The University of Wisconsin–Madison School of Nursing is pleased to welcome visiting scholar Yuanyuan Zhang, who will study transition-to-practice programs for new nurses. Zhang, a doctoral student at the Shanghai Jiao Tong University School of Nursing, has been researching early career experiences of nurses throughout her graduate education in China.
Zhang says transition-to-practice programs for new clinical nurses, often offered as nurse residency programs in academic hospitals, are better established and more uniform in the United States than they are in China. Typically a year long, nurse residency programs gradually increase patient loads while offering structured mentorship and required educational components to recent graduates new to the field. Residents also have the opportunity to interact with each other, something that is otherwise challenging when individuals are employed in different units with different schedules. This interaction helps them understand what challenges are universal among new nurses and which might indicate the need for skill development.
While Chinese hospitals have orientation programs, they tend to vary greatly from organization to organization. They also often lack safeguards that enable new nurses to fully participate. For example, U.S. residencies, Zhang says, are often structured to enable new nurses to ask questions and talk about challenges with mentors who are not direct supervisors. This, she says, allows for greater candor and learning since new nurses can openly discuss issues without fear of negatively affecting performance reviews or generally appearing incompetent or unqualified for their positions. Without these impartial mentors, she says, new nurses are reluctant to ask questions or admit lack of understanding or knowledge gaps. This, she says, greatly increases the stress new nurses feel and diminishes the quality of care they are able to provide.
“What we found is that when nurses enter practice in China, they are in shock,” Zhang says. “What we learn in school and what we do in the clinic are sometimes different. New nurses lack the experience and judgment to understand why that is, and they often assume they were not adequately prepared to provide adequate care.”
An assigned mentor, she explains, can help new nurses recognize and cope with normal early-practice pitfalls or identify and close knowledge gaps that might be holding them back.
Ultimately, Zhang wants to develop standards for Chinese transition-to-practice programs new nurses are generally better supported as they enter the workforce. This could ease the stress common in early-career nurses and, Zhang believes, improve longevity.
“We want to make the transition more successful for newly graduated nurses,” she says. “We know they are suffering.”