Perceptions of the clinical competence of newly registered nurses in the North West Province

Abstract

This study was based upon the requirements of the Scope of Practice of the Registered Nurses (R2598 of 1984 as amended) as prescribed by the South African Nursing Council. The clinical competency of new graduate nurses, with regard to the care of individual clients, depends on their ability to correlate theoretical knowledge learned in the classroom with practice and the development of clinical skills. Its foundation lies in the ability to identify and solve problems that emanate from critical thinking, analytic reasoning and reflective practice. It is clear that the quality of clinical exposure plays a leading role in the development of learners into nursing professionals. Nursing skills alone cannot ensure quality care of clients without the application of theory. Facilitation of this theory to practice remains, therefore, an essential component of nursing education. This study was aimed at identifying areas of incompetence of new graduate nurses (1998-2001) in the clinical area, by determining the new graduates and professional nurses perceptions of the competence of the new graduate nurses. The intention was to make recommendations regarding the identified areas of incompetence. Descriptive research was found appropriate to the study, using the parameters of the Scope of Practice of the Registered Nurse (R2598 of 1984 as amended) A quantitative non-experimental descriptive survey was undertaken to generate information on the clinical competence of new graduate nurses (1998-2001). <p. An in-depth literature study was conducted to generate information that was used as the basis for the study. For data collection, two types of structured questionnaires were used to obtain information from professional nurses and new graduate nurses (1998-2001). Permission to conduct research from the selected institutions was granted by the Department of Health in Mmabatho and the ethical committees of management of identified hospitals in the North West Province. An analysis of the data obtained from the study yielded the following findings with regard to clinical area: <ul> <li>Shortage of staff, equipment and supplies negatively affect the competency of new graduate nurses. </li> <li>New graduate nurses are expected to perform beyond their scope of practice and there is discrepancy between what the new graduate nurses learned in the classroom and what they see in the clinical area. </li> <li>Orientation programmes need to be reviewed and they are often neglected due to shortage of staff. <br> </ul> Findings with regard to performance of new graduate nurses: <ul><li>Ethics and professional practice need to be emphasized and graduates educated regarding the rights of patients. </li> <li>New graduate nurses have sufficient theoretical knowledge but lack competency in basic nursing skills due to an inability to correlate theory to practice. </li> <li>New graduate nurses are perceived to be arrogant and perceive themselves as having a higher education or qualifications. </li> <li>College graduates are perceived to be more competent than university graduates because of their "extensive" exposure to clinical practice. </li> <li>New graduate nurses consider themselves to be above certain basic skills after completion of training. <br> </ul> Conclusions that can be drawn from this study are that there are many factors that impact negatively on the competency of new graduate nurses. These emanate from the clinical area, as well as during the education and development of new graduate nurses. Recommendations regarding the education and development, evaluation of students and the clinical practice area have been made.