Faculty of Education - Theses
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ItemClinical congruence : where graduate nurse clinical reality meets organisational clinical requirements( 2004)In the mid 1980s, education associated with the requirement for registration as a Nurse in the State of Victoria moved from a hospital-based system into the university setting. This move brought with it many and varied requirements for change within the health care setting. The students of nursing were now no longer a part of the workforce, they were transient visitors in the patient care setting with very specific clinical requirements to be met; and they were there for less time! This research project is not about whether this change in preparation should have occurred. It is well accepted amongst the profession that this was necessary to raise the status of the nursing professional. We now have registered nurses with a primary degree in nursing or health science. The question here however, is what clinical capacities do the newly graduates and registered nurses have when they enter the clinical workforce, and what clinical capacities are required by the health care institutions that are employing them. Have these institutions an accurate and realistic knowledge of the clinical capacities of the newly graduated registered nurses they employ? This research concentrated on the self-perceived and reported clinical capacities of newly graduated registered nurses as they entered the clinical environment and the clinical capacities required by the clinical areas that employed them. Clinical congruence was then measured between these two sources. The findings demonstrated that in a supported environment, where graduates can expect and receive clinical support and mentorship, clinical congruence:is likely to be achieved. However, in an environment where clinical skills are required to be undertaken at an unsupervised level, there were a significant number of distinct clinical skills for which the graduates report unpreparedness. Graduates and Nurse Managers alike agreed that increased clinical experience during the undergraduate preparation time is optimal, but the universities indicated that the fiscal and chronological constraints of a three-year degree program, in an environment where there is a cost incurred for the clinical experience, is difficult to achieve. This research demonstrates, in a tangible way, the need for a supported Graduate Transition Program to facilitate the consolidation and / or achievement of clinical competency for the graduates as they enter the workforce. This support will assist in ensuring the maintenance of a dynamic nursing workforce into the 21st century to meet the needs of the Victorian community at a time when it is most vulnerable during the period of ill health.