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)

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).

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)

“I’m so glad this was implemented…I 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”
 To
enhance nursing student’s selfefficacy and their ability to meet the
CNA Entry-level Registered Nurse
Competencies.

Past Practice

Current Practice

Courses conclude in April

Course conclude in Feb
› Two 6 week rotations
› One 6 week rotation
(12 hrs/wk) with a nursing
educator

Consolidated practice –
(12 hrs/wk) with a nursing
educator

› 60 hrs and
› 348 hrs
› 40 hrs CRNE preparation
› 48 hrs and
› 96 hrs

Preceptor/preceptee
model
Consolidated practice –

Preceptor/preceptee
model

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

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?
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”
 What
are the barriers to the successful
implementation of the new practicum?
 What
adaptations/considerations
should be made to enhance the new
practicum?
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. doi:10.1111/j.13652648.2008.04898.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.