SINGAPORE: Nearly six in 10 nurses with fewer than two years’ experience are uncomfortable doing more complex procedures independently, a survey of new nurses has found.
These procedures include responding to a critical clinical emergency, chest tube care, and caring for and suctioning a tracheostomy - a surgically created hole in the windpipe.
Newer nurses therefore need a longer period of supervision for such procedures in order to ensure the quality of care is not compromised, Singapore General Hospital (SGH) said in a media release on Wednesday (Apr 17).
The study aimed to find out how ready nurses are when they enter the workforce.
Between November and December 2022, a team led by SGH surveyed more than 450 nurses who joined SingHealth institutions within two years after graduation with either a local diploma or bachelor’s degree.
“We wanted to examine how to best help young graduate nurses adjust to their new roles as they transit to the workforce and this study highlighted the key challenging areas they encountered when they started work,” said the study’s principal investigator Dr Lim Siew Hoon, who is also a nurse clinician at SGH.
The study’s findings were published online in February this year in Nurse Education Today, a leading international peer-reviewed nursing journal covering nursing, midwifery and healthcare education.
The study, which was conducted by SGH, Sengkang General Hospital (SKH) and Singapore Institute of Technology (SIT), also showed that more than 40 per cent of respondents felt overwhelmed by ethical issues associated with patient care responsibilities such as when a patient’s family’s desire conflicts with the required care for the patient.
Thirty-seven per cent of the nurses surveyed had difficulty managing a dying person and about a quarter of them felt challenged in prioritising the care needs of multiple patients at any one time, SGH said.
Such situations may arise for instance, when a junior nurse has to handle a patient requiring urgent medication and another’s call for urgent toilet assistance.
Speaking to CNA’s Singapore Tonight, deputy director of nursing at SGH Ang Shin Yuh, who is one of the study’s authors, said that she was not entirely surprised by the findings.
“I'm actually glad that the survey findings supported our improvement initiative to better support our new nurses coming into practice,” she said.
When asked if such results will shake the public’s confidence in the healthcare system, she said that on the contrary, the study would assure them that the nursing profession is always striving to do better.
SGH said in its statement that even though the survey showed gaps, all healthcare institutions have a robust competency assessment and training system to ensure new graduates quickly and safely assimilate into their roles.
Among the practical skills that nurses could be better equipped with are caring for a dying patient, managing a patient with complex needs such as tracheostomy and assisting in resuscitation. These events, however, do not happen frequently, Ms Ang noted.
“Nonetheless, our newly graduated nurses are supported by mentors and preceptors, especially during the early years of their careers. And, they're not left alone during such complex situations,” she said.
SGH acknowledged that more can be done to enable nurses to transit more smoothly into the workforce after their studies. One way is to look into the training methodology of nurses, it said.
For instance, a recently launched five-year Bachelor of Science in Nursing – Master of Science in Nursing (BSN-MSN) programme involves 36 weeks of clinical residency at one of SingHealth’s institutions.
This is up from the 32 weeks required by the Singapore Nursing Board. The extra four weeks of residency during the programme developed by SIT in collaboration with SingHealth will allow students to devote more time to clinical practice so that they gain more confidence to perform basic nursing procedures independently after they graduate, SGH said.
MSN students will be required to work on real-life clinical problems to improve patient care, said Adjunct Professor Tracy Carol Ayre, SingHealth's group chief nurse and the study’s senior author.
"I am confident that graduates from this new BSN-MSN programme will be better equipped, both in knowledge and practical know-how, to take on the nursing challenges that an ageing population will bring,” she said.
With the identification of such gaps, the institutions are working even closer with the schools, said Ms Ang.
“The survey findings really reinforce that we need to work even closer with our training arm, with our nursing school to make sure that we very much prepare our nurses better and smoothen the whole transition process,” she said.
One way to tighten the relationship between the learning and practical worlds is to allow students to identify their areas of interest early on, said Ms Ang.
“If we can match interest to a specific clinical practice, learning becomes more relevant, learning is enhanced. And this would then lead to a more successful transition of our student nurses into very confident practicing nurses in the future,” she said.
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These procedures include responding to a critical clinical emergency, chest tube care, and caring for and suctioning a tracheostomy - a surgically created hole in the windpipe.
Newer nurses therefore need a longer period of supervision for such procedures in order to ensure the quality of care is not compromised, Singapore General Hospital (SGH) said in a media release on Wednesday (Apr 17).
The study aimed to find out how ready nurses are when they enter the workforce.
Between November and December 2022, a team led by SGH surveyed more than 450 nurses who joined SingHealth institutions within two years after graduation with either a local diploma or bachelor’s degree.
“We wanted to examine how to best help young graduate nurses adjust to their new roles as they transit to the workforce and this study highlighted the key challenging areas they encountered when they started work,” said the study’s principal investigator Dr Lim Siew Hoon, who is also a nurse clinician at SGH.
The study’s findings were published online in February this year in Nurse Education Today, a leading international peer-reviewed nursing journal covering nursing, midwifery and healthcare education.
FINDINGS SHOW MORE GAPS
The study, which was conducted by SGH, Sengkang General Hospital (SKH) and Singapore Institute of Technology (SIT), also showed that more than 40 per cent of respondents felt overwhelmed by ethical issues associated with patient care responsibilities such as when a patient’s family’s desire conflicts with the required care for the patient.
Thirty-seven per cent of the nurses surveyed had difficulty managing a dying person and about a quarter of them felt challenged in prioritising the care needs of multiple patients at any one time, SGH said.
Such situations may arise for instance, when a junior nurse has to handle a patient requiring urgent medication and another’s call for urgent toilet assistance.
Speaking to CNA’s Singapore Tonight, deputy director of nursing at SGH Ang Shin Yuh, who is one of the study’s authors, said that she was not entirely surprised by the findings.
“I'm actually glad that the survey findings supported our improvement initiative to better support our new nurses coming into practice,” she said.
When asked if such results will shake the public’s confidence in the healthcare system, she said that on the contrary, the study would assure them that the nursing profession is always striving to do better.
SGH said in its statement that even though the survey showed gaps, all healthcare institutions have a robust competency assessment and training system to ensure new graduates quickly and safely assimilate into their roles.
Related:
PLUGGING THE GAPS
Among the practical skills that nurses could be better equipped with are caring for a dying patient, managing a patient with complex needs such as tracheostomy and assisting in resuscitation. These events, however, do not happen frequently, Ms Ang noted.
“Nonetheless, our newly graduated nurses are supported by mentors and preceptors, especially during the early years of their careers. And, they're not left alone during such complex situations,” she said.
SGH acknowledged that more can be done to enable nurses to transit more smoothly into the workforce after their studies. One way is to look into the training methodology of nurses, it said.
For instance, a recently launched five-year Bachelor of Science in Nursing – Master of Science in Nursing (BSN-MSN) programme involves 36 weeks of clinical residency at one of SingHealth’s institutions.
This is up from the 32 weeks required by the Singapore Nursing Board. The extra four weeks of residency during the programme developed by SIT in collaboration with SingHealth will allow students to devote more time to clinical practice so that they gain more confidence to perform basic nursing procedures independently after they graduate, SGH said.
MSN students will be required to work on real-life clinical problems to improve patient care, said Adjunct Professor Tracy Carol Ayre, SingHealth's group chief nurse and the study’s senior author.
"I am confident that graduates from this new BSN-MSN programme will be better equipped, both in knowledge and practical know-how, to take on the nursing challenges that an ageing population will bring,” she said.
WORKING CLOSER WITH SCHOOLS
With the identification of such gaps, the institutions are working even closer with the schools, said Ms Ang.
“The survey findings really reinforce that we need to work even closer with our training arm, with our nursing school to make sure that we very much prepare our nurses better and smoothen the whole transition process,” she said.
One way to tighten the relationship between the learning and practical worlds is to allow students to identify their areas of interest early on, said Ms Ang.
“If we can match interest to a specific clinical practice, learning becomes more relevant, learning is enhanced. And this would then lead to a more successful transition of our student nurses into very confident practicing nurses in the future,” she said.
Related:
Continue reading...