Practice makes perfect for graduate nurses

Linda Hall says NETP helped her to gain confidence. Photo / Supplied

The ADHB's 10-month Nursing Entry to Practice (NETP) Programme is designed to transition graduate nurses competently in their first year of nursing.

NETP nurses are employed into vacant permanent positions in wards or units where they develop clinical practice experience by working alongside their preceptor and other registered nurses and completing postgraduate academic study.

Each graduate is allocated a preceptor; a registered nurse who teaches, supports and guides them through the 10 months. Up to 16 hours off the ward is allocated for the graduate and preceptor to plan, reflect, discuss and evaluate the graduate's progress.

The graduates also undertake postgraduate papers in their chosen area.

Child health postgraduate study is taught through the AUT, while adult health, primary health care and mental health is taught through the University of Auckland. Twelve days is allocated for this tertiary study and students are expected to do a further 10 hours of study each week in their own time.

The number of vacancies available per intake is reliant on vacancies within the organisation. This January, ADHB employed 80 new graduates across adult and child health; last January 108. Sixteen mental health and 10 primary health new graduates were also employed.

GRADUATE

Lisa Hall
* 24
* Registered Nurse
* Starship Hospital (General Surgical)
* Completed NETP end of 2007

I worked in retail for two years when I first left school. I also volunteered for Order of St John, which gave me insight into hospitals and medicine, and I decided I really wanted to nurse.

I did my nursing degree through Wintec, graduating end of 2007. I decided to apply for the NETP at Starship for a couple of reasons. I liked the continuity of one placement over 10 months; some hospitals require you to do two. I wanted a permanent position after NETP and I wanted to work with children and in surgical nursing. There is always so much to learn on a surgical ward.

My work involves assessing children, recording and acting on observations, working with families to formulate a plan of care, administering medicines and IV fluids and working with nurse specialists to teach children and families about managing long-term conditions. I escort patients to and from theatre and provide post-op care, which involves management of fluids, infusions, epidurals, drains and catheters. A big challenge is dealing with parents and family and gaining their trust while you take care of their most precious child.

I've now finished my second year at Starship. NETP really helped me consolidate my practice on the ward and feel confident working alongside experienced registered nurses.

Preceptors are vital. They oversee your practice, coach you in techniques and procedures, and give you feedback and reflection. I found it really helpful to talk things through with my preceptor. You can't be afraid of not knowing something and I found everyone helpful, not only my preceptor. Initially you shadow your preceptor, then share a workload and eventually take on your own workload.

You also do an academic paper. I really liked working on the ward while I was doing the paper because I was continually applying theory to practice.

Shift work is hard initially. I do three or four 12-hour shifts, either 7am to 7.30pm or 7pm to 7am. Night shift is particularly hard to adjust to. I have a routine of coming straight home, eating, having a shower and then sleeping. I make sure I exercise when I wake up. I love shift work now because it gives me lots of flexibility.

MANAGERS

Jane Cameron, Charge Nurse Manager
Jessica Irvine, Ward Nurse Educator

* Ward 24B Paediatric General Surgery, Starship Children's Health

Not only do paediatric nurses have to care for the child but it is vital they incorporate the child's family's values and needs into the plan of care and then advocate them to the healthcare team.

Another integral component of paediatric nursing is to understand children's growth and developmental needs. We provide care for newborn babies upwards to 18-year-olds, so graduates need to understand each life stage and respect the unique needs related to them. Graduates must also be able to work well within a team. Lisa demonstrates all these qualities well.

The undergraduate degree prepares the student nurse for a variety of assessment and care provision needs across a diverse health sector, including mental health, medical/surgical nursing, primary health care. However, it doesn't allow for speciality nursing, hence they do not have the comprehensive skills and knowledge related to a specific area of practice.

The NETP programme provides a more structured and in-depth orientation and consolidation of skills in a specific area of practice. It also provides a solid form of preceptorship and support for newly graduated nurses.

NETP has enabled Lisa to become a competent paediatric surgical nurse equipped with the skills and knowledge to practice to a high standard. Not only has she consolidated the specific skills needed for this scope of practice, she has further extended her skills by completing postgraduate study. This study enables her to rationalise assessment findings and critically analyse these in relation to her specific client group.

The recession has meant staff turnover is well below previous years and existing staff are not moving to other positions, which in turn decreases opportunities for new graduates.

TRAINING PLACE

Qualification: Nursing Entry to Practice (NETP)
Programme: Streams in Adult Health, Child Health, Primary Health Care and Mental and Addictions Nursing
Organisation: Auckland District Health Board (ADHB)
Phone: 0800 733 968 or 09 631 0710
Email: recruit@adhb.govt.nz
Web: http://careers.adhb.govt.nz (application form on website)
Entry requirements: Graduated with nursing degree within last 12 months and worked as a registered nurse for six months or less. Hold annual practising certificate.
Cost: Free
2010 September intake dates: Applications open beginning of May for four weeks. Interviews probably in first two weeks of June.
Employment: Most new graduates are employed for .9 fulltime equivalent. They need to be doing at least .8 to be eligible for the programme.
Starting salary: $44,562 plus penal rates

angela@careerideas.co.nz