The SN to RN
Transition
Marisol Masella Beth Berg Isis Cruz
Elisa Warren Carli Cervantes
Learning Objectives
You will be able to:
● Verbalize methods for decreasing role transition shock
● Recognize common issues new graduate nurses struggle with
● Understand obstacles faced when transitioning from LPN- RN
○ Methods to overcome them
● Understand issues related to role transition as well as methods to
aid during transition
● Verbalize methods to ease the transition from SN to RN
What are your fears
regarding the
transition from SN to
RN?
What advice have you
received from your
preceptors/mentors to
help you transition?
Role Transition Defined
Role Transition is transforming your professional identity
You may experience the following according to Role Theory:
• Role Expectation: What is expected by people already in the new role (role set)
• What are rights, duties, responsibilities
• Role Conception: Own idea of the role and reality of the position.
• Comes from personal experiences applied to new situation
• Role Performance: Fulfilling the role.
• Intersection between self concept and role expectation
• Role Stress: When role set and self concept conflict
Reality Shock is conflict between perceived role and performed role
You may experience Intrapersonal Conflict
as you are transitioning from SN to RN
Intrapersonal: conflict within the individual
- role transitions from student nurse to working nurse
- “I thought I was ready, but am I?”
- “Who am I going to contact with questions without my
clinical instructor there?”
- Orientation or residency programs help bridge gaps in
intrapersonal conflict
Why is Role Transition from SN to RN
important?
Role transition is important to prevent turnover and early
burnout. Role transition helps the individual manage
their feelings and fears. It is estimated that between
15% and 50% new nurses leave their first job due to
inadequate transition.
Soooo…. participate in your unit’s orientation and talk to
your mentor on a regular basis!
Initial Feelings
“Excited”
“Grown up”
“Happy”
“Relieved”
“Delighted” “Proud”
“... I was quite excited that I had qualified… I felt a real sense of
achievement for having attained and achieved my degree.”
But then...
Those initial feelings start to change into: nervousness,
feeling vulnerable, described as traumatic, confusing
and shocking.
New graduate nurses mostly struggle
with
Standing on their own two feet
“....I would now be expected to make decisions on my own and care for my own case load without
having somebody with me all the time..”
Becoming visible
“... You are ignored as students, when you put on the white (student) uniform, this invisible coat
that you are putting on. No one looks at you as though you are a person, and then when you
come out as a staff nurse… you are getting lots of questions right, left, and centre.”
Being responsible and accountable
“...I was nervous starting on the new floor… your own patients… your own case load...your
responsibility!”
Succeeding Your First Year of Practice
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•
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“They were there for me”
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•
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Staff, preceptors, and other new graduate nurses
Collaboration with other staff
Resources
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Sharing information
Questions are expected
New ideas should be sought
Evidence is part of practice
Questions provide the safety net for new graduates to practice
•
“Nursing school is like planting seeds of knowledge; it is not until you begin working
and giving those seeds what they need to grow that your knowledge comes to fruition.
Add one skill at a time”
“There are no stupid questions”
“Nurturing the Seeds”
•
The LPN/CNA: Challenges for
Transition
The new grad with LPN/CNA experience
faces special challenges as they transition to
the role of an RN:
● Changing scope of practice
● Increased responsibility/accountability
● The task of delegation
● Expectations of coworkers/managers
“Qualitative study of Enrolled Nurses
transition to Registered Nurses”
Interviews with LPNs as they transitioned to
RN role produced 3 themes:
1) “Stepping out of the comfort zone”
2)“Being taken advantage of”
3) “Needing support as much as others”
Cubit, K., & Lopez, V. (2012). Qualitative study of Enrolled Nurses transition to Registered Nurses.
Journal Of Advanced Nursing, 68(1), 206-211. doi:10.1111/j.1365-2648.2011.05729.x
AONE
“Organizations are faced with increasing demands on
resource utilization and simultaneous cost reductions
which means that adequate attention to ensure
successful transition for the newly licensed nurse may
be not be appropriately designed, managed, supported
or evaluated. A newly licensed nurse may not be
adequately prepared for practice and be confident and
competent in the professional role.”
Development
Development of professional nursing practice follows Benner’s novice-to-expert continuum.
Examples of continuum
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Standardized orientation programs with trained preceptors have shown to be beneficial in
recruiting and retaining nurses.
Structured nursing orientation programs are part of hospital strategies to improve the work
environment.
Successful orientation programs promote confidence, competence, and satisfaction.
Expert nurses must be identified and taught to understand the processes necessary to
advance the novice nurse through knowledge acquisition and implementation.
A preceptor workshop is an effective method for educating the expert nurse to the role and
responsibilities of being a preceptor.
Mentor and preceptor roles
“One of the most important tasks in your career is to Identify and cultivate mentor relationships.”Sullivan, 2013.
● Roles
○ provide new RN learning opportunities
○ give counsel
■ mistakes/need to improve
■ things to know
○ Introduction to key people
○ Provide/pass down knowledge to new RN
google images
○ Important to have personable, safe relationship with mentor (eases transition)
● Benefits
○ New RN gains sense of accomplishment
○ Gain knowledge/skills from mentor
○ New RN gives mentor a sense of fulfillment
SN to RN successful transition
● Components for Successful transition
○ Identify/Acquire mentor
■ Preceptors are key players in transition process
○ Identify own strengths and weaknesses
○ Seek/ask for help when unsure
google images
Tips for successful transition
• SPEAK UP!
• Ask questions, ask for help
• Utilize and Adapt your skills, but don’t
forget to delegate
• Find a consistent preceptor, role model,
and/or mentor
• Focus on process, not just procedure
More Tips for Transition based on the literature
• Give yourself time to adjust to your new role
• Discover and utilize your resources
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•
•
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• ie printed, electronic, or other staff
One day at a time, and one skill at a time
Give yourself credit, you’ve come so far!
Use evidence to practice
Residency/orientation programs…. USE THEM!
• The best way to transition******
Conclusion
• The transition from SN to RN can be associated with
a lot of difficulty and emotions.
• Recognize that this is an emotional experience
• Explore your role identity
• Know your responsibility
• Find your support
• Interpersonal and Organizational
References
American Organization of Nurse Executives (AONE) (2010). AONE Guiding Principles: for the Newly Licensed Nurse’s Transition into
Practice. Chicago, IL
Chandler, G. (2012). Succeeding in the First Year of Practice. Journal for Nurses in Staff Development, 28(3) 103-107.
doi:10.1097?NND.0b013e31825514ee
Cubit, K., & Lopez, V. (2012). Qualitative study of Enrolled Nurses transition to Registered Nurses. Journal Of Advanced Nursing,
68(1), 206-211. doi:10.1111/j.1365-2648.2011.05729.x
Kumaran, S., & Carney, M. (2014). Role transition from student nurse to staff nurse: Facilitating the transition period. Nurse Education
In Practice, 14(6), 605-611. doi:10.1016/j.nepr.2014.06.002
Sullivan, E. J. (2013). Effective Leadership and Management in Nursing (8th ed.). Boston, MA: Prentice Hall. ISBN 13:978-0-13281454-6
Waite, R. (2004). Psychiatric Nurses: Transitioning from Student to Advance Beginner RN.American Psychiatric Nurses Association,
10(4), 173-180. Retrieved from: http://jap.sagepub.com.ezproxy.westminstercollege.edu/content/10/4/173.full.pdf+html
QUIZ TIME!!!
1) According to the study on LPNs transition to the RN role, what is one
aspect of nursing scope of practice that previous LPNs found
particularly difficult?
a. Medication administration
b. Therapeutic communication
c. Delegating to LPNs
d. Collaborating with MDs
Answer
c. Delegating to LPN’s
QUIZ TIME!!
2) Based
on our “Tips for successful transition” slide, which of these elements
could be helpful when transitioning from the LPN/CNA role to that of the
RN?
a. Copies of facility protocols
b. Taking notes during meetings
c. The “Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and
Rationales”
d. A consistent preceptor or role model
Answer
D. A consistent preceptor or role
model
QUIZ TIME!!
What is one of the issues that new graduates struggle
with the most?
A. Not having 57 pg.-long process paper to complete
B. Standing on their own two feet
C. Missing out on 3 hour long lectures
D. Interacting with fellow classmates
Answer
B. Standing on their own two feet
QUIZ TIME
According to Sullivan the roles of mentors/preceptors
include: (Select all that apply)
A. Provide fulfillment
B. Provide learning opportunities
C. Give Counsel
D. Gain knowledge and skills
Answer
• B- Provide learning opportunities & C- Give Counsel
•
A & D are benefits
QUIZ TIME
According to AONE why might organizations not be
adequately equipped to ensure successful transition for
the newly licensed RN?
A. They don’t have time
B. Increased resource demands and cost reductions
C. They are an incompetent facility
ANSWER
B- increased resource demands and cost reductions
QUIZ TIME
Which of the following are literaturesupported methods of easing the SN to RN
transition?
A. Ask questions to only your preceptor
B. Ask for help
C. Rely solely on EBP if you don’t know the answer
D. Opt-out of Orientation programs
ANSWER
B) Ask for Help!