Newly graduated registered nurses' self‐assessed clinical competence and their need for further training

Willman, Anna; Bjuresäter, Kaisa; Nilsson, Jan

doi:10.1002/nop2.443

Cited by 24 publications

(26 citation statements)

References 57 publications

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“…In the process of developing clinical competence that can be applied to complex patient situations, this study showed that reflection gave NGRNs the opportunity to learn how to handle the demands of nursing complex patient situations. NGRNs' clinical competences in acute care hospital settings increased over time, with a significant difference seen between 9–15 months (Willman, Bjuresäter, & Nilsson, 2020b). Experience alone does not automatically lead to increased competence, in order for clinical competence to develop and transit through one competence stage to the next, intellectual and critical thinking is essential (Benner, 2001).…”

Section: Discussionmentioning

confidence: 99%

“…In relation to competence development and lifelong learning, the results in this study show the importance of self‐reflection as a way to further develop oneself, and this has also been shown in other studies (Forsman et al., 2019; Nilsson et al., 2019). Yet, the ability to think critically decreased after 9–15 months of clinical practice among NGRNs (Willman et al., 2020b). Possible reasons for a negative development in critical thinking include that NGRNs lack time for reflection, the lack of experienced RNs to support them and give new perspectives and the lack of possibilities for NGRNs to meet patients.…”

Section: Discussionmentioning

confidence: 99%

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Insufficiently supported in handling responsibility and demands: Findings from a qualitative study of newly graduated nurses

Willman

Bjuresäter

Nilsson

2020

Journal of Clinical Nursing

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Aims and objectives To explore newly graduated registered nurses' experiences and how they manage complex patient situations. Background Newly graduated registered nurses' working in acute care hospital settings are challenged by managing complex patient situations in rapidly changing clinical contexts involving increased patient acuity, comorbidities and staffing shortages. Design Qualitative study design. Methods Data were collected using focus groups interviews of a total of 16 newly graduated registered nurses with clinical work experience of 6 months of direct patient care in an acute care hospital setting. Analyses were conducted using qualitative content analysis. COREQ reporting guidelines were used. Results The analysis resulted in the overarching theme “Not being sufficiently prepared and supported to meet responsibilities and demands.” The theme included three categories: “Responsibility is not in proportion to competence,” “Lack of medical competence and experience complicates patient safety” and “Strives for control to manage and organise nursing care.” Conclusion The results show that newly graduated registered nurses' are not sufficiently supported for the level of responsibility and the demands placed on them when providing nursing in complex patient situations in acute care hospital settings. If they are given sole responsibility for multiple complex patient situations, patient safety may be compromised. Relevance to practice Special attention need to be paid to NGRNs support to medical competence in the areas of assessing, planning, prioritizing, leading, and distributing nursing care in daily clinical settings for at least their first year of professional work.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Insufficiently supported in handling responsibility and demands: Findings from a qualitative study of newly graduated nurses

Willman

Bjuresäter

Nilsson

2020

Journal of Clinical Nursing

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“…The development process of the PROFFNurse SAS I and II are described in Finnbakk et al (2015) (version I) [ 20 ] and Wangensteen et al (2018) (version II) [ 21 ]. The PROFFNurse SAS II used in the present study was developed ahead of a study among postgraduate nurses [ 21 ] and has also been used in studies by Taylor et al 2020 [ 32 ], and Willmann et al (2020) [ 33 ]. The questionnaire consists of 50 items and asks for responses on self-assessment of: a) competence (A-scale) and b) need for further training (B-scale).…”

Section: Methodsmentioning

confidence: 99%

Self-assessed competence and need for further training among registered nurses in somatic hospital wards in Sweden: a cross-sectional survey

et al. 2020

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Background: Professional competence and continuous professional development is essential for ensuring high quality and safe nursing care, and it might be important for motivating nurses to stay in the profession. Thus, there is a need to identify the developmental process of nursing competency. Assessment of competence and need for further training helps to identify areas for quality improvement, and to design interventions in order to facilitate continuous competence development in different work contexts. The current study aimed to 1) describe registered nurses' self-assessment of clinical competence as well as the need for further training, and 2) explore possible differences between registered nurses with varying lengths of professional experience as a nurse (≤ 0,5 year, > 0,5-5 years, and ≥ 6 years). Methods: A cross-sectional survey design was applied, using the Professional Nurse Self-Assessment Scale of clinical core competencies II. Registered nurses (n = 266) working in medical and surgical contexts in hospitals in Sweden responded (response rate 51%). Independent student t-test and analysis of variance were carried out. Results: Registered nurses assessed their competence highest in statements related to cooperation with other health professionals; taking full responsibility for own activities; and acting ethically when caring for patients. They assessed their need for further training most for statements related to assessing patients' health needs by telephone; giving health promotion advice and recommendations to patients by telephone; as well as improving a creative learning environment for staff at the workplace. For self-assessed competence and need for further training, differences between the groups for 35 and 46 items respectively, out of 50 were statistically significant. Conclusions: Although the registered nurses assessed their competence high for important competence components expected of professionals such as cooperation with other healthcare professionals, it is problematic that knowledge of interactions and side-effects of different types of medication were reported as having the highest need of training. Longitudinal follow up of newly graduated nurses regarding their continuous development of competence as well as further training is needed.

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“…In this complexity, the supervisory role of RNs and IDNs will be even more essential to support the education of competent newly graduated candidates [ 22 ]. As RN and IDN educators (all female, one with a Ph.d. and one pofessor), with several years of clinical experiences, to our knowledge few studies have explored RN and IDN supervisors’ perspectives on supervision across primary- and hospital healthcare services and also across RN and IDN education programs.…”

Section: Introductionmentioning

confidence: 99%

Supervising students in a complex nursing practice- a focus group study in Norway

et al. 2021

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Background The supervisory role of registered nurses and intellectual disability nurses will be even more essential in the future, to support the education of competent newly graduated candidates. To our knowledge few studies have explored nursing student supervisors’ perspectives on supervision across primary- and hospital healthcare services and also across nurse educational programs. The aim of the current study was to investigate supervisors’ perspectives on supervising from different clinical settings, and across registered nurses’ and intellectual disability nurses’ clinical practice. Methods The study had an exploratory and descriptive design. The study was conducted within one university college catchment area in Southeastern-Norway. Eight focous group interviews were conducted in primary healthcare (n = 4) and hospital (n = 4) wards. A total of 31 registered nurses and three intellectual disability nurses participated. Hsieh and Shannon’s conventional content analysis was used to analyze the data. Results Participants across primary- and hospital healthcare agreed that clinical practice was complex, and required that students gained competence in both technical and non-technical skills. Moreover, needed skills were described both as general and arena specific, and as both basic and advanced. Participants perceived that technical and non-technical skills together, ideally should lead to students being able to «see the person» behind the patient. Conclusions Supervisors emphasized the challenges of supervising students in a complex nursing practice. Students should gain both procedural competence and an ability to provide person-centred care, and this challenged the supervisors’ own competence. Our findings indicate a need to support supervisors, to enable them to meet these challenges.

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Newly graduated registered nurses' self‐assessed clinical competence and their need for further training

Cited by 24 publications

References 57 publications

Insufficiently supported in handling responsibility and demands: Findings from a qualitative study of newly graduated nurses

Insufficiently supported in handling responsibility and demands: Findings from a qualitative study of newly graduated nurses

Self-assessed competence and need for further training among registered nurses in somatic hospital wards in Sweden: a cross-sectional survey

Supervising students in a complex nursing practice- a focus group study in Norway

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