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New nurses turn to senior staff 'more than evidence-based sources'

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Newly-graduated nurses draw heavily on the guidance of senior colleagues to make decisions about their clinical practice, even when more relevant or evidence-based sources are available, a study has found.

The findings demonstrate the importance of experienced nurse mentors who encourage junior staff to reflect on their own practice, according to the research paper published in the Journal of Clinical Nursing.

The paper, based on research in Denmark, found that newly-graduated nurses were unlikely to question the responses given by more experienced nurses whom they had approached for help.

”The experienced nurses as a knowledge source often took precedence over other more relevant and evidentiary strong knowledge sources”

Research on newly graduated nurses’ use of knowledge sources

It said: “The experienced nurses as a knowledge source often took precedence over other more relevant and evidentiary strong knowledge sources.”

“If newly graduates are to be supported in an articulate and reflective use of a variety of sources, they have to be allocated to experienced nurses who model a reflective, articulate and balanced use of knowledge sources,” concluded the paper, called Newly graduated nurses’ use of knowledge sources in clinical decision-making: An Ethnographic Study.

The study was based on nurses with between six and 18 months of post-university clinical experience, working in eight wards at a metropolitan hospital in Denmark.

Only three of the nine female participants had received formal training in the highly specialised clinical environments in which they were working.

”The experienced nurse was by virtue of her professional experience perceived as a respected and fully legitimate source of knowledge”

Research on newly graduated nurses’ use of knowledge sources

None had an official mentor, but they all sought and selected unofficial mentors and “sounding boards” among their more experienced colleagues.

The paper said: “The experienced nurse was by virtue of her professional experience perceived as a respected and fully legitimate source of knowledge whom they trusted to give the best possible care for the patients.

“Their credibility was only questioned when there was a discrepancy with what the newly graduated nurse thought themselves.”

The researchers found that good mentors were willing to help, provided time, communicated in a friendly and respectful tone, passed on their knowledge and told the newly graduated nurse what to do and why.

However, the newly-graduated nurses were often simply told what to do, which underpinned the newly-graduated nurses’ perception of themselves as being unqualified to perform the tasks required.

Other sources of information used by the newly-graduated nurses included a website providing medication information, medical and nursing records and care guidelines.

But these were often used in an unreflective way, the research showed.

Doctors were also used as a source of advice, and over time the nurses grew more confident in challenging them, the researchers noted.

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Readers' comments (2)

  • I look forward to seeing other people's comments on their source of evidence-based data and if they use NICE guidelines or journals available via their NHS athens account

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  • karen Webb

    The pressure on newly qualified or newly appointed nurses to "fit in" has always undermined our professional duty to provide evidence based Care. It is a major cause of theory practice gap and the tectonic plates of research, management, practice and education. Unless or until we sort this out we will remain as easy to subdue as sheep.

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