Perception of Final Year Nursing Students of Selected Nursing Colleges in Mangalore Regarding Role Transition from Student to Staff Nurse

Introduction

In an ever-dynamic health care scenario, the demand for nurses remains unchanged and also the need for the same is very critical now than before. The demand for nurses has increased due to a wide range of reasons such as population growth, ageing population and of existing workforce, increase in acuity of the patient,  chronic conditions and co morbidities in clients, and cost containment in the health sector. To face these challenges, a large number of new graduate nurses are needed and they must be able to provide safe, competent and quality care. In general, student nurses are not aware about the depth of responsibility that will be entrusted to them once they become staff nurses and also may lack confidence in their ability to think critically, be accountable and finally to make the clinical judgement. Transition is an inevitable rite of passage which a student nurse must ride from novice to experienced nurse.

Role transition refers to the process of change from one role to another, i.e. a student nurse transitioning to be a staff nurse which can affect the aspects such as physical, psychological, and social states. This period can be most stressful and even exciting.¹ During this period of change, the newly graduated nurses can face various problems such as work load and newly added responsibility, lack of clinical skills, time management.² Organizations play an important role in shaping the role change of a newly graduated nurse whereby nursing programs, webinars help in making individual more skilful and brings about more individualized interest towards various concepts building his/her managerial skills.³

The staff nurse plays a vital role especially focusing to meet the needs of patients, and improving quality care. Knowledge about the expectations that are needed during the transformation period will help to reduce the stress that occurs while accepting and transitioning into new role. This study will help to reduce the stress related to role change, responsibility, and will help build coping skills in newly graduated nurses.⁴

Nowadays health care has become more and more complex and it requires newer modalities of thinking. The consumer population of health service is increasing with novel diseases, with varying degrees of severity and present with multiple diseases. So, a nurse should be competitive enough to use the theoretical knowledge in an applied situation. This study will help to manage their fears and feelings.⁴

Objectives

1. To assess the perception of final year nursing students regarding role transition.

2. To determine the association between perception of role transition and baseline variables.

Materials and Methods

Research Approach In this study, quantitative approach was used to assess the perception of final year nursing students regarding role transition from student to staff nurse in selected nursing colleges at Mangalore.

Research Design

Cross sectional descriptive survey design was selected for the study.

Sample

In the present study, the population included all the final year nursing students from selected nursing colleges in Mangalore.

Sample size and Sampling technique

In the present study, the sample size included 190 final year nursing students from select nursing colleges in Mangalore.

Sampling Criteria

Inclusion criteria

All the selected final year BSc nursing students from selected nursing colleges in Mangalore.

Exclusion criteria

Student who have not responded to the google form link after a fortnight of receiving the link.

Description of the Tool

Tool I: Baseline Proforma

Tool II : Modified Perception of Role Transition (29 statements, Five point Likert scale)

Tool I: Baseline Proforma

Baseline proforma consisted of seven items to obtain information regarding age in years, gender, area of residence, family members in nursing profession, future plan following graduation, feelings about graduating as a nurse, confidence on clinical performance skills.

Tool II: Modified Perception of Role Transition

Organized under five domains: Role preparation (6 statements), Role competence (8 statements), Support (4 statements), Organization (7 statement), Role expectation (4 statements).

Validity and Reliability and Scoring of Instruments

Validity The tool was validated by five experts from nursing profession. As per the opinion of the experts, one question was modified.

Reliability

The investigators collected data from 12 nursing students to check the internal consistency. The reliability was found by using Cronbach’s alpha formula. The reliability obtained was 0.98 which was considered to be reliable.

Data Collection Procedure

Official consent was obtained for the purpose of collecting essential information of research study. The investigators provided information to the participants regarding the need for study, technique required to gather essential information, duration of the study and consent was obtained from the participants through google form. The data collection was conducted from 25-6-2021 to 9-7-2021. Subjects were selected using convenient random sampling technique. The subjects were provided with baseline proforma and modified perception of role transition questionnaire through google form. The subjects had taken approximately 20 minutes to complete the questionnaire. After the completion of the questionnaire, the data collected was tabulated and analysed.

Results

In the present study, majority of students (96.3%) were females and only 3.7% were males. 36.3% of students resided in urban area, 35.3% resided in semi urban areas and 28.4% were residing in rural areas. 45.3% of students never had any family member or close relatives in nursing profession, 24.2% of students had a primary family member in nursing profession, while 30.5% reported having a secondary family member in nursing profession. Majority of the participants (88.9%) were interested in joining clinics, whereas only 1.1% participants were interested in teaching. 8.4% expressed their interest to pursue higher education while 1.6% wanted to quit or change profession. 16.3% of students responded that they were anxious, majority (68.4%) were excited, 11.6% were worried and only 3.7% were uncertain about graduating as a nurse. About 22.6% students responded that they are very confident, 54.2% students reported to be somewhat confident, 20% were fairly confident and only 3.2% responded to be not confident at all in their clinical abilities (Table 1).

Section Ι: Baseline characteristics of final year nursing students

Table 2.1 suggests that majority (81%) of the students agreed that they were supplied with enough opportunity to cultivate the role preparation ability, and only 3% students were uncertain about their response. At the same time, 82.7% of students stated that their syllabus content was adequate to bring about necessary role preparatory changes, while 3.7% students were uncertain.

Table 2.2 shows that majority of the students (79%) reported to be confident enough to render patient care and were able to manage time efficiently, whereas only 1% were not confident enough. Meanwhile, 82.1% students responded that they are capable enough to educate the client regarding their concerns related to care provided for promotion of health, while 1% students reported not to be confident.

Table 2.3 shows that majority 92% students responded as they were confident to get support and feedback from their ward in charge and colleagues and only 1% were not expecting the same.

Table 2.4 shows that majority of participants (83%) stated that they will be able to introduce new evidence-based findings in work setup, while 16% was uncertain and 1% disagreed. At the same time, 91% of students felt they will be respected in the ward, while 15% of students were not convinced with the same. Around 90.5% of students stated that there will be a good communication pattern with the working team and the organization.  

Table 2.5 suggests that 84% students stated that majority of their time will be spent talking to the patients while only 1% of the students did not agree.

Meanwhile, 72.1% of the students stated that there will be sufficient opportunities to grow economically while working as a clinical nurse, while 11% of students did not perceive the same and 17% responded with a neutral response.

Section ΙΙΙ: Range, maximum score, mean, standard deviation, median and mean percentage.

Data in table 3 shows the distribution of the subdomain scores of perception of role transition. It shows that overall mean score obtained by the students was 117.4±12.82 and those of role preparation, role competence, support, organization, and role expectation were 23.3±3.72, 31.9±4.19, 16.5±2.22, 29.4±3.51, 16.3±2.2, respectively. The results revealed not much difference among subdomain scores of perception of role transition, and the major predictor of perceived role transition among nursing students was support from organization with mean percentage of 84%.

Section IV: Association between perception of role transition and baseline variables

Table 4 shows the computer fisher exact / Chi-square test values between baseline variables and perception of role transition. There was a significant association between confidence on clinical performance skills of the nursing students with their perception on role transition (p 0.021) at 0.05 level of significance. Hence, the research hypothesis can be partially accepted and a significant association between baseline variables and perception of role transition was also observed.

Discussion

Section 1: Baseline characteristics

In the present study, the mean age of the students was 21.74±0.91 years and majority (96.3%) of students were females and only 3.7% were males. About 36.3% of students resided in urban area, while 35.3% were from semi urban areas and 28.4% were residing in rural areas.

The present study findings are congruent with another study conducted in Tanta University to assess the perception of role transition among nursing interns. The mean age of the students was 22.5±2.5 years and majority were females (88.5%), while 11.5% were males. About 51.4% of students resided in urban area and 48.6% resided in rural.³

On comparison of both the studies, the majority were females compared to males, the common age group was 22-23 years and they mainly resided in urban areas.

Section II: Assessment of perception of role transition among final year nursing students In the present study, the overall mean score of perception of role transition obtained by the students was 117.4±12.82 and those of role preparation, role competence, support, organization, and role expectation were 23.3±3.72, 31.9±4.19, 16.5±2.22, 29.4±3.51, 16.3±2.2, respectively.

The present study findings are in congruence with another study conducted in Menofia University to assess the perception of role transition among nursing interns. The mean score of role preparation was 9.52±1.35, role competence was 18.11±4.34, organization and support was 19±5.60.5

While evaluating the studies, it was found that the present study differed in comparison to the study conducted with respect to support domain.

Section III: Association between role transition and baseline variables

In the present study, the baseline variables of nursing students considered were gender, area of residence, family members in nursing profession, future plan following graduation, feelings about graduating as a nurse, confidence on clinical performance skills. There was a significant association between confidence in clinical performance skills of the nursing students and their perception on role transition (p 0.226) at 0.05 level of significance. 

The present study findings are in congruence with another study conducted in Haryana to assess the career preference and perception regarding role transition from students to nursing professionals among final year nursing students. The baseline variables of final year nursing students such as gender, marital status, siblings, father education, family income, occupation of mother, type of family were not associated with perception regarding role transition at 0.05 level of significance.⁶

On comparing the findings of both the studies regarding association of role transition and baseline variables, it was known that both the results vary in their values.

Conclusion

The results of the present study revealed that most of the final year students are prepared for the role change with respect to their duties, preparing themselves to perceive in many roles. Hereby it was understood that among the given ratio of sample, most of the students were clear to bring out essential change from student to a professional. As this study was conducted in respect to views of role preparation, role competence, support, organization, role expectation as such to evaluate their efficiency to attain themselves to be prepared with changes occurring in staff period, to determine their knowledge to be competent with others in respect to knowledge and other aspect relevant to seek whether they will be supported by peer group, and can satisfy the needs of organization and satisfied with their duties as they meet their expectations.

Conflicts of interest

There are no conflicts of interest