The process of transition from student to professional nursing practice has been considered as complex and very challenging, much more after the pandemic. In the recent years, it has been highlighted that nurses experience a lot of challenges when transitioning to their professional roles because of the growing demand for “real-world” ready nursing professionals who can already adapt to the complexities of the healthcare environment. This transition to clinical practice still brings significant anxiety and feelings of instability among novice nurses because the realities of working in a healthcare setting are brought about by increasing responsibilities and accountability which they were not so much used to during their academic years as they were still under the supervision of their clinical instructors.

While there are already programs and initiatives that provide support to novice nurses and promote positive and safe transition into practice, matters become more complicated as healthcare innovations and digitalization set in. The rate of clinical advancement and utilization of innovative technologies in various healthcare settings especially in the hospitals grew exponentially brought about by the impact of the pandemic; thus, adding to the demand of having professional nurses who are expected to learn, adapt and utilize these healthcare innovations at a fast pace when they provide care to patients at the bedside. However, these technologies and innovations were not yet fully embedded in academia, so much so that novice nurses were not prepared and equipped to utilize it in clinical nursing practice, adding to the stress and uncertainty of work expectations. This role conflict can lead to unsafe practices putting patients and nurses at risk. The growing concern over new nurses’ transition to practice in the digital era has also been documented globally in various research studies and forums and is said to influence nursing workforce retention.

Joseph, et al. (2022) highlighted in their study the extent of the nursing turnover problem among new graduate nurses which was supported by the report from the National Healthcare Retention and RN Staffing in the US indicating a high percentage of about 43% who left their initial jobs within the first to third year of employment. The multi-faceted challenges associated with the transition include lack of orientation, an unwelcoming environment, heightened responsibilities, disproportionate workload and nowadays, inadequate support system to help them navigate through the advanced technologies and healthcare innovations which they are not familiar of. It is then imperative to identify measures and streamline efforts that will support novice nurses’ transition to clinical practice as well as their transition to adopting multiple innovations in the delivery of safe, quality care.

The Role of Nursing Education

Effective transition to nursing practice is grounded on a firm and rich foundation from the nursing students’ academic years. The role of nursing education is a significant factor in driving the acquisition of knowledge, skills and attitude that will build the confidence and competencies of novice nurses who will soon be entering clinical practice in various healthcare settings. Thus, academic institutions will also need to transform the way they prepare nursing students for professional roles in healthcare. Healthcare innovations and advanced modalities must be introduced at this stage and further elucidated in their related learning experiences so that graduate nurses will know what to expect when they are exposed to these kinds of innovations. Required skill set and competencies in using health information technology tools must also be developed during these formative years so that these future nurses will be more aware and equipped to utilize health technologies. There are various strategies that can be employed to enhance nursing education which are geared towards this positive transition.

With the recent growth of digitalization in healthcare, nursing and midwifery programs nowadays have started to integrate health informatics in their curricula. This strategy is said to enhance nursing and midwifery students’ digital health literacy and prepare them to use technological innovations to support their learning both in the academic and clinical environment. In embedding nursing informatics and healthcare innovation in the nursing curricula, nursing students also become more aware of the available technologies and innovations that are already being used in the care settings. They are also able to understand how these tools can make their work more efficient at the bedside while still upholding the value of caring and of patient safety.

Another strategy is to provide opportunities to nursing students for actual clinical experience that involves utilizing healthcare innovations. Certain practices in some countries involve academic institutions having partnerships with hospital and other healthcare settings to intensify related learning experiences and clinical immersions for their students; thus, they can actually observe, manipulate and navigate through these technologies and gradually develop digital competencies and skills. This approach prevents “shock” and anxiety for nursing students when they are already in transition to their professional roles in nursing because they are already exposed and familiar with the healthcare innovations that they encounter. They become more confident and engaged in further developing their prowess and later on, their expertise.

Providing nursing informatics infrastructure and ICT tools is also a very significant aspect of improving nursing education that will prepare nurses for such transition. Academic institutions will also need to upgrade and equip their learning facilities with innovative and technologically advanced equipment and tools that can be used for training, simulation exercises and other cutting-edge methodologies which the nursing educators can employ when they teach nursing students. Having these educational resources and infrastructure cultivates a proactive approach to learning and developing the required skills, competencies and attitude when utilizing various innovations in the care of patients.

Collaborative Teaching and Learning in Hospital In-service Trainings and Orientation

The strategies to equip academic institutions in preparing nursing students for professional practice in this digital age is also tantamount to elevating the standards of teaching and learning in the hospital setting. Part of the collaborative approach to the transition of nurses for clinical practice is also developing a robust in-service training program and orientation for nurses in the hospitals. As novice nurses enter hospital practice, they expect thorough orientation and discussion of their roles and responsibilities, opportunities for learning and patient care expectations. However, teaching and learning in the hospital setting must also be a transition to collaborative, outcome-based and simulation-driven approach so that nurses will not only be equipped with knowledge and skills required to utilize healthcare innovations but also have the capability and flexibility to troubleshoot problems, make clinically informed decisions and maximize the use of healthcare innovations towards efficiency and patient safety. Ideal scenarios as well as critically challenged scenarios must be integrated in the orientation programs and hospital training programs so that nurses will determine how to respond and understand the implications of these advanced tools and modalities in the work that they do at the bedside.

Hospitals will also need to invest on healthcare IT infrastructure, systems and applications, high-fidelity mannikins and even artificial intelligence and augmented realities. These will intensify training and education among their doctors, nurses and allied healthcare providers who are not only geared towards developing competencies but also promoting critical thinking and evidence-based clinical decision making. Implementing this kind of approach and methodology can provide a safe, learning environment for novice nurses and healthcare providers alike in the hospital settings leading to the transition to their respective roles in healthcare.

Empowering Nurses to be Involved

Successful transition to nursing practice in this complex, demanding healthcare environment and digital era also entails active involvement of nurses. What better way to aid them in this kind of transition but to determine how they can take part in the various aspects of healthcare innovation implementation. In the early phases of healthcare innovations and advancement, nurses are viewed as mainly end-users of technology. Recent studies though showed that there are other roles that nurses can employ to be more involved and proactive in the utilization of healthcare innovations. There are already nurses who take part in the development of innovations and advanced tools; nurses who take part in health technology assessment together with the multi-disciplinary team; and nurses who evaluate health innovations for patient outcomes.

As they become more involved in these roles and responsibilities and develop expertise in this field, they are able to determine gaps in learning, strategies for effective implementation and utilization of these innovations and methods to enhance teaching and learning from a deeper and clinically driven perspective, not just from a theoretically driven outlook. The recommendations of such nurses involved in this field are now driving the change in streamlining initiatives that will enhance transition to clinical practice in the future as we anticipate more healthcare innovations and advancement in the years to come.

Conclusion

The transition to clinical nursing practice will continue to be challenged by people, process and the environment as healthcare innovations and clinical advancement continue to expand. Academic nursing institutions, hospitals and other healthcare settings must also be equipped and prepared to provide a learning environment that is not only centered on theory but also on evidence and various clinical situations that will challenge nurses in terms of their knowledge, skills, critical thinking and decision making which are very essential in their transition to professional roles in the clinical setting. Nurses will need to be more empowered to define and elevate their practice as experts in the field of healthcare innovations in this digital age as they can be effective change agents in transforming nursing education towards successful transition to practice.

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