Reality Shock Nursing One of the biggest challenges for modern nursing is the challenge that newly graduated nurse's face once they leave school and enter a full-time health care facility. Colloquially known as "reality shock," this is the view that despite years of training, time in the clinical setting, and even prior experience, the stress...
Reality Shock Nursing One of the biggest challenges for modern nursing is the challenge that newly graduated nurse's face once they leave school and enter a full-time health care facility. Colloquially known as "reality shock," this is the view that despite years of training, time in the clinical setting, and even prior experience, the stress of the new nurse is that they are unprepared for the pace, attitude, culture and expectations within their new career.
The new nurse is now expected to have not only clinical knowledge but already know the hospital or facility logistically, be able to juggle multiple horizontal priorities, and even get to know colleagues and patients. This reality shock often causes new nurses to doubt their abilities, question their career choice, or, as a last resort, leave the profession entirely.
For most nurses, reality shock is then the result of the emotional and psychological conflict between a new graduate's expectations and the reality of the actual role and responsibilities within the work setting (Marquis, B., et al., 2009). When dealing with the ethical aspects of reality shock in nursing, we must first understand that the profession has evolved into a complex and multidisciplinary field in which there are numerous interactions between clinical knowledge, carative paradigms and knowledge acquisition and management.
The old model of nursing as simply the physician's assistant is no longer viable, and continual reinvention of the field, the individual's ability to perform multiple tasks, and the push towards new technical capabilities while, at the same time, understanding that nursing is about compassion, advocacy, and ethics, requires a different way of synthesis and analysis than ever before.
This difference may be summed up in the assertion that modern nursing now has at least five different components that combine clinical knowledge with a mode of operational expertise and philosophy: emancipatory, ethical, personal, aesthetic and empiric (Kajander, S., et al., 2013) Because nursing is, by its very nature, far more multi-disciplinary in the contemporary healthcare environment (business, emotion, leadership, management, clinical knowledge and more), we often realize that we do not understand things directly, but by the impressions and observations we place -- which are naturally unique and personalized -- on the world.
This mode of thought complicates nursing because it combines the evolution of nursing care with the radical change in stakeholders. Nurses must be communicators -- but advocates as well; and in this, they must balance the carative notion of patients with the pragmatic needs of the institution. In nursing, particular, the conception of knowing then reflects the balance and combination between intuition, past-knowledge (clinical and other), experience and empathy (Bonis, 2009).
However, for the field of nursing, one can adapt a marketing paradigm -- because of the customer, the business exists -- and thus for the nurse, because of the patient, the nurse exists. It does little good to have trained clinical nurses with expertise if they enter a health care environment only to find themselves dejected or so uncomfortable that they have a psychological breakdown or leave the field.
In general, the ideas of utilitarianism and deontology may be used as a paradigm for the issue of reality shock for nurses. Deontology says that we cannot make the determination about actions only by looking at the result. To make this affective, the individual should find the motives that allow us to translate actions from simply the philosophical idea into reality. Utilitarianism is an outcome-based theory, focusing primarily on the results of an action.
In this theory, an action is ethical if it produces the most good and the least harm for everyone affected by the action ("the greatest good for the greatest number."). Stated another way, an action is ethical if more of society benefits; the social benefits for society are the positives less the social costs. There are several important issues surrounding this theory. This view tends to place the onus of responsibility solely in terms of the result produced by any action.
It looks only at the conclusion, not the means to get there. Second, the benefits and costs include any kind of good or harm, including things (such as the value of a human life) that may be difficult to value in precise noncontroversial ways. Third, the benefits and costs include those that happen now and those that will happen in the future; future benefits and costs must be discounted to present value.
Fourth, to be considered ethical, it is not enough that the action does more good than harm; the action must do the most good and the least harm to be judged ethical (MacIntyre, 2006). Using deontology as a personal model though, it is not just the outcome of patient care and service to the profession that is paramount, but the manner and way of modeling the.
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