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The purpose of this paper is to explore emotional resilience as an area for improvement during my transition from a student to a registered nurse using the concepts of transition theory and reality shock (Kramer, 1974). The rationale for choosing emotional resilience is a need to improve my weaknesses in the SWOT analysis in preparation for the transition. Nurses face stressful situations during the transition due to increased patient caseloads and expectations which require them to be resilient to continue with their nursing practice (Christensen et al., 2016). The exploration of the transition process entailed a SWOT analysis to help me as a newly qualified nurse (NQN) to identify my professional strengths and areas of improvement for my future nursing practice. The discussion will include the formulation of a search question on personal resilience because the SWOT analysis showed that I need to improve in some areas before the transition. A literature review and search will be conducted through a systematic search strategy for critical appraisal.
The literature searches and review yielded three critical themes about emotional resilience‒psychological stability, leadership, and organizational culture. The chosen articles have details about the causes of emotional resilience among NQNs and how they can address the problem during the transition into nursing practice. In combination with the literature review, short and long-term action plans will be proposed to help me to prepare for and experience a smooth transition to registered nursing practice. I will develop overall ideas on the action plan to address my weaknesses in the SWOT analysis and use the opportunities I have for improvement in my nursing career.
Transition Theory
Nurses gradually move from one level of nursing career to another based on their skills and knowledge acquisition. Transition theory is pegged on the phenomenon of a continuum of life changes in nursing practice (Moran & Nairn, 2018). Transition theory explains the experiences of nurses during organizational and situational transitions which involve development, movement, or flow from one state of practice to the next. As a final year nursing student, it is useful to know about transition theory in order to predict my experiences in my new roles once qualify to be a registered nurse. The theory will help to identify the potential challenges which students might face during my first role in nursing practice, and how to use my strengths to address the problems. Therefore, knowing about transition theory will ease my transition to registered practice by helping me to foresee and prepare to overcome challenges in nursing practice.
Why nurses leave the profession is an important thing to know and transition theory is one explanation why this may be related to the NHS issues on nursing shortage and retention. The NHS is faced with a nursing shortage with more than 40,000 vacancies in nursing practice in England (RCN, 2020). The need for nurses keeps on rising despite the low nurse retention rates. The NHS will need 50,000 more nurses in the next 5 years, and the UK healthcare system must have a plan for delivering this need (RCN, 2020). The emotional resilience of nurses is important in tackling nurse shortages and staff retention by ensuring that NQNs overcome the challenges of new practice. For instance, 1 in every 5 nursing staff members leaves their place of work before the year ends (Buchan, Charlesworth, Gershlick, & Seccombe, 2019). The low retention rates have led to high staff turnover and instability of nursing care within the NHS (Buchan et al., 2019). Therefore, nurses must improve their ability to work with the NHS by properly improving their emotional resilience to stress during the first year of registered nurse practice.
NQNs face challenges that could impact their transition from a nurse student to registered practice. The risk of emotional burnout is high among the NQNs because the transition shock occurs when moving from student to registered nurse (Christensen et al., 2016). Theorists have explained the occurrence of emotional distress among the NQNs through different phenomena and phases. The new nurses experience a phase whereby they have feelings of insecurity and self-doubt due to the increased responsibilities and expectations after registration (Christensen et al., 2016). Kramer and Duchsher are renowned theorists in nursing transition who have defined the contexts of nursing transition. Kramer (1974) noted that the first few months of nursing practice are the most challenging period due to the unrealistic expectations of self and others coupled with the fears of failure, responsibility, and making mistakes. An NQN would experience these negative feelings during the initial periods of practice. Kramer (1974) called this transition theory experience a reality shock that might contribute to the NQNs leaving the nursing profession at an early stage of their career.
The NQNs go through four phases of reality shock as they try to adapt to their new work environment. The four phases of the reality shock in the transition theory are honeymoon, shock, recovery phase, and resolution (Kramer, 1974). The nurse experiences the joy of practicing as a registered nurse in the honeymoon period but starts to experience conflicting ideas and a lack of security in the shock phase which is dominated by feelings of discomfort in the new work environment. However, healing begins in the recovery phase as the NQN begins to understand the new organizational culture (Kramer, 1974). The final stage is the resolution phase whereby a nurse adjusts to the new environment and operates fully as a professional nurse. The reality shock stages are important to the transition phase to ensure NQN attains resolution faster because preparedness for transition is correlated to the reality shock (Christensen et al., 2016).
On the other hand, Duchscher expounded on the findings of Kramer to determine how NQNs adjust to the physical, social, developmental, and emotional changes during the transition (Duchscher, 2009; Lindmark et al., 2019). Nurses experience changes in their circumstances at workplaces after the transition. NQNs have gaps between pre-registration and the realities of registered nurse practice (Duchscher et al., 2019). To overcome the new practice challenges, NQNs require time and leadership support in their transition phases. The competence and confidence of nurses have been shown to increase over time after practicing their new roles (Duchscher et al., 2019).
The concept of transition in nursing practice is multidimensionally identified with a complex interaction between personal awareness, time span, difference and change, events, and critical points (Lindmark et al., 2019). The nurse must be ready to navigate through difficult clinical situations which require unwavering support from the organizational leadership. NQNs have internal feelings about their performance, and they question their competence due to fears of acting like imposters in healthcare (Christensen et al., 2016). Therefore, knowledge of the reality shock phases and the Imposter Phenomenon is important to ensure that I address challenges that could limit my self-perceived level of competence in nursing practice.
SWOT Analysis Discussion
Knowing my personal attributes that could influence my functionality as a registered nurse will help me to establish a plan to accomplish my professional ambitions in my first year as a registered nurse. The SWOT tool, as shown in Appendix 1, is an analytical approach to decision-making and planning by identifying the areas for growth as well as challenges to meeting a set objective (Longhurst et al., 2020). To complete the SWOT analysis, I evaluated the performance feedback that I got from the mentors in the booklets from years 1, 2, and 3. Feedbacks from the mentors were important as a flashback to the previous experiences during the placement to enable me to identify my strengths, weaknesses, growth opportunities, and threats to my practice as a registered nurse.
Gaining further insight through E-coach career assessments was also important in personality identification. The E-coach (2020) provided me with an opportunity to determine how my personality affected different areas of nursing practice. Through a series of career assessments, I noticed that I have poor adjustment capabilities to new roles in nursing (Ecoach, 2020). Therefore, I should update my personal resilience skills to achieve better results on my last placement.
I found the emotional resilience of nursing during the transition as the most important topic for review in this paper. My SWOT analysis showed that I should make efforts to improve my aspects of personal resilience such as organization and support networks (Ecoach, 2020). I scored average on my self-confidence which can reflect arrogance and lead to poor interpersonal relationships. In addition, my weaknesses also surround being anxious about decision-making on issues pertaining to evidence-based practice. Nurses should be educated to have a perception of belonging to the right profession (Jang et al., 2019). Therefore, I require further development of my confidence to practice clinical skills and remain stable to become emotionally resilient. To address my shortcomings in personal resilience, the assessment report indicated that I should continuously work on my level of self-confidence while ensuring that I cope with changes in the nursing profession (E-coach, 2020).
I also have strengths that will enable me to utilize the opportunities for growth in adapting new resilience skills to fit into my new practice as a registered nurse. I had high scores on problem-solving skills, giving feedback, and identification of practice gaps (E-coach, 2020). Overall, the completion of the SWOT analysis enables me to identify emotional resilience as a priority area that I should improve in order to ensure a smooth transition to register practice as an NQN.
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