The use of personal, quick-reference lanyard cards to reduce transition shock in New Graduate emergency nurses.

Ms Sophie Williams1
1Calvary Health Care Bruce, Evatt, Australia

Background: The commencement of professional practice is daunting for newly registered nurses, who often experience ‘transition shock’ – the culture shock of transitioning into the clinical reality of nursing. Critical care settings have comparably higher rates of transition shock, which is hypothesized to be due to the added fears of time-critical situations in a fast-paced environment. In the authors’ workplace, staff are recruited at regular intervals to undertake the departments’ Emergency Nursing Program. Due to operational demand, new/graduate nurses are frequently allocated to Acute bedspaces, where new patients are received for initial assessment and work up.
Development: Inconsistencies were observed in the patient assessment/workup by new or graduate staff and were believed to be related to the two main factors of a) restricted Nurse Educator support outside of business hours; and b) the graduates’ mimicry of the habits of their assigned mentor only. In response, a ‘quick-reference’ guide was suggested for initial patient assessment/workup, targeting ‘ATS2-Urgent’ patients, who require assessment and intervention within ten minutes. In these instances, new nurses may find themselves unsure of the immediate requirements or a logical, prioritised sequence in which they should be attended. The quick-reference guide was produced in the format of personal lanyard cards, one each for the most common ATS 2-style presentations such as Chest Pain or Shortness of Breath. The card captures the essential nursing interventions for each type of presentation, referencing departmental policies and best-practice guidelines, and is presented in a dot-pointed step-by-step order to guide initial patient assessment and workup.
Findings: The use of quick-reference lanyard cards were found to be successful in reducing the transition shock in new/transitioning nursing staff through reducing anxiety and providing guidance for consistent initial patient workup and assessment.

Sophie is a Registered Nurse in the Emergency Department at Calvary Hospital in Canberra, currently working in a variety of roles including Advanced Practice, Resuscitation, Triage and as the hospitals after-hours Clinical Assist Nurse. Sophie has strong interests in advanced practice and education, having completed postgraduate qualifications in Clinical Education and Emergency Nursing from the Australian Catholic University and the University of Sydney.