6 December 2000

Graduate Nurses - The Future of Nursing (includes QNC Position Statement)

Recent press articles identifying the serious shortage of nurses nationally and internationally have highlighted the need to again reflect on the way we treat our new nurses.

Graduate nurses are beginning practitioners and should be recognised as such. We would not expect a newly graduated solicitor to handle our murder trial nor a newly graduated doctor to undertake our heart by pass operation. But for some reason if a new graduate cannot hit the floor running and handle six to eight patients there is something wrong with them or the system that produced them.

It is time we treated them as the future of nursing and nurtured them. The Queensland Nursing Council's Position Statement on Transition Support Processes is supported by the QNU. It is time nurses at all levels incorporated the principles of this statement into their processes and practices.

There are a number of practices with regard to Graduate Nurses in this state which fall short of this standard and they have to stop. You will note there is no mention of the conduct of 12 month Graduate Nurse Programs nor of temporary appointments of new graduates.

Twelve month Graduate Programs with three month rotational placements are not supported. They propagate the disposable workforce model of the student nurse period. They put additional burden on the graduate and preceptors as just a each is becoming confident in their area the graduate moves on to another new environment.

The QNU supports the Position Statement in that it supports appropriate orientation, competent preceptorship and an appropriate patient load. If these are put in place then the development of graduates will meet the needs of the graduate and the facility not some predetermined program outcome.

Further, the last two Enterprise Bargaining Agreements in the public sector have entrenched the need for permanency of employment for new graduates. Despite the loud cries of heresy this created amongst some in this state about graduates not getting jobs and it being unmanageable there has been no major crisis created by this move. Historically the majority of facilities of all sizes and types have employed new graduates permanently. Why then is this a problem for some?

Even then the policy in the agreements allows for consultation with the QNU in such circumstances where there is a problem. There have been only three formal approaches to the QNU in the past year. The QNU sought information from each which would assist the QNU to understand the specific circumstances. Only one - the Royal Brisbane Hospital - followed this up and as a result an innovative agreed approach has been taken to meet both the facility's and the graduates' needs. All such approaches now should go to the Principal Nurse Adviser who will liaise with the QNU and the facility.

The nursing shortage is very likely to get much worse before it improves - if ever. One of the first steps nurses can take to limit the attrition from nursing of new nurses is to embrace them as new, permanent members of the workforce and support them with appropriate orientation, preceptorship and patient load.

Royal Brisbane Hospital Rural Graduate Nurse Project

The QNU has agreed to the implementation of a project with the Royal Brisbane Hospital designed to facilitate the development of up to twenty new graduates for rural placement.

RBH originally approached the QNU because of the difficulty it was having ensuring adequate graduate places in a period of significant change as it approached moving to new buildings over the next two years.

After consultation between the QNU and management a project was agreed which would allow the RBH to specifically appoint up to twenty graduates to project positions. These graduates will, within twelve months, be assisted in finding permanent employment in rural or remote facilities.

During the twelve months of placement at the RBH they will also be exposed to clinical experiences which will enhance their confidence when they reach their rural or remote facility. The graduates will be recruited through the current centralised recruitment process being coordinated through the Nursing Advisory Unit.

The outcomes of the project are to be fully researched and it is hoped that a model can be developed which can be applied in other similar facilities in the state. The project should also assist with the significant problem of recruiting nurses to rural Queensland.

Additional funding is being sought from Queensland Health Workforce Management funding to support the research.

Queensland Nursing Council Position Statement - Transition Support Processes
Introduction

The purpose of this position statement is to provide guidance for the review and/or implementation of individually focussed transition support processes for nurses entering or returning to the workforce. These nurses may include:

• New graduates demonstrating beginning level competence after completion of a pre-registration or pre-enrolment course, and entering the workforce for the first time;  
• New graduates from specialist post-graduate courses such as midwifery and mental health; 
• Nurses returning to practice after an absence of five or more years; 
• Nurses moving to new practice settings1

Transition support enables nurses to effectively apply knowledge and skills gained through educational processes. During the transition period the nurse requires support until they gain confidence in their practice and in effectively applying contemporary knowledge and skills in the practice setting. Appropriate support for these nurses within the work environment can result in a high level of job satisfaction for both the nurse and the experienced nurses acting as preceptors or mentors who provide guidance and support during the transition period. In order to maximise the effectiveness of transition support processes it is necessary to provide support for both groups.

Transition support is an integral part of workforce planning.