With a lack of support at the start of their careers, newly registered nurses (NRNs) are feeling the pressure of staff shortages and difficult working conditions.
In a survey of 5,000 nursing staff, students and educators, the Nursing Times reveals the steps and procedures thought necessary to continue supporting the sector. The need to embed confidence and skills through preceptorship programmes was thought to be critical.
The Nursing Times writes that preceptorship programs are “structured support plans offered by employers for newly registered practitioners to aid their transition from student to professional, and to help build their confidence and consolidate their learning.” These programs – whilst highly beneficial to new nurses – are voluntary, so not all nurses are receiving the easily achievable gains from this method. This is has been further exacerbated by the pandemic, and thus the first recommendation from the survey is to make preceptor programs mandatory, with 91% of students and 94% of nurses agreeing to that effect.
The survey also found that a huge proportion of the respondents reported that the initial stages of nursing practice had become more difficult, and that this had been made worse by Covid-19.
“Thrown into the deep end” and “stretched beyond capacity”
The rapid entry into the workforce and pressure on their mental health was prompting some NRNs to quit early on after being left in charge of wards just weeks after starting.
The impacts fall not just on the students, but their patients and junior practitioners. Due to Covid-19 pressures, some NRNs were left by themselves to look after 20 patients, and junior doctors whose questions they could not answers. According to one, it was “beyond dangerous”.
Lack of staff therefore was identified as the next largest issue, as this impacted the quality and existence of the programs and guidance available themselves. The survey showed that 48% of nurses felt there were “insufficient experienced staff in their organisation willing to be preceptors or clinical supervisors”. Those that were on ward were then consequently being stretched far beyond their means in order to look after patients, leaving little time for mentoring.
One suggestion for resolving this issue has been to pay more to those who take up preceptor roles, which would recognise the extra responsibility they have to observe. Data corresponding to the quality of preceptorship programs shows that 36% are rated as good or excellent, 29% as average, and 29% as bad or awful. The disparity stems not only from varying levels of quality, but from geography, access and current staffing levels.
Is the program critical?
Of the 800+ students that participated in the survey, 62% expected to receive a preceptorship program when they joined the workforce, whilst 52% said getting a preceptorship would influence their decision on their future first job.
Preceptorships are seen as even more important now given the impact of Covid-19 on learning for students and newly registered nurses, which has affected opportunities to develop key skills. 75% of students reported that the program was vital for their future transition from student to professional practitioner. One respondent commented that “preceptorship [programmes] are essential in promoting safe practice and patient safety.”
Among registered nurses, 85% believed preceptorships programs were vital for NRNs – with 92% specifying due patient safety, 97% citing NRNs’ confidence and development, 88% for staff wellbeing, 80% for staff retention and 72% mentioning team building.
Retention specifically stood out here as the transition into nursing becomes more vulnerable without the support of these programs when newly qualified nurses enter the workforce. The program was described as “not just as a tick-box exercise”, but something that “will inspire, support and transition [nurses] to the most important part of their career, which will either hold and empower them or could crush their enthusiasm and devastate [them]. It is vital to invest, to enable, inspire, empower, show value for that nurse and keep them in the workforce.”
Moves to develop a mandatory program have been initiated, with a national preceptorship program aiming to start in September 2022.
The program is designed not only to support NRNs and their careers, but to ensure their retention in the workforce through quality and consistency, and guarantee the longevity of the nursing sector.
Read more on the Nursing Times.