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Inspiring confidence in new nurses

VOL: 97, ISSUE: 02, PAGE NO: 35

Clare Bennett, BSc, DipN, Maggie Mallik and Barbara Workman are members of the Practice Development Team, Royal Free Hospital, London

During the 1990s, a number of studies sought to identify outcomes of the Project 2000 diploma in higher education programmes (May et al, 1997). Findings suggested that although diplomates exhibited high levels of knowledge, they lacked confidence and ability in performing clinical skills during the early months of their first staff nurse posts (Runciman et al, 2000).

During the 1990s, a number of studies sought to identify outcomes of the Project 2000 diploma in higher education programmes (May et al, 1997). Findings suggested that although diplomates exhibited high levels of knowledge, they lacked confidence and ability in performing clinical skills during the early months of their first staff nurse posts (Runciman et al, 2000).

The limited research that is available also suggests that Project 2000 diplomates experience significant stress and anxiety during their first six months of postregistration experience (Charnley, 1999). Charnley (1999) contends that transition stress is largely caused by a deficit in practical and management skills and a lack of qualified support in clinical areas.

This stress has been further exacerbated by the national shortage of nurses (Commons Health Committee, 1999), with high levels of unfilled qualified nurse vacancies being a particular problem in the London area (Buchan and O'May, 1998).

Providing support for the transition
Throughout the last decade, a variety of support programmes for new staff nurses have been developed in the UK. These vary in length of time, the level of support offered and whether or not they include the opportunity to gain experience through rotation of several different clinical areas.

Many transition support schemes are completed within six months. Field (1999), however, recently implemented an 18-month programme that included a comprehensive support and development system and the opportunity to rotate in a variety of clinical areas.

But very little research has been carried out in evaluating the efficacy of such support programmes in the UK.

The supervised postdiploma development year (SPDDY) project
In March 2000, funding was obtained from Middlesex University and the Royal Free Hospital to initiate and evaluate a one-year development programme for newly qualified staff nurses. The programme, which began in October 2000, consists of a 40-credit, level-3, work-based learning module that will take students 12 months to complete. It has been designed in partnership with the practice development team at the Royal Free Hospital and Middlesex University. Newly qualified nurses who participate in the programme will be released from duty for one day per month to attend supportive study days (Box 1).

Work-based learning is an ideal way to acknowledge skills learnt through work and can be tailored to individual needs. It facilitates learning that focuses on the working environment.

The SPDDY project enables personal, professional and local service needs to be recognised and integrated into a local continuing professional development programme. It carries transferable academic credits and promotes flexible learning by using work experience, critical incidents and reflection.

This first SPDDY programme is a pilot. Project data will be collected to evaluate the impact of the programme on practice, retention and recruitment. A pre-experience questionnaire has been drawn up to investigate the development needs, anxieties and career concerns of all new staff nurses recruited to their first post in an acute NHS trust. A modified version of this questionnaire will be administered 12 months later to measure these variables - comparisons will be made between those who participated in the SPDDY and those who did not.

A performance measurement indicator (O'Connor et al, 1999) will be used to evaluate the programme's impact on clinical practice, while in-depth interviews and focus groups will be used to explore the needs of newly qualified nurses and evaluate the programme in more depth.

Conclusion
The SPDDY project is an innovative method for addressing the needs of both employers and newly qualified staff nurses. We plan to report on the outcomes of the project throughout the next 12 months and will recruit newly qualified staff nurses on to the programme each April and October. We envisage that the SPDDY programme will offer a positive contribution to reducing transition stress and will therefore benefit newly qualified nurses, their patients and the organisations in which they work.

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