Transition From Undergraduate Student to Registered Nurse – Term Paper

Undergraduate Students Introduction 

Undergraduate students who complete their nursing causes face difficulties as they try to integrate themselves with the profession.  In most cases, the transition process is never smooth for them as they are required to overcome a pile of obstacles that at times threaten to affect their careers. Among them include delegation, communication, supervision, coordination, and consultation. These young graduates have little or no experience regarding how the systems work. At times, they do not know where to start or what to do when faced with various circumstances. For instance, they need to understand the manner with which communication in the system is conducted. They also need supervision as they are new in the profession and might require guidance from their seniors. Consultation and discussion are essential during the transition time as well. However, undergraduate students lack access to all these as they transit to become registered nurses. The development process for nurse graduates is critical. Nursing is a complex profession which is highly dynamic (Halcomb, Peters, and McInnes, 2012; Kovner & Djukic, 2009). There are a variety of settings in the field as well. Nurse graduates will be expected to be working in collaboration with the experienced professions. They should be prepared for the work environment as a lot of challenges dominates it. For instance, it is not uncommon for a nurse to lose a life on their hands (Valencia, 2016). This paper is a peer-review for literature relating to the transition from undergraduate student to the registered nurse about the “use delegation, supervision, coordination, consultation and referrals in professional relationships to achieve improved health outcomes.   

Transition from undergraduate student to registered nurses

Over the years, the shift of fresh graduates to the work environment has been an issue of utmost significance to the organizations where they work as well as to their learning institution. It is the aim of any school to produce highly performing individuals. The learning environment is entirely different from the workplace (Keleher, Parker &Francis, 2010). While students will apply the knowledge they have gained from the institutions at their work, it is worth noting that they are also expected to be extra creative, innovative and also more logical. They will be faced with real time problems which they are supposed to solve. These are different from the case study problems which they solve at school. They face some challenges during the transition period. 

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One of the problems they face is delegation. This issue is as a result of staffing shortages which has been an issue in most health institutions. The deficit of nurses as compared to the number of nurses means that fresh graduates will be rushed to get into real practice. At the same time, there are no enough staffs, and hence delegation becomes a problem (Halcomb, Peters, and McInnes, 2012; Chang & Daly, 2015). For a fresh graduate, it is too overwhelming to be overworked when one has barely gained any experience. They are highly likely to make mistakes, a factor that might adversely affect their confidence and self-esteem. It is worth noting that an error in the nursing profession puts lives of patients at stake. At times, there could be enough staffs for delegation, but the new graduates may not be aware of whom they should delegate particular works.  

Fresh Graduates Problems

Further, shortage of workers means that consultation may become a problem since the few available nurses are likely to be busy and hence may lack time to offer consultancy to the new graduates. As undergraduates, students may need to consult their seniors on various grounds. They face problems that they have not encountered before. Also, they may face challenges which they have no idea how to go about in finding a solution. Lack of sufficient consultancy during transition becomes a problem especially due to the many acute conditions today. Many patients are suffering from severe diseases as compared to the number of similar patients in the past years (Alberto and Herth, 2009). It is a challenge for any fresh graduate to handle patients who have acute problems. It is important to note that a patient who is suffering from a serious issue is at a higher risk of losing their life (Thomas et al. 2016). They are more delicate and complex to handle. In fact, dealing with such a patient requires experience and specialized knowledge which can only be acquired at the workplace. Graduates who get into the practice directly without proper transitioning will feel overwhelmed when handling such patient especially if they do not have people they can consult for guidance. The problem of short transition period faced by these graduates today spills over to add to their difficulties since they will lack sufficient skills to handle acute patients while at the same time they do not have enough consultation. At such times, they need people they can consult for guidance and advice.  

Supervision also becomes a problem for the new graduates due to shortages of staff among other reasons. They will be expected with little or no monitoring, and hence they will technically be on their own (Aiken, Cheung, and Olds, 2009). For a newly graduated nurse who is just starting their nursing career, it is a great challenge for them to work with no supervision. It is not easy for them when they are overloaded with work and have no one to delegate to (Gilliss, 2010). The fact that they can get sufficient consultancy support makes it even harder for them. The new and sophisticated technologies that are currently being used in the health institutions are further a challenge to new graduates. The technological systems are challenging to operate, and they may require extra knowledge which students may not have learned from school. For such systems, they will need enough time to learn and at the same time, they will need to consult sufficiently while working with them (Rush et al. 2013; Benner et al. 2009). Supervision is of utmost significance in such cases. During the transition period, graduate nurses are likely to have more monitoring and have more opportunities for consulting. But when there are not enough development times, it means that they will not have sufficient time to ask and hence wild has challenges using this technology.  

As it has been mentioned earlier, nursing is a profession that is highly sensitive because it deals with the lives of individuals. Therefore communication is important at their workplace. With proper communication, there is a high possibility that mistakes will be reduced.  An error by a nurse could put peoples’ lives at risk (Berlin and Sechrist, 2002). 

Referral of patients is another issue that can be challenging to undergraduates. It is a process that needs special documentation and communication. A fresh graduate is likely not to understand the procedures followed when taking in a referral or referring a patient to another hospital or specialist. Chances are,  this process will make them stranded as they might not know what to do. The fact that they lack sufficient opportunity for consultation and supervision makes it even more challenging. 

New Graduates Nursing Problems and Possible Solutions

The transition of new graduates to registered nurses is a challenge that needs to be addressed exhaustively to improve the quality of services at the health institutions. For the above-discussed problems, some remedies can be implemented to counter the problem. First, there should be a section in the health facilities for learning which should be used by the new graduates. These will emulate practical lessons, but students will learn with real-time situations (Keleher, Parker &Francis, 2010). They will be handling patients but under the guidance and supervision of senior nurses. This way, they will have a smooth transition as they will gain sufficient knowledge before they are registered as full-time nurses. They will have an opportunity to face acute problems and learn how to handle them under the guidance of senior nurses. Because there is a shortage of staffs in health institutions, retiring nurses could be assigned to train and offer advice to the new graduates during their transition period. Undergraduate nurses should also go through training before they are registered as full nurses so that they can learn the ways of communicating effectively. The institutions should also ensure that there are proper systems to enable effective communication.  

To address the issue of the staffing shortage, the government may increase the number of students who are admitted to training as nurses (Fedoruk, 2011). Probably, it should come up with incentives which will attract more students which will eventually be incorporated into the profession and consequently addressing the issue of the staffing shortage. For technology issues, IT professions could be groomed to handle health-related technology. They will, in turn, offer support to new nurse student graduates as well as to other nurses on matters of technology.

To address to problem of referrals,  health institutions should include referral documentations and communication as part of training for new graduates. They should be taken through a session to show them how to go about referral procedures. This way, it will be easier for them in event they encounter such a situation. 


Nursing is a profession that is highly dynamic with new dimensions sprouting too rapidly. The advancement of technology, the increase in the number of acute problems as well as the growth in the number of patients in general are some of the factors that have made the profession too dynamic. Graduates who are transitioning to registered nurses are facing challenges as they get only limited time to adapt and cope with this job. This may end up making them less competent and hence is a problem that needs to be addressed adequately.    


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