NR 446 Edapt Week 7 Introduction to Developing Self and Others

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Chamberlain University

NR-446 Collaborative Healthcare

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Date

Week 7 EDAPT NR 446 – Developing Self and Others

Benner’s Theory of Novice to Expert

Patricia Benner’s Novice-to-Expert model provides a framework for understanding how nurses develop clinical competence over time. This progression is based on the acquisition of knowledge, clinical experience, and critical thinking abilities. Nurses advance through five levels:

Level	Characteristics
Novice	Entry-level nurse with minimal or no clinical experience. Rigid adherence to taught rules. Requires ongoing professional development.
Advanced Beginner	Some exposure to real-world clinical scenarios; relies heavily on guidelines but begins to recognize recurring patterns.
Competent	Able to prioritize and plan care effectively based on prior experience. More confident and organized in practice.
Proficient	Sees patient situations holistically, recognizing subtle changes; improved decision-making through synthesis of past experiences.
Expert	Highly intuitive, confident, and skilled in managing complex cases. Able to teach and mentor others effectively.

Leadership Roles

Leaders in nursing prioritize skill development, encourage evidence-based practice, and model lifelong learning. They foster professional growth through mentorship, support of continuing education, and role modeling best practices.

Management Roles

Nurse managers facilitate growth by granting time off for training, offering career advancement opportunities, and implementing transition-to-practice programs to improve nurse retention and satisfaction.

Question: Who is responsible for developing nurses by providing time off for training and education?

Answer: Managers, functioning in a management capacity, are responsible for ensuring nurses have the time and resources to pursue training and education. Leaders focus more broadly on promoting evidence-based care and modeling professional growth, but the logistical provision of time off lies with managers. Supervisors and physicians do not hold this specific responsibility.

Benner’s Framework Applied to Nurse Managers

Level	Example in Management Context
Novice	First-time nurse manager, inflexible, requiring significant development.
Advanced Beginner	Understands some managerial principles but still relies heavily on established rules.
Competent	Prioritizes tasks effectively using prior management experiences.
Proficient	Possesses a comprehensive understanding of team dynamics and situations, enabling better decisions.
Expert	Confident, intuitive, skilled at navigating complex managerial challenges; mentors emerging leaders.

Self-Development and Professional Identity

Developing oneself and others is integral to nursing’s professional identity, encompassing values, ethics, leadership responsibility, and continuous learning. Nurses share the responsibility for their own career progression alongside organizational support.

Succession Planning

Succession planning ensures that future nurse leaders are identified, nurtured, and strategically placed to meet organizational needs. Effective succession planning requires collaboration between top-level leadership and management.

Key Organizational Responsibilities in Succession Planning:

• Talent Matching: Aligning nurses’ skills with job openings.
• Information Sharing: Posting vacancies via internal boards, email, and HR communications.
• Policy Development: Allowing internal mobility without unnecessary restrictions.
• Education & Training: Providing structured career development programs.

Self-Development Steps in Nursing

Applying the nursing process to personal career development includes:

1. Self-Assessment: Evaluate interests, strengths, weaknesses, values, and possible opportunities beyond current employment.
2. Goal Setting: Use SMART goals for short- and long-term planning.
3. Future Visioning: Reflect on desired career path within 3–5 years.
4. Strategic Planning: Identify educational needs, certifications, or specializations.
5. Implementation: Act on strategies, such as enrolling in courses or seeking mentorship.
6. Evaluation: Review progress at least twice a year and adjust accordingly.

Transition to Practice

New nurses transition from academia to professional roles through structured programs such as those accredited by the American Nurse Credentialing Center (ANCC) Practice Transition Accreditation Program® (PTAP). These include:

• RN Residencies: For nurses with <12 months’ experience.
• RN Fellowships: For experienced RNs transitioning into new specialties.
• APRN Fellowships: For newly certified advanced practice nurses.

Accreditation is voluntary but signals adherence to high-quality, evidence-based transition standards.

Question: Which accreditation program meets the gold standard for nurse transition programs?
Answer: The ANCC PTAP sets the global benchmark for such programs.

Tips for Success in Nursing

• Network: Introduce yourself to team members, attend professional events.
• Find a Mentor: Preceptors can become long-term guides.
• Ask Questions: Maintain open communication to promote safety and learning.
• Verify Information: Use credible sources and policies before acting.
• Embrace Lifelong Learning: Continue education and skill refinement.
• Self-Care: Prioritize mental and physical well-being to maintain performance.

Nursing Orientation

Orientation is a critical period for skill development and social integration into the workplace. According to Nurse.org, effective orientation includes:

Tip	Purpose
Be mentally prepared	Adjust expectations for a steep learning curve.
Ask questions	Clarify doubts immediately to avoid errors.
Observe broadly	Learn from a variety of patient scenarios.
Delegate	Use team members’ skills effectively.
Prioritize learning	Focus on common conditions and medications.
Advocate for yourself	Request a new preceptor if fit is poor.
Build support systems	Engage peers, mentors, and family.

Recruitment and Retention

Recruitment ensures the right candidates are placed in the right roles to meet organizational goals. Retention focuses on preventing turnover, which is costly and disruptive.

HR’s Role:

• Ensure compliance with hiring laws.
• Verify credentials and competency.
• Facilitate orientation and training.

NR 446 Edapt Week 7 Introduction to Developing Self and Others

Effective Recruitment Sources:

• Internal postings
• Professional job boards
• Social media
• Advertisements
• Recruitment agencies

Retention Strategies (Kelbach, 2020):

• Hire for best fit.
• Offer competitive benefits.
• Recognize achievements.
• Provide a welcoming environment.
• Maintain visible, supportive leadership.

Nursing Supply and Demand

The Bureau of Labor Statistics (2021) projects a 9% growth in RN employment from 2020 to 2030. Demand is driven by:

• An aging population with chronic conditions.
• Preference for home and residential care.

Supply Challenges:

• Limited clinical training sites.
• Faculty shortages due to lower academic salaries.
• Insufficient classroom space.

Legal Considerations in Interviews

Interviewers must avoid discriminatory questions about age, marital status, children, race, religion, or sexual orientation. Acceptable topics include education, clinical experience, and competencies.

Three Phases of Onboarding

1. Induction: Pre-start introduction to organizational policies, benefits, and culture.
2. Orientation: Role-specific training and skill development.
3. Socialization: Integration into team norms and culture.

Lifelong Learning in Nursing

A lifelong learner actively seeks evidence-based knowledge to inform practice. For example, when uncertain about dietary requirements for a patient with diverticulitis, the nurse consults credible clinical guidelines before proceeding. Lifelong learning fosters competence, adaptability, and safe care delivery.

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I’ll also preserve Level 3 and Level 4 headings, and place references at the end.

Extrinsic Motivation and Orientation for New Nurses

Extrinsic motivation refers to external factors that drive an individual’s behavior, such as pay, title, authority, status, or responsibility (Ryan & Deci, 2020). For example, a new nurse who has been in orientation for two weeks has not yet attempted any clinical skills because the preceptor insists on four weeks of observation to ensure patient safety.

What actions should the new nurse take initially to ensure they obtain a thorough orientation in their new position?

The new nurse should take deliberate and professional steps to maximize learning while respecting the preceptor’s instructions:

• Build rapport with the preceptor to establish mutual trust and clear expectations.
• Demonstrate knowledge of correct techniques for essential nursing skills.
• Show authentic interest in the preceptor’s expertise and experiences.
• Honestly communicate the need to practice skills during orientation.

Mutual goal alignment between preceptor and preceptee is essential for effective learning. It may take time for the preceptor to assess the new nurse’s competence; therefore, proactive demonstration of knowledge and technique is important. Respect for the chain of command is crucial—reporting the preceptor to the state board of nursing is inappropriate when no laws are broken and patient safety is not compromised. Similarly, bypassing the preceptor to approach other nurses or the manager undermines professional relationships. Avoiding action altogether may result in missed learning opportunities (Hughes, 2019).

Nurse Residency Programs

Nurse residency programs, also known as transition-to-practice programs, typically span 8–12 months and supplement preceptorship with structured, monthly courses designed to strengthen clinical reasoning, judgment, and professional integration. These programs may vary by specialty. For example:

• Critical care residencies may involve immersive skills-based training.
• Oncology programs might focus on chemotherapy administration and port-a-cath care.

Understanding the scope and focus of a residency before accepting a position ensures the new nurse receives the right kind of professional support.

Quality Improvement (QI) in the ICU

The new registered nurse is assigned to create a QI presentation for ICU patients. The following table shows whether each topic is appropriate or nonessential for ICU QI initiatives:

NR 446 Edapt Week 7 Introduction to Developing Self and Others

Topic	Answer	Rationale
Chemotherapy education	Nonessential	More suitable for oncology settings.
Inclusive care of transgender clients	Appropriate	Applicable across all healthcare settings, including ICUs.
Introducing telepsychiatry	Nonessential	Relevant mainly to behavioral health, emergency, or med-surg units.
Optimizing sepsis care	Appropriate	A high-priority QI focus in all ICUs.
Postpartum breastfeeding education	Nonessential	Appropriate for postpartum and obstetric care settings.
Reduced hospital readmissions	Appropriate	Relevant to all units and hospital-wide quality outcomes.
Ventilator-associated pneumonia	Appropriate	Critical QI focus in ICUs due to high ventilator use.

Evidence Review for Quality Improvement

When gathering evidence for QI, nurses should:

• Use sources published within the past five years.
• Consult professional nursing journals.
• Search databases that include systematic reviews.
• Use at least two different databases for broader coverage.

This approach avoids confirmation bias, ensuring decisions are grounded in comprehensive, up-to-date, and evidence-based information (Melnyk & Fineout-Overholt, 2023).

Continuing Education Priorities for Nurse Leaders

A nurse manager in oncology with four hours of continuing education left should prioritize educational activities based on relevance to their leadership role:

1. Leadership Practices for Organizational Change – highest value for role specialization.
2. Emotional Intelligence Practices for Oncology Nurses – enhances communication with patients and staff.
3. Patient Safety Changes on a National Level – relevant for future QI initiatives.
4. How to Thrive in an Online Nurse Practitioner Program – not relevant to current managerial role.

Certifications in Emergency Nursing

Certifications demonstrate commitment to specialty expertise. The following emergency department nurse is the ideal mentor for onboarding:

• 7 years’ ED experience
• Holds BLS, ACLS, PALS, TNCC, CEN, and TCRN certifications

This combination shows mastery in both general and advanced emergency nursing competencies.

Career Development in Nursing

Career development programs benefit healthcare organizations by:

• Reducing turnover.
• Offering equal advancement opportunities.
• Enhancing job satisfaction and productivity.
• Attracting highly educated professionals seeking growth.
• Supporting evidence-based practice.

Professional portfolio maintenance is recommended to document skills, competencies, and achievements throughout a nurse’s career.

Advocating Self-Care in Nursing

According to the American Nurses Association’s Code of Ethics (2015), nurses have a duty to promote their own health, maintain integrity, preserve character, and continue personal and professional growth.

Examples of self-care advocacy:

• Healthy diet and regular exercise.
• Adequate sleep (7–8 hours per night).
• Maintaining supportive relationships.
• Participating in spiritual or leisure activities.

Managers can support staff self-care by:

Individual-Level	System-Level
Attendance at ethical competence training	Employing a chief nursing wellness officer
Refraining from substance use	Offering mindfulness and resilience training
Seeking emotional support from colleagues	Providing organizational resources for healthy habits
Taking regular personal time off	Ensuring policies support work-life balance

Example: Burnout in Nurse Management

Case: Joey, an ICU nurse manager, is experiencing work-related stress due to budget cuts and staffing shortages. Joey works extended hours, has difficulty focusing, and is unable to take personal time.

Findings:

• Eating healthy and walking to work = Consistent with self-care.
• Inability to take time off, fatigue, lack of focus, excessive work hours = Not consistent with self-care.

Appropriate actions: Discuss workload with the department director, address health concerns linked to work stress, and explore solutions such as resource reallocation.

Immediate Action in Staff Safety Concern

Scenario: A charge nurse sees a staff nurse nodding off and becoming irritable.
Action: Address privately and immediately to prevent compromised patient safety.

References

American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. ANA.

Hughes, R. G. (2019). Patient safety and quality: An evidence-based handbook for nurses. Agency for Healthcare Research and Quality.

Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.

Ryan, R. M., & Deci, E. L. (2020). Intrinsic and extrinsic motivation from a self-determination theory perspective: Definitions, theory, practices, and future directions. Contemporary

Educational Psychology, 61, 101860. https://doi.org/10.1016/j.cedpsych.2020.101860

American Nurses Credentialing Center. (n.d.). Practice Transition Accreditation Program® (PTAP). https://www.nursingworld.org

Bureau of Labor Statistics. (2021). Occupational Outlook Handbook: Registered Nurses. https://www.bls.gov

NR 446 Edapt Week 7 Introduction to Developing Self and Others

Kelbach, C. (2020). Strategies to retain nurses in the workforce. Journal of Nursing Management, 28(7), 1620–1626.

National Academies of Sciences, Engineering, and Medicine. (2021). The future of nursing 2020–2030: Charting a path to achieve health equity. The National Academies Press.

Robert Wood Johnson Foundation. (n.d.). The true cost of nurse turnover.