent on the patient technology support. ‘O’represents outcome where I anticipate reducing stress, enhance worksatisfaction and reduce turnover. ‘T’ represents time frame whichin this case is six months.


Accordingto Imogene King on middle range theory and conceptual system, nursingpractice focuses on human beings. According to her, nursing goalsinclude restoration of heath and maintaining the sick, those who areinjured and dying (Alligood, 2014). Her theory is also found onseveral aspects among them positive interaction, effectivecommunication, role expectation, effective performance of the nurseand patient, growth and development and resolving stress andconflict. Middle range nursing theory is applicable in my clinicalproblem in several ways. First, the transactions are some of theissues facing novice nurses. As noted earlier, novice nurses haveless experience. This makes them vulnerable to instructions in almostall procedures (Della, 2016). Considering an example of an emergencysituation where a patient has been involved in an accident and isbleeding heavily while crying in pain, a new nurse is likely toexperience challenge on the right procedure to follow to address thesituation in the shortest time possible. According to middle rangetheory, one of the goals is reducing injuries and maintaining thesick. To achieve this goal and in consideration to the emergencysituation example, there should be good communication between thenurse responsible for the emergency situation and the novice. Thiswill ensure attaining the expectations of their roles as well as goodperformance of both the patient and nurse.

Essentialto note also is that the novice nurse must integrate with the currenthospital’s culture to aid in achieving maximum performance. This isapplicable whether I will be treating health situations, management,addressing related neurological issues such as behavior and arrangingoccupational therapy. Further, I am aiming at addressing the totalityparadigm which will assist in accomplishing nursing goals. Myunderstanding of the nursing practice is centered on four metapadigminvolving a person, nursing, health, and environment. Considering the‘person’, a patient’s welfare also includes their familymembers. This, therefore, gives them control, purpose, and support toachieve these goals. Achieving these goals is also dependent on aconstant relationship between the nurse and patient which ensuresquality outcomes (Mantzorou, 2011). Regarding ‘health’, the maingoal is to achieve wellness state and health satisfaction whilepromoting optimum functioning. Finally is the ‘environment’ whichthe patient surrounding is promoted through an interdisciplinary teamwho ensures healing, recovery, quality care, and safety.

Developmentof my Intervention

Everynew graduate has high expectations regarding their career. Most arehopeful on a smooth transition from learning to actual clinicalpractice. Additionally, most anticipate an easy integration of thetheoretical knowledge to clinical practice which is not the case.What most of them experience upon arrival at a new workplace is ademotivation. As I came to understand, not all healthcare providersare friendly to armatures. This makes the new nurses uncomfortableand dissatisfied. With a negative perception towards the nursingpractice, most of the novice nurses resolve to quit their job. On theother hand, through dissatisfaction and pressure to perform theirduties amicably, their work quality is affected. At the same time,most of them will be condemned for poor performance, an aspect thatwill affect their morale. According to Sparacino (2010),dissatisfaction at the workplace results in abandoning of the nursingprofession. Callista Roy on adaptation framework considers nursing asan adaptive system (Medeiros et al., 2015). This implies thatphysiological stress prompts negative responses from an individual.This, therefore, hinders development and job performance. Sparacino(2010) further suggests that comprehending the challenges thatnurse’s face is the key to developing and implementing profoundintervention which aids the nurses to adapt to the environment.

Inline with my strategies, Sparacino’s research indicates that thereis a need to avert the challenges faced by the novice nurses. Basedon this insight, my idea is based on altering the nursingorganization culture which will enhance work satisfaction among thenovice nurses who experience stress. While establishing some of theclinical challenges that stress in novice nurses results in, theyinclude poor patient outcome, increase in hospital revenue andextending the patient’s length of stay. Notably, these are thebasis for developing the intervention. Identifying the cause ofstress is also imperative. According to Sparacino (2010), the bestintervention would be that addressing a particular problem.Considering the lack of experience by the novice nurses, the floatnursing strategy is employed. Bonis (2009) suggests that everyindividual gains knowledge through personal experiences that are alsoprofessional. In this regard, it is essential to consider trainingand development to the new nurses. This entails both the theoreticaland practical approach. Alienating this with my mission in thisprofession while relating it to totality paradigm, I aim at promotinghealth, quality, and safety of the care. This is achieved throughaltering and modifying organizational culture which improves theperformance of the institution as a whole.


Novicenurses are noted to face several challenges among them psychologicalstress. This is attributed to lack of experience and problems ofintegrating with the organizational culture. As a result of thisstress, the quality of work of these nurses is affected which in turnimpacts the patient’s outcome negatively. Other factors thatcharacterize nurse’s stress include poor communication, increasedworkload, inadequate resources and coping with the patient`s demands.The middle range theory, therefore, describes the nursing practice asfocusing on the human beings. According to this theory, the nursinggoal is centered on positive interaction, growth, and development,effective communication, resolving stress and conflicts and improvingthe role and expectation of both the nurses and patients. In thisregard, my strategy to address the issue of stress in novice nursesis to change the healthcare culture which will accommodate the growthand development of these nurses. This, therefore, provides afoundation to achieve the expectations of these new employees.Workload should also be reduced while embracing effectivecommunication and interaction within the organization


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DellaRatta, C. (2016). Challenging graduate nurses` transition: Care ofthe deteriorating patient.&nbspJournalof Clinical Nursing,&nbsp25(19-20),3036-3048.

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