Compassion fatigue (CF) and burnout (BO) in the novice nurse population can negatively affect the organization, patient safety, patient satisfaction, and the individual. Novice nurses are susceptible to the development of CF and BO due to a lack of knowledge about the causes and the stress experienced as the novice nurse transitions to practice. The purpose of this staff education project was to fill the gap in practice by creating awareness about CF and BO during the nurse orientation process and by providing prevention strategies. The relationship-based care model and the theory of planned behavior were used to guide the project development and to discover motivational factors to encourage self-care and improve the well-being and resiliency of the novice nurse. The post-education evaluation was an anonymous, 10-question, Likert-type survey. All participants scored each question based on the course learning objectives, feasibility, and efficacy of the program, with a (5) strongly agree or (4) agree. A descriptive analysis of the data collected from the survey scores provided information that positively supported the practice-focused question that staff education on CF, BO, and prevention strategies would add value to the novice nurses' orientation program by validating the stressors of working with patients and providing tools to promote self-care as they transition from student to practicing registered nurses. Future recommendations would be to offer this education to staff nurses in all units during the annual skills day, huddles, and staff meetings. This project has the ability to create positive social change by educating novice nurses early in their career about the symptoms and self-care measures designed to promote resiliency, thus preventing CF and BO.

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Hospitalized patients increasingly present with complex health issues that place them at risk for acute patient deterioration (APD). Novice nurses are ill-equipped with the critical clinical skills to function competently in recognizing APD, placing patients at risk for negative health outcomes. This project addressed the need to educate novice nurses to recognize APD and answered the project focused questions that asked if an educational intervention with high-fidelity simulation (HFS) would improve nurse knowledge and clinical confidence in recognizing APD. Benner's novice-to-expert and the constructivism theory were used to guide the project. Based upon a review of the literature, the HFS was developed to provide scenarios in which participants would view APD evolving case studies and demonstrate knowledge and skill for caring for patients with APD. A convenience sample of 11 novice nurses participated in the pre- and posttest design project to determine if knowledge and clinical competence increased. Data from the HFS program were analyzed; results showed no statistically significant change in knowledge or confidence post intervention (p = 0.441). A larger sample size is recommended for future HFS interventions at the site to determine if the program of education will increase knowledge and clinical confidence with future iterations of HFS. The project has the potential to promote positive social change as novice nurses learn to recognize and respond to APD and as APD events are reduced.

Att vara nyutexaminerad sjuksköterska ställer höga krav på kompetensutveckling och förmåga att klara övergången till en ny miljö. Sjuksköterskebrist råder hos samtliga arbetsgivare och det finns en utmaning i framtidens kompetensförsörjning. Hög arbetsbelastning med ihållande stress, bristande personalkontinuitet och otillräcklig kompetens har en negativ inverkan på vårdens kvalitet och tillgänglighet. Det är oklart om den nyutexaminerade sjuksköterskan tillåts vara ny, då hen förväntas vara självständig efter introduktion. Författarna har därför utfört en litteraturöversikt med syftet att beskriva den nyutexaminerade sjuksköterskans upplevelse av sin övergång och kompetensutveckling de två första yrkesverksamma åren. Resultatet visar på fyra huvudteman; att klara övergången, handledningens kraft, upplevelse av arbetsmiljö och att greppa helheten med totalt tio subteman. Det synliggörs att trygga relationer i arbetsgruppen, där särskilt handledarens roll, medverkar till en positiv övergång som främjar kompetensutveckling. Den nyutexaminerade sjuksköterskan utvecklar sin professionella identitet genom att dela med sig av erfarenheter. Genomgående finns det en känsla av att vara oförberedd att möta det ansvar som ges i ett tidigt skede. En rädsla för att göra misstag leder till en strävan att vara felfri. Inledningsvis upplever den nyutexaminerade sjuksköterskan svårigheter i organisatorisk förmåga, vilket kan resultera i en bristande helhetssyn kring patienten. Efter övergången upplevs tillfredställelse och stolthet att utföra yrket. Diskussionen berör komplexiteten som finns i handledning, inverkan av personliga variationer och betydelsen av relationer. För att främja en hållbar utveckling kan vi dra slutsatsen att det är värdefullt att verksamheten arbetar preventivt med arbetsmiljö. Detta för att behålla och stärka den nyutexaminerade sjuksköterskan i sin övergång och kompetensutveckling.

Les centres hospitaliers universitaires détenant une expertise pour les grands brûlés pédiatriques ont la responsabilité d’avoir du personnel infirmier compétent pour donner ces soins spécialisés. Cependant, il est constaté que les infirmières débutantes ne possèdent pas les connaissances suffisantes sur les soins de plaie de brûlures pour bien intervenir auprès de cette clientèle. Il y a donc un besoin urgent de formation pour préparer les infirmières débutantes à la prise en charge de ces patients. Cette étude pilote pragmatique avait pour buts : (i) de développer et de mettre à l’essai une formation en ligne sur les soins aux grands brûlés pédiatriques destinée aux infirmières débutantes; (ii) et d’évaluer la faisabilité et l’acceptabilité de la formation en ligne en plus d’estimer les effets de la formation sur l’amélioration des connaissances de ces infirmières débutantes en soins aux grands brûlés pédiatriques. Les cadres de référence utilisés pour soutenir cette étude incluaient le « Référentiel de compétences de l’infirmière en soins aux grands brûlés » de l’American Burn Association (2017b) pour développer le contenu théorique de l’intervention ainsi que les « Principes de l’apprentissage en ligne » de Clark et Mayer (2016) afin de guider la conception de la formation en ligne. Un devis préexpérimental prétest-posttest à un groupe d’infirmières débutantes (n=16) a été employé à l’unité de soins médico- chirurgicaux du Centre hospitalier universitaire Sainte-Justine entre mars à juillet 2020. La faisabilité, l’acceptabilité et les effets préliminaires de la formation en ligne ont été évalués par un questionnaire de connaissances sur les soins infirmiers aux grands brûlés pédiatriques et de satisfaction. Les analyses statistiques utilisées incluent des statistiques descriptives et des tests- t pour échantillons appariés. En ce qui concerne la faisabilité, toutes les participantes ont complété la totalité de l’étude via la plateforme en ligne. Les résultats préliminaires ont révélé une différence significative entre la moyenne des scores de connaissances des 16 infirmières débutantes pré-formation en ligne (58,6%±14,5) et post-formation en ligne (87,7%±8,7) (p<0,001). Pour l’acceptabilité, la moyenne des scores était satisfaisante avec 95,5% (3,8±0,2) post-intervention. Ainsi, cette nouvelle formation en ligne, basée sur des données probantes, semble faisable et acceptable, en plus d’indiquer un effet préliminaire sur l’amélioration des connaissances d’infirmières débutantes sur les soins aux grands brûlés pédiatriques. / Nurses working with pediatric burn care patients require to be properly trained to provide optimal burn care. However, it was found that novice nurses from this service do not have sufficient knowledge regarding burn wound care to provide efficient care for this specialized clientele. Therefore, an urgent need exists to train novice nurses to care for pediatric burn patients. This pilot study aimed to: (i) develop and pilot a pediatric nursing burn care e-learning training for novice nurses; and (ii) assess the feasibility and acceptability of this educational intervention as well as evaluate the intervention’s preliminary effects on novice nurses’ knowledge on pediatric nursing burn care. The frameworks that supported this study included the “Burn Nurse Competencies” from the American Burn Association (2017b) to develop the theoretical content of the intervention as well as the “Multimedia Principles ” from Clark and Mayer (2016) to design the e-learning training. A pragmatic quasi experimental one-group (n=16) pretest-posttest design was conducted from March to July 2020 at a pediatric burn care unit at the CHU Sainte-Justine Pediatric University Hospital. Feasibility, acceptability and preliminary effects of the e-learning training were assessed by a pediatric nursing burn care knowledge level questionnaire and a satisfaction survey. Statistical analyzes included descriptive statistics and tests-t for paired samples. In regards to feasibility, all participants completed the entire study with the e-learning platform. A significant difference was observed between the knowledge level mean score of novice nurses pre-training (58.6% ± 14.5) compared to post-training (87.7% ± 8.7) (p<0.001). Results showed that novice nurses’ mean score on satisfaction was 95.5% (3.8 ± 0.2) post-intervention, indicating a high satisfaction level. This new evidence-based pediatric nursing burn care e-learning training appeared feasible and satisfactory by novice nurses as well as indicating a preliminary effect on knowledge improvement regarding pediatric burn care.

The health care field has become increasingly more complex, requiring new nurses to be prepared upon graduation to respond to a variety of complex situations. Unfortunately, many graduates from associate degree nursing (ADN) programs are not able to think critically upon entering the work force. This presents a major problem for the nurse and for the employer. The purpose of the study, therefore, was to gain a deeper understanding of the graduates' perceptions of their ability to critically think during their first year of clinical practice, and if they believed their program prepared them to be critical thinkers. The key research questions focused on how the novice nurses reconciled their performance on a critical thinking, online assessment, the Health Sciences Reasoning Test (HSRT), with their perception of their critical thinking skills, and if they felt prepared, during their first year of clinical practice, to critically think. The conceptual framework applied was Bloom's Taxonomy and Tanner's clinical judgment model. A purposeful sampling of 7 novice nurses from 3 ADN programs was chosen. After completing the HSRT, audio-taped phone interviews were conducted. The data indicated that the participants felt unprepared to respond to emergent patient situations, thus undermining their self-worth and clinical competency. The participants agreed there was a need for a critical thinking course in ADN curriculum. A project was created for a 9-week critical thinking course, incorporating theory, clinical practice, and simulation exercises. Social change is expected to occur when student nurses are able to critically think upon graduation, resulting in positive patient outcomes, both of which will benefit patients, their families, and their communities.