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Gemma Stacey School of Nursing Midwifery and Physiotherapy

The shock of reality : Utilising Reflective Practice Learning to Facilitate Professional Socialisation in Pre-Registration nursing programes. Gemma Stacey School of Nursing Midwifery and Physiotherapy. Background . Reality Shock

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Gemma Stacey School of Nursing Midwifery and Physiotherapy

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  1. The shock of reality: Utilising Reflective Practice Learning to Facilitate Professional Socialisation in Pre-Registration nursing programes Gemma Stacey School of Nursing Midwifery and Physiotherapy

  2. Background • Reality Shock “the reactions of new workers when they find themselves in a work situation for which they have spent several years preparing and for which they thought they were going to be prepared, and then suddenly find they are not." (Kramer 1974) • Recent studies, current experiences and attrition data continue to reiterate this message

  3. Background • Consequences • Loss of ideals • Loss of values associated with caring and person centred practice • Loss of analytical thinking skills • Compartmentalising the “ideal” and separating it from the “reality” • Low job satisfaction • Attrition

  4. Reducing the reality shock • Preventive anticipatory socialisation • confront student nurses with some of the realities of the real working world. • Promoting equilibrium by reducing stress • support to develop or identify resources to cope with the challenges. • Followed up with a preceptorship period to complement the educational interventions.

  5. Digital Stories • 8 mental health nurses recruited to take part • Three day workshop facilitated by the Patient Voices Programme (http://www.patientvoices.org.uk/) • Participants were asked to identify a story about a situation that they have found challenging during their early experience of practice.

  6. Digital Stories • Themes • Conflict of values • Challenges of the therapeutic relationship • Coping with the emotional consequences of distressing events

  7. Designing the Learning Environment • Primary Intervention: Viewing the digital stories allows knowledge to be given to the person prior to a stressor being encountered • Secondary Intervention: Discussing the issues that arise from the stories in a safe and supportive learning environment. • Tertiary Intervention: Recognition and/or development of personal resources that will enable the individual to restore a sense of balance and regain a feeling of control. This can be achieved by looking at past transitions and reminding students of the resources they drew upon to cope

  8. Evaluation of the learning environment • Authenticity of the stories ‘It made my learning more meaningful and real.’ • Raising issues that were of concern ‘It raised issues and problems which I had been thinking about in the back of my mind.’ • Sharing with others ‘It helps you to realise the things you worry about are what others go through too, so you’re not alone.’

  9. Evaluation of the learning environment • Developing ways of coping ‘I felt I could relate to the feelings she was experiencing. It made me look at how I would deal with that scenario.’ • Initiated a deeper reflection ‘Probably the most I have reflected on anything as I was able to put myself in Susanna’s shoes as she was the one telling the story, not just reading it.’

  10. Linking with Clinical Practice www.startingoutnottingham.org.uk

  11. References • Bradby, M. (1990) Status passage into nursing: another view of the process of socialization into nursing. Journal of Advanced Nursing.15(10): pp. 1220-5 • Clouder, L. (2003) Becoming Professional: exploring the complexities of professional socialization in health and social care. Learning in Health and Social Care. 2(4) pp. 213-222. • Department of Health (2006) Recruitment and retention of mental health nurses: Good Practice Guide. HMSO:London • Holland, K., (1999) A journey to becoming: the student nurse in transition. Journal of Advanced Nursing. 29(1) pp.229-236. • Kelly, B. (1998) Preserving moral integrity: a follow-up study with new graduate nurses. Journal of Advanced Nursing28(5), pp.1134-1145. • Kramer, M. (1974), Reality Shock - Why Nurses Leave Nursing, St. Louis: Mosby. • Mackintosh C (2006) Caring, the socialisation of pre-registration student nurses, a longitudinal study. International Journal of Nursing Studies. 43 8 953-962

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