|dc.description.abstract||Nursing has recognized a dramatically changing practice environment.
Graduate nurses are exposed to greater challenges and stresses than in
previous decades. In a competitive healthcare delivery system, where cost conscious
practices may limit orientation, graduate nurses are asked to perform
competently, safely and proficiently within a short period of time. With increased
scrutiny of nursing practices by regulatory and quality organizations, the pressure
for quality without incident creates even greater demands on hospital educators
and nursing staff to ensure competent and safe patient care. The expectations
for graduate nurses entering the hospital or acute care setting may also be
changing. New graduates who are unprepared for the realities and complexities
of the practice setting have been leaving their entry-level positions within one
year, creating vacancies and shortages and contributing to the high cost of
recruitment and orientation (Halfer & Graf, 2006).
The purpose of this study was to identify and describe the practice
expectations hospital educators have of entry-level graduate nurses. Benner's
(1984) Novice to Expert model provided the theoretical framework for this study.
A non-experimental descriptive study was used to identify and describe
the expectations hospital educators have of graduate nurses. A researcher
created self administered questionnaire based on Benner's Framework, was sent
out to hospital educators in Eastern Wisconsin from two large health systems.
Demographic information was obtained. The survey consisted of questions
surrounding perceived practice expectations that hospital nurse educators have
of graduate nurses. Descriptive statistics were used to answer the research
By recognizing the expectations for graduate nurses entering the practice
setting, this study helped identify the need to develop training and orientation
programs that transition the graduate nurse successfully from novice to
competent practice. The study found that externships or prolonged clinical
experiences may facilitate early transition to a proficiency level of competent.
Structured orientation programs lasting greater than four to six months, along
with consistent mentors may improve retention of newly hired graduates.
Demonstrating safe patient care practices, motivation to learn, communication
skills, accountability, and respect for healthcare team members were identified as
most important skills and attributes graduate nurses should possess. The study
suggested that collaborative efforts between academic institutions and practice
settings will strengthen and realistically prepare graduate nurses as they
transition into the practice setting.||en