Assessment Task Overview
Transitioning to professional practice is a critical phase for the novice Registered Nurse. Managing professional role requirements, organisational technologies and team dynamics while on shift can be challenging. This is often accompanied by changed personal circumstances, with graduates balancing shift work, working full time and socialisation with friends and family. The case study below highlights the professional and personal challenges you may face as a Graduate Registered Nurse.
Critically analyse the following case study to answer the essay questions.
Case Study Background
Harry is a Graduate Registered Nurse (RN) who is 8 weeks into his first graduate rotation at the local metropolitan, tertiary hospital. He is currently working on a Medical Ward. For the first four weeks Harry worked alongside his nurse preceptor, predominately rostered on morning shifts. Harry has just completed his first five (5) night shifts yesterday morning and is back on an afternoon shift today (Saturday).
Harry is still trying to manage his roster and other commitments like social touch football with his friends and mountain biking. Today, Harry is feeling tired and frustrated because he slept through his alarm this morning and missed his sister’s birthday breakfast celebration. He is also disappointed that he can’t join his team for the touch football end of season breakup in the evening.
On Shift
Harry has arrived 15 minutes prior to this shift starting. On arrival, he realises that he hasn’t worked with
the Nurse-in-Charge before but there are other nurses on the shift that he has met.
Harry feels a little nervous, but he knows two (2) of the patients he has been allocated from his recent night shifts and he is allocated a further two (2) patients who are to be discharged this afternoon. He has not arranged a discharge before so he prioritises these activities as he prepares his shift planner.
A short time later the Nurse-in-Charge tells him that his patient allocations have changed due to skill mix. A different nurse will arrange one (1) patient discharge and Harry will be receiving a new patient from Emergency Department.
His patient allocations are now as follows:
| Patient | Age | Diagnosis | Relevant Information |
| Mrs Rita Williams | 71 | Pneumonia | New admission from the Emergency department (ED). Febrile and hypotensive on arrival to the ward. For IVAB and chest X-Ray. Urgent bloods have been taken. Patient’s family present and appear distressed. |
| Ms Frances Fernandez | 68 | Hyperglycaemia | Ready for discharge. Discharge paperwork has already been completed by morning shift nurse. Pharmacy has delivered discharge medications and has conducted patient education. Waiting for family to arrive and pick up. |
| Mr Sandeep Patel | 62 | Trans Ischaemic Attack | Requires minimal assistance Needs IVC to be removed Awaiting neurological team review. |
| Mr Gerald Sommersby | 83 | Urinary Tract Infection with Increasing confusion | New admission from ED. Mr Sommersby is a Nursing home resident. He is a high falls risk. D |
Harry feels overwhelmed with the admissions and discharge. He is unsure how he will cope with the rest of his shift. Harry has not looked after a patient (Mr Somersby) who is confused, high risk of falls and wanders around the ward. He is reluctant to ask the Nurse in Charge for assistance as he does not want to appear ‘incompetent’. He decides he must push on, and soon it is time for handover.
At handover, Harry realises that after he had not given Mrs Williams her IVAB. To help with his time management, Harry had set the observation machine to take automatic observations. However, he had forgotten to go in and check this patient for the last 3 hours. Harry has not yet completed the admission documentation for Mr Sommersby as he has been trying to stop him from wandering out of the ward. Additionally, he has not completed any of his patient notes on the computer on wheels (COWS) machine. The nurse he his handing over to rolls her eyes when this information is handed over. Harry stays 30 minutes after the end of his shift to complete his work.
Following his shift
On his commute home, Harry feels anxious and feels that he did not provide sufficient care for his patients, in particular Mrs Williams. He is frustrated with himself that he may have missed other things this shift and that he had to stay late to finish his patient notes. At home, he spends some time reflecting on his shift and plans to ask his nurse preceptor for any advice/tips on their next shift together.
Assessment Task 2
Harry appears to be struggling during his clinical shift. He also seems to be having difficulty maintaining a work/life balance. Critically analyse the provided case study to answer all the following three questions within an essay format:
- Determine and justify whether the graduate RN met (or did not meet) their role and responsibilities as an RN during his shift. Provide at least two (2) case study examples and support your discussion using evidence, including Nursing and Midwifery Board Australia (NMBA) Registered Nurse Practice Standards (2016) (LO1 & LO3).
- Construct at least three (3) recommendations as to how the graduate RN could have undertaken this shift differently. Consider in your discussion the knowledge, skills and attitudes inherent in the RN role, including utilisation of technology and teamwork skills, and support your discussion with literature (LO2, 3, 5 & 6).
- Transitioning from student to Graduate Registered Nurse can be difficult. Construct at least two (2) evidence-based strategies that could be implemented to promote resilience, build capacity, and support work/life balance during the graduate RN’s transition period (LO3, 4, 5).
Instructions:
- Word limit is 1800 words (+/- 10%), including the introduction and conclusion.
- Paper to be written in essay format, must answer the above questions, and should be written in academic writing style (not first person). You may use headings.
- Ensure you consider the AT2 Rubric, Appendix 2 in the Unit Outline, when undertaking this assessment task.
- Submit your paper to Turnitin by the due date.
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