Analysis of Evidence

Entry-level nurses are faced with various challenges. Entry-level positions are mainly designated for recent graduates and may not require prior experiences. Though most new nurses are subjected to onsite training or orientation, it is crucial they have competence in various fields related to nursing. Competence and skills they gain during their nursing education should be relatively sufficient for them to transition into nursing careers without conflict or many struggles. This essay gives the competencies of current practice as well as their strengths and weaknesses and an overview of the six QSEN competencies and how they can be integrated into the job description of an entry-level registered nurse (RN). The essay will also highlight the attitudes, skills and knowledge necessary in the clinical practice setting.

Key competencies of current best practice

Several changes in the nursing practice has meant that practices have also changed. Current practices aim at ensuring patient outcomes and satisfaction are positive. Several competencies are associated with current practices. Willman, Bjuresäter, and Nilsson (2020) identified “consulting other professional experts” a competency necessary for newly hired nurses. This competency is informed by the fact that newly hired nurses might not be fully confident in decision making and may require them to clarify difficult situations. Consultation with peers is supported by Sheldon and Hilaire (2015) who, however, argue that communication skills are essential for the competency to be successful. Communication as current practices is captured by Sheldon and Hilaire (2015), who argue communication skills are necessary for engagement with high-level personnel, patients, or patient’s families as well as coworkers. Theisen and Sandau (2013) noted that schools of nursing should add communication skills to their current focus, given the growing importance of the competency. 

Enough literature agrees that new nurses must have leadership skills. Hofler and Thomas (2016) who examined the challenges that new nurses undergo noted that leadership programs were a solution. The authors, both of whom are affiliated to the Vidant Medical Center, stated that a new graduate nurse residency program that had been successful in retaining the new nurses and instilling them with leadership roles as coaches, charge nurses, and preceptors. Willman et al. (2020) identified clinical leadership as a crucial competency. 

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Strengths and weaknesses of current best practice

Communication skill as a current best practice is challenged by a lack of confidence among newly hired employees. They may feel they are confident enough to answer questions from patients and families. Lack of confidence is persistent may interfere with a new nurse’s ability to advocate for patients. Communication may further be challenged by conflicts between coworkers. This challenge is most evident in the horizontal hierarchy where experienced nurses or professionals in other fields may view new nurses as incompetent. This intimidation affects a new nurse’s communication with peers and colleagues. This barrier also affects new nurses’ “consultation” competency.

Nursing leadership plays a vital role in current practice as it nurtures teamwork, encourages growth and success. Leadership also ensures proper organization that eliminates chaos, which is a bad thing in the demanding, fast-paced healthcare world. Leadership in nursing care is challenged by perceptions of experienced nurses who may view new nurses as incapable of leading. 

The six competencies from the QSEN initiative

The Quality and Safety Education for Nurses (QSEN) are the competencies necessary to improve the quality and safety of healthcare systems. The six are informatics, safety, quality improvement, evidence-based practice, teamwork and collaboration, and patient-centered care. 

These competencies are incorporated into the entry-level RN by requiring students to have knowledge and skills in the six competencies. The job descriptions should require that nurses have knowledge in information technology. This position is informed by the fact that the electronic health record (EHR) has come to play a crucial role in most healthcare organizations. The entry-level RN job description should also require a nurse to understand safety basics in caring for patients. This safety skills should extend from handling of patients, shift reporting to giving medications. 

The job must also require that nurses demonstrate an understanding of EBP. The new nurses must demonstrate their ability to research a nursing problem and apply the findings in improving patient outcomes. This requirement can be linked with quality improvement (QI), which also requires a nurse to seek evidence first and rectify a problem affecting a general problem in a ward, clinic, or hospital. Since most established nurses tend to be burdened by different tasks compared to new nurses who might not be busy, the latter are well-positioned to identify problems affecting the hospital. Therefore, the entry-level position should require nurses to demonstrate research skills. 

The requirement should also require newly hired nurses to demonstrate the ability to work with colleagues and senior officers as well. That is, they should demonstrate the ability to collaborate and work in teams. On patient-centered care, the job description should require new nurses to be able to handle patients with compassionate and coordinated care concerning their needs, values, and preferences.

The attitudes, skills and knowledge necessary in the clinical practice setting

The attitudes, skills and knowledge that are required in clinical practice include communication skills, critical thinking, and compassion, and time management. Nurses should uphold a professional attitude. This means that everything nurses do should reflect their moral values and ethical principles (Brown & Crookes, 2016).  

References

Brown, R. A., & Crookes, P. A. (2016). What are the ‘necessary’ skills for a newly graduating RN? Results of an Australian survey. BMC Nursing, 15(1). https://doi.org/10.1186/s12912-016-0144-8

Hofler, L., & Thomas, K. (2016). Transition of New Graduate Nurses to the Workforce: Challenges and Solutions in the Changing Health Care Environment. North Carolina Medical Journal, 77(2), 133-136. https://doi.org/10.18043/ncm.77.2.133

Sheldon, L. K., & Hilaire, D. M. (2015). Development of communication skills in healthcare: Perspectives of new graduates of undergraduate nursing education. Journal of Nursing Education and Practice, 5(7). https://doi.org/10.5430/jnep.v5n7p30

Theisen, J. L., & Sandau, K. E. (2013). Competency of New Graduate Nurses: A Review of Their Weaknesses and Strategies for Success. The Journal of Continuing Education in Nursing, 44(9), 406-414. https://doi.org/10.3928/00220124-20130617-38

Willman, A., Bjuresäter, K., & Nilsson, J. (2020). Newly graduated nurses’ clinical competencies and need for further training in acute care hospitals. Journal of Clinical Nursing. https://doi.org/10.1111/jocn.15207