NMIH304 Impact of Pre-Registration Workplace Experience On Nursing Practice Assessment 3 Answer

The impact of pre-registration workplace experience education (clinical placement) on nursing practice

Introduction

Clinical placements are a step to make the student nurses learn and master the new knowledge and attain practical skills so that they can be placed in the authentic world setting. The clinical placement has pioneered the key investigation around the clinical experience of pre-registration nursing students that have been part of the Australian University. Learning in the clinical environment helps to understand the real world and how nursing students should develop the knowledge, skills, attitudes, and values that can make them a better-registered nurse (Wright, et al, 2018). Students hold experiences on clinical placements which would not be fully practical in accordance with the classroom. The use of clinical experience can work in accordance with the student's expectations by drawing a respectable understanding and relationship with the expectations required to become a professional nurse. Clinical placement and learning through on-the-job skills are an essential part of the pre-registration student’s journey. The nurses must undergo clinical placements to become successful registered professional nurses (Wright, et al, 2018). The main aim of the report is to understand how professional nurses can outline the goal of pre-registration nursing education in Australia. The students enrolled in Australian pre-registration nursing programs can get placement during the clinical placement which is within the baccalaureate programs. Further, the main aim of clinical placement is how the students can gain on-the-job technical experience which would help them to practice and deliver quality results safely as a knowledgeable clinician. Clinical placement is a vital step to contribute significantly towards public safety within the Australian healthcare system (Scarinci, 2018). Equitable access and having a good quality service can only be achieved if the nurses are prepared to become self-sufficient and confident to deliver quality results as a future practicing RN nurse. Clinical experience gained through clinical placement is an important step to become a successful practicing RN nurse.

Process

The purpose of the registered nurses’ placement is to know how a nurse can fit into the practice.  In the recent times, the Australian governments have accessed the situation to fill shortage gaps and to seek accurate support during the workforce shortages, in order to provide the solution during the quality and sustainability situation during the Australian health care. It is important to have the key strategy that can aim to provide better health practitioners that can be supportive of the increased workforce numbers (Scarinci, 2020).  As described, the first tertiary based nursing program has started to support hospitals with the training programs, which is done in accordance with the guidelines of the federal government (Oikarainen, et al, 2018). Gradually, the full transition of the nurse education in Australia began from the hospital-based training and was supported within the University sector. Due to the shortages of nurses and to fill gaps, the Clinical placement providers (CPP) offer clinical placements who would arrive during the pre-registration nursing students' stages. These are the nurses who are generally part of the higher education and would like to work actively in the health service providers and can gain valuable information, guidance, mentoring, and experience by being placed during the clinical placements’ stages (Waldock, 2010). The clinical placement is the stage from the pre-registration stage, where the nursing students can become a successful professional nurse. CPP and the universities collaborate for the partnerships offers and to make nurses learn valuable clinical works (Keeping-Burke, 2020). It is evident, without the clinical placements student nurses would not have the relevant clinical exposure and they have limited preparation when they are working fulltime in the job roles while servicing and delivering the practices inline to the safety and the competency to become a successful clinician (Scarinci, 2020). The pre-registered nurse must also learn how to apply the regulatory requirements, nursing principles, code of conduct, and help to make decisions on the basis of moral duties, values by providing patient care (Wright, et al, 2018). 

Positive

The accreditation standards have integrated the ANMAC specific minimum number of hours within the BN program to make the nurses practice within the clinical placement hours and to recognize the accreditation in accordance with the program consecutive the initial registration as a nurse. The main aim is to train the new graduates to fill in the vacant spaces of the future practicing nurses is through the preparation of new graduates.  As the RN preparatory education has a good tenure in completion and while entering the workforce, it is necessary to practice and match with the demand of the nurses who can deliver quality results (AIHW 2012). The professional experience or clinical training makes the nurses develop professional competencies. Clinical placements aim to provide nurses to work under supervision and know the specific health-care context and apart from gaining theoretical knowledge, the central purpose is how to apply the practical application which can help to create a supportive working environment (Birks et al., 2017). The clinical placement which consists of 40 percent of total course time, has been included in the study programs to consider eligibility for RN registration. It is necessary to formulate effective clinical placements programs part of the nurse's courses, that can work to develop competent and confident professional nurses. When being part of the clinical environment, the nurses gain on-the-job knowledge, skills, attitudes, and how to apply values, which is required to become a registered nurse. It is important to teach the students nurses about the mandatory clinical hours and fine-tune with the governing bodies. It is the strength of relationship between the universities and the Clinical Placement Provider that becomes the key reason of pre-registration clinical placement of nursing students (Connor, 2016). An effective placement helps the future nurses to acquire a systematic and formalized approach to work in a collaborative way that helps in facilitation of better career opportunities in future (Briks et al., 2018). It is to be noted that pre-registration placements are a key factor in development of reflective, evidence-based practitioners who are committed towards efficient care and support in practice environment. A consolidation of learning coupled with benefits of authentic experiences makes such placements necessary as nursing students experience consistency (Connor, 2016). Consistency is critical as it supports continuity and provides opportunities of returning to same working environment or working with the same staff members. Such consistency is beneficial as it facilitates familiarity between students and staff in relation to the capabilities of the students (Connor, 2016). 

Negative

Negative experiences during clinical placements have been a leading cause of why nursing students hesitate to be part of the nursing homes and practice in the learning environment. It is to be noted that quality clinical placements are controlled by a competitive environment where universities and institutions focus on meeting the minimum registration requirements under the rules defined by the accrediting authority (ANMAC, 2012). These requirements are also supported by the clinical values while dealing with certain political and economic constraints. These factors result in some key issues faces by nursing students and specifically relates to the planning of the clinical placement (Connor, 2016). Short placements that are planned under distributed models fails to provide enough time to settle into the clinical setting influencing the students’ experiences of ‘belongingness’ (Birks et al., 2017). There is an absence of a sense of ownership for the clinical staff as well making it difficult for them to understand and meet the needs of students or allocate proper time to help them explore the opportunities (Waldock, 2010 and Doherty et al., 2020). Students often complain of the stigma associated with being a student as placement environments are experienced to be least welcoming or facilitative of their learning. Another problem lies with inappropriate sequencing of placement that makes it difficult for students to align their practice experience with theoretical and chronological stages of academics (McKenna et al., 2010). They often find it stressful to maintain a work life balance and link their academics with the evidence-based practices. 

Furthermore, Staff incompetence, lack of guidance, low mentoring attitudes, and negative peers can lead to more negative experience than positive when being part of the clinical placement. Moreover, due to inadequate students support from hospital management and also facing high-performance jobs in a short time, can lead to more negative effects (Birks et al., 2017). The practicing nurse can also experience high burnout and working in the erratic hours, leading to low sleep and high stress can cause a pessimistic view and create an obstruction in learning during the on-the-job clinical placement.  The staff misguidance and poorly showing on the unenthusiastic job experience by treating the patients negatively can lead to adverse impacts over the nursing students' behaviors (Budden, 2017). The high-pressure job can also show to be robust, adaptive, and adjust in accordance with the demand of the clinical setting (Materne, 2017). The problems and challenges can also be based on how the students can face consequences while being part of the clinical learning environment as the stakeholders around can be biased and can create an uncooperative professional survival. Failure to identify patient care and when to intervene can be the biggest problem for the practicing nurse (Devenish et al, 2017). The other challenges can be, for unable to understand the instructions, guidelines, and governing principles can be a failure to deliver when being part of the clinical learning environment and how to have effective learning and growth (Scarinci, 2020).. 

Discussion

Moxham (2016) explains the main aim of the clinical placement, apart from making nurses learn the on-the-job programs also must make students nurse know the importance of working alongside with the interprofessional workforce. The main purpose of the training and the on the jobs skills is to make graduate nurses apply theoretical education into practical training. Nursing education is one of the important elements of the tertiary level in Australia. Due to which, now the clinical placement aims to make the students to integrate practice and obligate the nursing theory within the real-life settings. The graduate nurse needs to learn how to fulfill the path to become the professional status nurses who can work independently in the clinical areas. Phillips (2017) describes the actions are also perpetual based on the perceptions of an unequal relationship. The clinical placement purpose and how it has been integrated into the BN programs have to be consistent with developing and including the curriculum which can be based on mutual understanding and through collaborative partnering (Scarinci, 2020). Phillips, et al, (2017) has identified, how due to the collaboration is based on the universities and CPPs that have highlighted the vulnerability of nursing education, and how it would lead to the lack of communication and agreement which is part of the learning program. Oikarainen et al (2020) mention that it is important to understand how the strong partnership can influence clinical placement to be included in the BN programs. The teaching education is to focus on developing programs and how there would be attribution in clinical practice based on academic content and professional courses (Wright, 2018).

The demand for the accreditation standards needs to meet as per the ANMAC (Australian Nursing & Midwifery Accreditation Council), NMBA (Nursing and Midwifery Board of Australia) and the NMC  (Nursing & Midwifery Council)  that can help to fulfill the standard of several clinical placement hours part of the BN program and directs the process to register the nurse. It is important to focus on future generations of nurses which can be done by making the new graduates prepare for the job role. The time required by the students to complete their RN preparatory education while entering the program is a long and lengthy process (Phillips, 2017). By making the graduate nurses undergo the clinical placement, it would help to absorb trained nurses during the crisis time, high fluctuation time, and to fill in the demand-supply gaps (Wright, et al, 2018). During the transition process, higher education institutions partnering with the hospitals at a local level, to adjust with the increasing shortages of skilled nurses, along with the active support from hospital agencies, to meet the demand for clinical experiences (placements) required for the nursing students. It was an important step to include the programs that can lead to registration as a nurse and collaborate with the various stakeholders as a part of the contemporary trends in nursing and education (Wright, et al, 2018).  

The graduate nurse career growth and development can be based on the skills which they have learned from the hospital staff, peers, and other healthcare people. However, the students who experience high antipathetic and the non - effective exposure can even lead to graduate nurses dropping out from the courses (McCloughen, 2020 and Au et al., 2016). It is rightly said, if the mentor or the guider who guiding the graduate nurses, does not fulfill the job roles of educating nurses rightfully, it would only lead to lower enthusiasm and motivation in the practicing nurse (Oikarainen, et al, 2018). The relation of the conflicts and improper treatment can lead to students negatively learning from the staff about the clinical teaching trend. Due to improper communication, it can obstruct student motivation (McCloskey, et al, 2020). 

Conclusion

To conclude, newly graduated registered nurses can experience a lack of confidence in professional practice. The Universities and the health care institutions has partnered to provide the clinical placement jobs by developing accurate knowledge and experiences in the interprofessional collaboration for nursing student.  The main aim of the clinical placement is to make the nurses adaptive and practice while gaining the nursing students’ education. The main purpose of the clinical placements helps the student’s nurses to learn who has been placed in the learning. During the nursing placement, the nurses learn to experience and to understand the experience during the professional studies, while being still part of the academics. The main role of the universities is to work constantly for the betterment of graduate nurses who can work during the increased placement options for students and secure during the pre-registration nursing degree. Graduate nurses who are working constantly during the clinical placements to become the professional work readiness nurses. The clinical placement also offers, the nurses to note, how the job can be demanding, what is expected out of the job role and how to better deliver the job role professionally. BN nurses learn how RN nurses are expected to perform in the health care setting. The main focus of the nurses is to become work readiness, which would help them address patient safety and would leave low space for any sort of errors. However, It is important to understand the positive as well as negatives of clinical placements of nurse before the registration. It is necessary that the placements are based on pedagogical needs instead of financial and practical factors.

Considering the positives and negatives of pre-registration placements, it is clear that there is a need to ensure proper sequencing of placements to help students align the theoretical and chronological steps of academics. As consistency is regarded as a major benefit of placements, it is important to ensure that students get the opportunity to return to a familiar work environment. At the same time, it is also important that students are given the opportunity to prepare for the clinical environment by providing them details of the future working/placement environment and establishing a culture encouraging nursing students to develop a sense of belongingness in the working team.