Baccalaureate degree nursing graduates in Canada are prepared for generalist nursing practice and have a solid grounding in critical thinking, clinical reasoning, self-evaluation, self-regulation, and inter-professional practice skills (CASN, 2016). It is not uncommon for senior students to lack confidence in their abilities and to feel overwhelmed with respect to their upcoming nursing role (Guner, 2014; Saber, Anglade, & Schirle, 2015). The nursing work environment poses numerous challenges for new graduates and this time of transition can be extremely stressful. Unique transitional challenges occur when new graduates are from ethnically diverse backgrounds and include lack of emotional and moral support, discrimination, isolation and loneliness, and family responsibilities (Loftin, Newman, Dumas, Gilden, & Bond, 2012).
Due to their own lived experiences, Indigenous nurses are considered experts in providing care to Indigenous peoples (Exner-Pirot & Butler, 2015). Cultural congruency between nurses and clients results in positive therapeutic relationships and enhanced satisfaction with care provided, which can positively influence the health status of Indigenous peoples (Banister, Bowen-Brady, & Winfrey, 2014).
Numerous issues hinder the success of Indigenous new nursing graduates (Kulig et al., 2010). Job dissatisfaction and turnover can occur in an already stressful work environment for a newly graduated Indigenous nurse due to racial challenges, strained interprofessional relationships, and lack of inclusivity in the workplace (Kulig et al., 2010).
By understanding the readiness for practice perceptions of Indigenous nursing students and facilitating the successful transition from student to nurse, nursing education programs can honor the Truth and Reconciliation Commission of Canada’s (2015) Calls to Action related to: 1) increasing the number of Aboriginal professionals working in the healthcare field and 2) ensuring the retention of Aboriginal healthcare providers in Aboriginal communities. Overall, Indigenous peoples represent an important and growing part of the Canadian population and this study aimed to address the lack of literature regarding Indigenous nursing students’ preparedness for practice and new graduates’ experiences as they transition into practice.
Purpose
The purpose of this presentation is to explore the readiness for practice perceptions of senior undergraduate nursing students of Indigenous ancestry.
Methods
A descriptive, exploratory study design was utilized for this project which was conducted in the province of Saskatchewan, Canada. The Readiness for Practice Survey (Casey, Fink, Jaynes, Campbell, Cook, & Wilson, 2011) was used to measure senior nursing students’ perceived readiness for practice and was divided into three sections: 1) demographic data, 2) a self-report on level of confidence and comfortability with both clinical and relational skills, and 3) an open-ended question related to students’ perceptions on what could have assisted them to feel more prepared to enter nursing practice (Casey et al., 2011). Indigenous nursing students who were in the final two months of their nursing program were eligible to participate in the study. Quantitative data were entered, stored, and analyzed using SPSS (v. 23) software.
Results
Twenty-six First Nations and Métis senior nursing students participated in the study. The mean age of participants was 29 years and the majority were female. Participants specified the nursing skills they were most uncomfortable performing were electrocardiogram or telemetry monitoring and interpretation, responding to an emergency or code blue, and performing trach care and suctioning. Students indicated their level of comfort in caring for two, three, and four patients and students became less confident as the number of patients they cared for increased. When asked what could have been done to help students feel more prepared to enter the nursing profession, participants had several suggestions including greater assistance with NCLEX preparation, additional clinical hours, greater physiology and pharmacology in upper years, and more hands-on practice with nursing related paperwork.
In terms of students’ perceived clinical problem solving, they believed they used evidence to make clinical decisions and they were confident in their ability to problem solve. They also felt confident identifying actual or potential safety risk to patients. Students were least comfortable knowing what to do for a dying patient. When considering student learning perspectives, students believed simulation activities assisted them in being prepared for clinical practice. The least effective learning strategy they perceived was reflective journal writing.
Most participants were satisfied in choosing nursing as a career, however, they were less confident in their readiness for entering the nursing profession. Students were comfortable asking for help and communicating with patients and family members. Participants did not feel overwhelmed with ethical issues and believed they had opportunities to practice skills more than once.
Implications for Nursing Curricula
The readiness for practice experiences of Indigenous nursing students from our study appear to be similar to other research projects that have sampled from a non-Indigenous population (Casey et al., 2011; Saber et al., 2015; Usher, Mills, West, Park, & Woods, 2015; Woods, West, Mills, Park, Southern & Usher, 2014). Based on our study findings, cultural background does not appear to influence students’ readiness for practice perceptions. This study contributes to the sparse literature on readiness for practice perceptions of Indigenous nursing students and demonstrates that feelings of lack of preparation are common for most senior nursing students as they transition into the workforce regardless of cultural heritage. Nurse educators have a responsibility to facilitate student supports that increase confidence, decrease anxiety, and promote successful transition of new graduates into the nursing workforce.