Stage of Transition in Nursing Socialization

Role Socialization 3
Section I - Summary of Kramer’s Postgraduate Resocialization Model in Nursing
Contemporary using practice entails cyclical events of socialization and resocialization. Socialization is the concept by which individuals acquire knowledge, skills, and attitude that support functionality in society. Dimitriadou, et al., (2013) asserts that the process of socialization exerts a working understanding, internalizes working philosophy, the skills, knowledge, attitude, and value espoused in the nursing practice. As such socialization helps create an identity as a nurse. Socialization in nursing practice occurs in several institutional contexts including both the academic institution and hospital/health institutions (Dimitriadou, et al., 2013). Professional socialization entails experience in multiple types of care setting, case study discussions, reflective journaling, post-conference debriefing, and service activities.
Kramer (1974) provides a theoretical construct of resocialization of nurses that models the transition of nurses from the academic setting to practice setting. Kramer developed the “Reality Shock” theory that elucidates the incongruence between the nursing workplace practice and the values instilled by the university as nursing students pursue Bachelor of Nursing (BSN). The “reality shock” theory is conceptualized on the argument that there exist discrepancies in core values of realistic version of nursing practice and theoretical academic courses of nursing practice. According to Kramer, as nurses transition to practice, they are confronted by unexpected intellectual, social, emotional, cultural and physical shock as they assume new responsibilities (Kramer, 1974). The reality shock theory has over the years evolved conceptualized to transition shock.
Kramer (1974) identifies three cyclical phases that provide a framework of nurse socialization: honeymoon, reality shock, recovery/conflict resolution. The “honeymoon” phase is linked to the focus of skill building, excitement and exhilaration as the nurses enroll for practice. As such the novice practitioners portray positive outlook of application of their clinical knowledge irrespective of the mismatch between their academic orientation and reality in nursing practice. Given the incongruence, poor role satisfaction is experienced at the “honeymoon” phase setting the precedence for the “reality shock” phase. According to Kramer (1974), the reality shock phase is characterized by disorientation, outrage, and attrition by the New Graduate Nurses (NGN) as they phase rejection by the practice that is supposed to assimilate them. The disconnect between the theoretical knowledge and the actual practice yields frustration and fatigue to the NGN (Dimitriadou, et al., 2013). Ultimately, the NGN develop a realistic perspective of the nursing practice and a sense of balance, which is the third phase of recovery/conflict resolution. The three phases are characterized by change in role satisfaction with the second phase having the least role satisfaction feeling
Kramer (1974) models four stages of postgraduate resocialization; skill and routine mastery, social integration, moral outrage, and conflict resolution. During the skill and routine and mastery stage, the NGN focuses on building his/her ability to perform techniques and procedures in an efficient and competent approach. The second phase of social integration is characterized by backstage behaviors as the NGN seeks integration to the group of nurses and establish interpersonal relationships with co-workers. Kramer (1974) notes that as the reality of the work environment becomes clear, the NGN enters a phase of frustration, disillusion, and moral outrage. Subsequently, the NGN enters into the conflict resolution phase which Kramer (1974) identifies several possible outcomes: biculturalism, withdrawal, behavioral capitalization, plague on both your houses or value capitalization.
Section II - Stage of Transition in Nursing Socialization
The reality of nursing practice is “fast-paced” which the university system may inadequately prepare the BSN students. Consequently, the university experience is not relatable to the increased workplace responsibility as the NGN transition to practice (Dimitriadou, et al., 2013). As proposed by Kramer (1974), resocialization elucidates the process of internalization of the nursing practice and transitional from a struggling novice to a functional professional.
Socialization is a critical aspect of career development of BSN students and occurs both at an educational institution and a clinical context. Socialization is a two-step process that entails acquiring skills and knowledge from academic training and adjusting of the skills and knowledge to the demands of the work setting (Duchscher, 2009). As a newly BSN graduate working as a nurse, I’m in the social integration phase of professional socialization in nursing. The phase entails seeking assimilation into the work-place by the fellow co-workers. Consequently, I engage in activities and social events that present opportunities to build interpersonal relationship with the colleagues. The phase entails surviving the pressure of cultural behavior and attitude of the nursing professionals. The stage is a block-building phase that seeks to establish legitimization and a sense of belonging. Working under instructors who have been in the nursing practice for a longer term has significantly modeled the social integration journey. However, the nursing practice is hierarchical as opposed to collegial which often could be energy- draining for the novices (Duchscher, 2009).
Section III- BSN and Socialization
Professional nursing identity is borne out of socialization. Socialization in nursing is realized through both academic education and through on-job learning. According to Bibi & Inayet (2017), BSN education influences nursing socialization by cultivating professional competence and values by imparting high clinical knowledge. The Analysis by Bibi & Inayet (2017) identifies a greater correlation between BSN and nurse’s confidence as well as the recovery rate of patients. The process of acquiring a BSN entails internalization of the relevant knowledge, skills, attitudes, values, culture, and behavior fundamental in executing the nursing roles. The BSN lays a foundation for maneuvering through the transition shock that is inherent in nursing practice. Through exposure to the BSN curriculum, the nursing students become socialized into the nursing practice and development of a nursing identity.

References
Bibi, F., & Inayet, S. (2017). How Nursing Education Affects the Socialization of Student Nurses of Post RN BSN in IUH FSD. International Journal of Scientific & Engineering Research, Volume 8, Issue 6.
Dimitriadou, A., Pizirtzidou, E., & Lavdaniti, M. (2013). The Concept of Socialization in Nursing Education. International Journal of Caring Sciences, Vol 6 Issue 3.
Duchscher, J. (2009). Transition shock: the initial stage of role adaptation for newly graduated Registered Nurse. Journal of Advanced Nursing, 1103- 1113.
Kramer, M. (1974). Reality shock: why nurses. C V Mosby, St Louis.