The performance and politics of practice for New Graduate Nurses

The change from nursing student to Registered Nurse (RNs) is both a desirable and anticipated event for New Graduate Nurses (NGNs). Having completed their formal education, most NGNs approach the threshold of their professional career with mixed emotions. While excited about the future and eagerly awaiting the commencement of employment, many are aware that this change also signifies a time of personal upheaval, professional insecurity and further personal learning. In the nursing professions’ enthusiasm to facilitate a smooth passage for NGNs a vast literature now addresses preparation-for-practice degrees, as well as the perceived workplace deficits and support needs of NGNs. However, the importance this change from working as a student to working as a NGN is not well conceptualised, theorised or understood as this largely instrumental literature essentially reduces the problematisation of the NGN transition experience to the problematisation of the individual by identifying NGNs as ‘the’ problem. Subsequently it fails to expose or challenge the normative assumptions underpinning processes that have formerly been considered solutions, or, the impact of such processes in a workplace that frames itself as “supportive”. Conspicuously absent is an exploration of how the NGN role is performed by former students, now beginning RNs undergoing the very personal transition of “becoming registered nurses”. Using Goffman’s (1956) theorisation of performance in everyday life exploring how process and meaning in mundane interactions present themselves in the “regular” lives of people at large, and Margaret Archer’s (2000) work emphasising the significance of the inner dialogue for managing the emotions that emerge out of situations that confront us, this paper draws upon data collected during a study of NGNs’ experience of transition to practice (Malouf 2010). It focuses on an emergent understanding of the need to differentiate the performance of ‘student’ from that of ‘NGN’ role. Further, it explores how these roles have become conflated into a conceptual continuum and viewed as a slide from student to NGN performance, rather than a significant moment of change involving roles that need to be distinctly defined as a necessary precursor to enhancing and supporting the professional and personal development of beginning practitioners.

Validation of a new hand-held electronic data capture method for continuous monitoring of subjective appetite sensations

Background When large scale trials are investigating the effects of interventions on appetite, it is paramount to efficiently monitor large amounts of human data. The original hand-held Electronic Appetite Ratings System (EARS) was designed to facilitate the administering and data management of visual analogue scales (VAS) of subjective appetite sensations. The purpose of this study was to validate a novel hand-held method (EARS II (HP® iPAQ)) against the standard Pen and Paper (P&P) method and the previously validated EARS. Methods Twelve participants (5 male, 7 female, aged 18-40) were involved in a fully repeated measures design. Participants were randomly assigned in a crossover design, to either high fat (>48% fat) or low fat (<28% fat) meal days, one week apart and completed ratings using the three data capture methods ordered according to Latin Square. The first set of appetite sensations was completed in a fasted state, immediately before a fixed breakfast. Thereafter, appetite sensations were completed every thirty minutes for 4h. An ad libitum lunch was provided immediately before completing a final set of appetite sensations. Results Repeated measures ANOVAs were conducted for ratings of hunger, fullness and desire to eat. There were no significant differences between P&P compared with either EARS or EARS II (p > 0.05). Correlation coefficients between P&P and EARS II, controlling for age and gender, were performed on Area Under the Curve ratings. R2 for Hunger (0.89), Fullness (0.96) and Desire to Eat (0.95) were statistically significant (p < 0.05). Conclusions EARS II was sensitive to the impact of a meal and recovery of appetite during the postprandial period and is therefore an effective device for monitoring appetite sensations. This study provides evidence and support for further validation of the novel EARS II method for monitoring appetite sensations during large scale studies. The added versatility means that future uses of the system provides the potential to monitor a range of other behavioural and physiological measures often important in clinical and free living trials.