Newly qualified nurses face many challenges - being in charge of the care needs of patients who are seriously ill, having to delegate and often taking higher than expected levels of responsibility at short notice due to staff shortages.
This is nothing new, of course. I qualified as a registered general nurse after completing “apprenticeship-style” training where we spent most of our time in practice. Students made up the majority of the workforce in NHS hospitals. Routinely, wards were managed by a single staff nurse with only students for support.
My first job after qualifying was on the ward where I’d done my final student placement. Was it then a seamless transition from apprentice to RGN? Unfortunately, it wasn’t. Like so many nurses before and since, I found the role very different from that of a student. Yes, I could do the tasks associated with looking after a ward full of patients, but nothing can prepare you for the reality of that accountability.
In 2013, this is at least as big an issue for the newly qualified as it was in the 1980s - but the life of the new RN has undoubtedly become more complicated in the intervening years.
Some of us survive this period of uncertainty to have careers as nurses and others don’t. Left to sink or swim, too many newly qualified nurses simply give up the profession in the early months because of this “reality shock”. However, it doesn’t have to be like this. A large body of evidence shows that, given support for a few months after qualification, most of those newly qualified nurses become valuable, experienced RNs. That is why it is vital that employers follow the advice of the Nursing and Midwifery Council and the Department of Health to provide a period of preceptorship after qualifying. We simply cannot afford to lose these new members of our profession.
We know from our extensive recent systematic review that any form of support is better than nothing (Whitehead et al, 2013). Nevertheless, once employers have a system of support in place they should work to improve it. To do this, a culture of support is needed everywhere that newly qualified nurses are deployed.
According to our recent preceptorship research, this appears to work best in organisations that take a three-level approach: they deliver a preceptorship programme for all newly qualified nurses and meet regularly for peer support; they encourage local teams to look out for newly qualified nurses and be aware of their needs; and newly qualifieds have a personal preceptor. The preceptors are essential elements of this and require specific preparation, ongoing support and recognition of their role by their employers.
These systems of support should be the norm, not the exception. If we want to prepare a high-quality, caring workforce, we need to start by caring for the members of our profession at the start of their careers.
Bill Whitehead is assistant subject head of nursing, University of Derby
Whitehead B et al (2013) Supporting newly qualified nurses in the UK: a systematic literature review. Nurse Education Today; 33: 4, 370-377.