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Identification and discussion of inconsistency in an approach to clinical practice, support and justification of choice of topic.

In the last decade, Saudi Arabia introduced the policy of “Saudization”, which means increasing the numbers of Saudi employees in all sectors, including nursing. This policy associated with an

improved attitude and acceptance of nursing as a profession among young people. Many nursing schools were established, producing growing numbers of graduate nurses. Such nurses,

inexperienced and with little background schooling, were immediately introduced into the workforce, replacing a large number of highly experienced non-Saudi nurses (Fielden, 2012). This issue

and the low standard of nursing school education in Saudi are the focus of this discussion.

However, it is important to identify the inconsistency approaches, strategies or programs that have been implemented in order to facilitate the transition of new Saudi nurses into work. Most

hospitals, for instance, require new nurses to complete two weeks’ general hospital orientation, followed by a three-month Departmental Orientation Program, and are then expected to be safe

to be assigned to patients and provide patient care.

The effectiveness of these orientation programs is negatively affected by factors such as language barriers, where the materials are written in English and most of the educators are non-Arabic

speakers, and the level of English of the new nurses is not up to expectations. Library facilities, internet access and data bases, even appropriate nursing classes, are often absent.

Furthermore, retention and recruitment are falling, while turnover is rising. Most of the nurses leave within the first year because of stress or lack of job satisfaction, self-confidence or the

requisite skills and knowledge. An inconsistent approach to assisting new graduate nurses to transition into work could compromise the quality of patient care and the overall standards of the

organization (Strauss, 2009). This situation indicates the requirement of investigation and justifies the choice of the topic.

Task 2- Identification of the question.

Using the PICO format, the following question was formulated:

Would the implementation of a “one-year graduate nurse program” instead of the current “three-month Departmental Orientation Program” improve the transition of new Saudi nurses to the

workforce?

POPULATION (P)    INTERVENTION (I)    COMPARISON (C)    OUTCOME (O)
new Saudi nurses    implementation of one-year “Graduate Nurse Program”    three-month “Departmental Orientation Program”    improve the transition of new Saudi nurses into work

The population of the area of concern consists of newly graduated and recently employed Saudi nurses. A search for evidence-based practice will be related to the proposed intervention of the

one-year “Graduate Nurse Program”. This intervention will be compared with the current three-month “Departmental Orientation Program”. Improved transition of new Saudi nurses into work is

the desired outcome.

Task 3- Formulation of search strategy, Task 4- Identification of five journal articles and their place on the NH&MRC evidence hierarchy, & Task 5- Justification and rationale for choosing each

article.

Using the PICO format, the question was initially broken down into different components. Synonyms for each term were then identified. The following terms and synonyms were used for the

search.

(new* OR graduat*) AND nurs* AND (transit* OR mov* OR shift*) AND (program* OR approach* OR strateg* OR train) AND (eas* OR assist* OR help*) AND (clinic* OR hospit* OR workforce) AND saudi*

The search for evidence commenced in CINAHL and Medline databases via the EBSCO host. The initial result was 683. In order to refine the research, Boolean operators were also used, limiting the

search to the last five years and selecting journal articles. This yielded about 200 articles, which could be further reduced to 84. The following three articles were selected:

1-
Reference:
Duchscher, J. (2009). Transition shock: the initial stage of role adaptation for newly graduated registered nurses. Journal of Advanced Nursing, 65(5), 1103-1113. doi:10.1111/j.1365-

2648.2008.04898.x

Accessed on 8 August 2013:

http://web.ebscohost.com.ezp01.library.qut.edu.au/ehost/pdfviewer/pdfviewer?sid=de07c541-0b32-436f-add1-8ce5c0f45d28%40sessionmgr12&vid=1&hid=26

Match Grade IV on the NH&MRC evidence hierarchy (NH&MRC, 2000).
This article deals with newly graduated registered nurses and explores the theoretical framework for the transition of new nurses into work, covering emotional, physical, sociocultural and

developmental considerations. The article also highlights the requirement for effective strategies to ease the transition.


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