Introduction
The field of nursing is both a science and an art. New nurses graduate with, at least, acceptable basic competence. They are expected to have the ability to effectively communicate and make decisions in a complex environment with multiple demands on their practical comprehension. However, they usually lack the experience to apply this learned theory. This limited knowledge results in anxiety and difficulty in transitioning from the role of student to leader. How these students can best learn these skills is a topic that has come under considerable debate. We know that most become overwhelmed with multiple tasks and not able to prioritize with critical thinking in a fast pace acute hospital. This begs the questions: How do we make that transition phase easier for them and the staff around them? How do we get the doing and thinking to intertwine together? The article, Coaching for competence, gives one example of how to foster critical thinking skills in novice nurses as well as establish a culture that would help its entire staff to grow and excel together.
Model concept and implementation
The nursing leadership of a 37-bed acute medical unit at the Mayo Clinic in Rochester, MN faced a challenge when they had significant numbers of new nurses hired during the year for a busy acute care general medical unit. The original policy for new nurses involved a six to eight week orientation with a preceptor who assisted new hires to assume complete care for an increasing number of patients. Once the new hire was handling a full patient case load independently, a "resource nurse" with her own full patient assignment remained available for direction and guidance for the next four weeks. While this orientation process was considered extensive, an extended learning period was needed due to the number of new hires. For this reason, the leadership team began to devise a plan to blend the acts of thinking with doing. This plan needed
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