EASING THE

TRANSITION
FROM STUDENTS
TO NURSES
INTRODUCTION

 School is a world of “black &

white”

 Thetransition from nursing

student to RN is called “transition
shock” or “reality shock”.
 Movie clip:
The New Nurse
LEADERSHIP AND
PRECEPTORSHIP
 Preceptorship emerged as the "reality
shock" that students were
experiencing at the transition phase
from a student to a professional nurse,
became the focus of concern for the
profession (Kramer, 1974, McGrath &
Koewing, 1978).
 Preceptorship was adopted as a way
for preparing clinically competent
graduates who would be able to
assume full patient care as soon as
they are employed (Myrick, 1988).
LEADERSHIP AND
PRECEPTORSHIP
 Ineducation preceptorship is usually
defined as an individualized one to one
learning and teaching interchange
between a student and a staff nurse
who supervises the student and acts
as a role model and a resource person
who is available any time during the
clinical instruction
  
MAKING THE TRANSITION FROM
STUDENT TO NURSE
There are 3 distinct aspects of any given role:

 Ideal role image: society’s expectations of what

a nurse should be.
Includes obligations and responsibilities, rights,
privileges.
CLEAR image of what is expected.
Often unrealistic.
 Perceived role image:an individual’s own
definition of nurse’s role. 
Often more realistic than the ideal role, but not be
realistic, either. 
This is usually the role with which the nursing
student usually graduates.
 Performed role image:what the nurse actually
does. 
MAKING THE TRANSITION
FROM STUDENT TO NURSE
 Reality shock occurs when the ideal or
perceived role comes into conflict with
this performed role image.
 Cognitive dissonance may occur in new
graduate nurses:they know what they
should do but their circumstances won’t
allow them to do it.
 Unresolved role conflict may result in high
levels of anxiety and eventually, physical
and emotional symptoms.(burnout)
WAYS TO DECREASE REALITY
SHOCK IN NEW GRADUATES
 preceptored clinical experiences
during the last semester of nursing
school. - this can produce a type of
anticipatory socialization into the role
of registered nurse.
 internships for nursing students after
their junior year in nursing school -
such experiences offer experience in
skills and help the student become
socialized into the professional role.
EMPLOYMENT IN TODAY’S
MARKET

Employers want graduates who

can:
 Function independently
 Require little orientation or re-
training
 Can supervise a variety of less
educated and unlicensed
personnel
EMPLOYMENT IN TODAY’S
MARKET

Ways to increase the likelihood of

being hired:
 Take advantage of internships,
and extern or precepted
experiences
 Try to obtain clinical experiences
in the hospital where one wants
to be hired
 Do your best in clinical and make
a good impression!
EMPLOYMENT IN TODAY’S
MARKET

Resumes
 An institution’s first impression of a job
candidate… has a substantial effect on
the hiring process
 A neat, thorough, professional-looking
resume is well worth the time and
effort.

Interviews
 An interview allows the institution to
obtain a first-hand look at the applicant,
as well as an opportunity for the
applicant to obtain important
information about the institution and
position requirements.
EMPLOYMENT IN TODAY’S
MARKET

 
First impressions are important. Be sure to do the
following at your interview:
 Wear clean, neat, well pressed and conservative
business clothes
 Hair should be conservatively styled and
clean.Jewelry and makeup should be tasteful
 No smoking, biting fingernails, chewing gum or
tobacco, or nervous pacing
 Arrive a few minutes early
 Carry a copy of your resume, cover letter,
references, and information about the hospital.Also
bring a pen and something to take a few notes on.
Bring your business card if you have one.
EMPLOYMENT IN TODAY’S
MARKET

Be prepared!!!
 Know something about the institution where
you’re applying. 
 Expect questions about your past jobs,
education, unusual activities outside the
employment setting
 Answer questions honestly but briefly
EMPLOYMENT IN TODAY’S
MARKET

At the end of the interview, applicants

may be asked if they have any
questions. At this time you should bring
up questions about:
 responsibilities of the position
 other staff in the area where you’re
applying
 client-to-staff ratios
 requirements for floating, weekends,
etc.
 opportunities for CE, clinical ladder,
advancements, etc
 policies for employee health and safety
ISSUES AFTER EMPLOYMENT
 Indeed, nurses are leaving the field at a
record pace. A recent study conducted by
Julie Sochalski, RN, PhD, of the University of
Pennsylvania reveals that new nurses are
abandoning the profession at much faster
rates than they did just 10 years ago. Four
percent of new female nurses drop out within
four years of earning their RN licensure; for
males, the figure is almost double (7.5%).
ISSUES AFTER EMPLOYMENT
Burnout
 Burnout syndrome has been recognized as a
problem that can be reduced or even
prevented.
 Burnout:a state of emotional exhaustion that
results from the accumulative stress of an
individual’s life, including work, personal, and
family responsibilities.
ISSUES AFTER EMPLOYMENT
People most likely to experience burnout
tend to be:
 above average intelligence
 hard-working
 idealistic
 perfectionistic
ISSUES AFTER EMPLOYMENT
Jobs which tend to produce a high
incidence of burnout have:
 demand for consistently high
performance
 unclear or unrealistic expectations
 little control over the work situation
 financial rewards are inadequate
 very demanding and stressful
 little recognition or appreciation 
 constant contact with people

Most of these elements are present in

NURSING!!
ISSUES AFTER EMPLOYMENT
Symptoms of burnout include:
 extreme fatigue, exhaustion, frequent
illness, overeating, headaches,
sleeping problems, physical
complaints, alcohol abuse, mood
swings, emotional displays, anxiety,
poor-quality work, anger, guilt,
depression.
ISSUES AFTER EMPLOYMENT
Symptoms of burnout include:
 extreme fatigue, exhaustion, frequent
illness, overeating, headaches,
sleeping problems, physical
complaints, alcohol abuse, mood
swings, emotional displays, anxiety,
poor-quality work, anger, guilt,
depression.
 may lead to feelings of helplessness,
powerlessness, purposelessness, and
guilt.
ISSUES AFTER EMPLOYMENT
There are ways to prevent burnout and to
deal with the stress that leads to burnout:
 Recognize early symptoms of burnout
 Manage stress and time. Set personal goals
(short term: 6 months- 2 years; and long
term: 10 years).Goals should be flexible.
 Identify problems that are producing the
stress. Time management is one important
technique to decrease work stress. The most
important aspect of time management is
SETTING PRIORITIES!!
 Take care of yourself. Take time after work for
“decompression”, to release the tension of
the work day. Relaxing activities, solitude,
prayer, etc. can all be effective.
PRACTICE MAKES PERFECT
 "Assertiveness ties in with self-confidence
and it comes with more experience," "Be
assertive when seeking opportunities to
develop strong clinical skills. Seek those out.
Don't be passive and wait on people to bring
those opportunities to you."
 “You may feel like you’re not quite ready for
it. But midway through, you will start gaining
confidence and thinking 'maybe I can do
this.' By the end, you are sure you can. You
will be able to see your own competence and
realize you know far more than they think
you do.”