Entering the workforce can be stressful for everyone, including new graduate nurses. Healthcare facilities have a huge responsibility to provide support in terms of mentorship and preceptorship as students transition to practicing nurses, which will lead to competent and independent nurse practitioners.
I am passionate about clinical competence of new nurses, and I advocate for them. I developed this passion from my research studies, where I explored and described professional nurses’ perceptions of final year student nurses’ clinical competence with a master's degree in nursing. The results of this study showed that student nurses were not clinically competent due to:
- Insufficient supervision from the nurse educators;
- Poor clinical supervision from the professional nurses;
- Attitudes of both students and nurses;
- Misunderstanding of the specific learning approach used by the nursing education institution, which is Problem-Based Learning (PBL).
The majority of participants were taught using traditional methods that made it difficult to understand and accommodate student nurses in order to meet the learning needs related to PBL.
The COVID-19 pandemic has highlighted the important role nurses play in a functional healthcare system. Healthcare facilities in many countries are faced with a shortage of nurses and material resources. This puts new nurses into situations they are not prepared for, which impacts their effectiveness. However, keep in mind that it takes about two years for new nurses to be to be fully competent according to literature. Consequently, new nurses experience challenges caused by the disconnect between what they have learned during training and what is happening in real-life situations, known as the theory and practice integration gap. Practical or clinical teaching is happening in a simulated environment, either in a classroom with mannequins or at clinical facilities where there is limited interaction with actual patients due to the fact it is only for learning purposes. The theory and practice integration gap occurs when a new nurse is unable to perform what they have learned during training to the best of their abilities.
New nurses rely on the guidance and support of experienced nurses to help fully develop their capabilities to provide quality nursing care for patients. For healthcare institutions, improving support systems, such as orientation and mentorship programmes for new nurses, will increase the number of adequately trained nurses available to best serve the public.
We also need to strengthen the collaboration between nursing education institutions and healthcare facilities in terms of clinical placement and clinical accompaniment during training to ensure that students get enough exposure during their clinical learning. The collaboration starts with a clear understanding of what students’ learning needs are in the clinical environment. Providing detailed learning objectives will help professional nurses meet those learning objectives for the students they supervise. Also, it’s important to work with the nursing education institutions by sharing students’ progress and collaboratively addressing challenges. This will limit the theory and practice integration gap.
I am currently working on a post-doctoral programme that aims to enhance clinical competence of new nurses through contributor’s collaboration in the Northwest Province, South Africa. The intention of this programme is to work together with the clinical facilities in terms of identifying learning and professional development needs then develop and provide workshops for new nurses employed at those facilities, which is in progress.
As part of my doctoral degree, I also developed the Clinical Competence Evaluation Tool for Community Service Nurses to evaluate new nurses. After completing their degree, new nurses in South Africa are required to complete a 12-month Compulsory Community Service before they can be registered as professional nurses. One of the objectives of Compulsory Community Service is to develop and strengthen their clinical competence; therefore, I wanted to develop a tool that would evaluate their level of competence, as there was no tool or any way to measure this.
By supporting new qualified nurses during their transition period, we will have competent and independent practitioners who are ready to serve the community. Furthermore, it will reduce the high rate of new nurses leaving the profession due to frustrations.
Kholofelo Matlhaba, PhD, is a senior lecturer for health sciences education at the Department of Health Studies, University of South Africa. She is a member of Sigma’s Chi Xi at-Large Chapter.