Page 215 - Essentials of Nursing Leadership and Management, 5th Edition

CikguOnline
2208_Ch13_197-216.qxd 11/6/09 6:01 PM Page 202
202 unit 3 | Professional Issues CikguOnline
When efficiency is the goal, the speed and (1981) recommended that new graduates refuse to
amount of work done are rewarded rather than the take the test rather than fail it. Another opportuni-
quality of the work. This creates a conflict for the ty for proving themselves will soon come along.
new graduate, who while in school was allowed to Additional problems, such as dealing with
take as much time as needed to provide good care. resistant staff members, cultural differences, and
Expectations are also communicated in different age differences, may also occur. Above all, the expe-
ways. In school, an effort is made to provide explicit rience of loss is frequently described by new grad-
directions so that students know what they are uates. Losses are described as the following
expected to accomplish.In many work settings,how- (Boychuk, 2001):
ever, instructions on the job are brief, and many
■ The ideal world of caring and curing they had
expectations are left unspoken. New graduates who
come to know through their education
are not aware of these expectations may find that they
■ Their innocence
have unknowingly left tasks undone or are considered
■ The familiarity of academia
inept by coworkers.The following is an example:
■ The protection of clinical supervision by nursing
Brenda, a new graduate, was assigned to give med- instructors
ications to all her team’s patients. Because this was a ■ Externally set boundaries of care and safety
fairly light assignment, she spent some time looking ■ A sense of collegiality and trusted relationships
up the medications and explaining their actions to the with peers
patients receiving them. Brenda also straightened up ■ Grounded feedback
the medicine room and filled out the order forms,
Resolving the Problem
which she thought would please the task-oriented
team leader. At the end of the day, Brenda reported Before considering ways to resolve these problems,
these activities with some satisfaction to the team some less successful ways of coping with these
leader. She expected the team leader to be pleased with problems are listed.
the way she used the time. Instead, the team leader ■ Abandon professional goals. When faced with
looked annoyed and told her that whoever passes out reality shock, some new graduates abandon their
medications always does the blood pressures as well professional goals and adopt the organization’s
and that the other nurse on the team, who had a operative goals as their own. This eliminates
heavier assignment, had to do them. Also, because their conflict but leaves them less effective care-
supplies were always ordered on Fridays for the givers. It also puts the needs of the organization
weekend, it would have to be done again tomorrow, before their needs or the needs of the patient
so Brenda had in fact wasted her time. and reinforces operative goals that might better
be challenged and changed.
Additional Pressures on the New Graduate ■ Give up professional ideals. Others give up
The first job a person takes after finishing school is their professional ideals but do not adopt the
often considered a proving ground where newly organization’s goals or any others to replace
gained knowledge and skills are tested. Many peo- them. This has a deadening effect; they become
ple set up mental tests for themselves that they feel automatons, believing in nothing related to their
must be passed before they can be confident of work except doing what is necessary to earn a
their ability to function.Passing these self-tests also day’s pay.
confirms achievement of identity as a practitioner ■ Leave the profession. Those who do not give
rather than a student. up their professional ideals try to find an organi-
At the same time, new graduates are undergoing zation that will support them. Unfortunately, a
testing by their coworkers, who are also interested significant proportion of those who do not want
in finding out whether the new graduate can han- to give up their professional ideals escape these
dle the job. The new graduate is entering a new conflicts by leaving their jobs and abandoning
group, and the group will decide whether to accept their profession. Kramer and Schmalenberg
this new member. The group is usually reasonable, (1993) stated that there would be fewer short-
but sometimes new graduates are given tasks they ages of nurses if more health-care organizations
are not ready to handle. If this happens, Kramer met these ideals.