AN INVESTIGATION INTO THE CHALLENGES NEWLY INDUCTRINATED NURSES ENCOUNTER DURING NIGHT SHIFTS IN GENERAL HOSPITAL UMUAHIA, ABIA STATE

CHAPTER ONE

INTRODUCTION

Background of the study

In healthcare settings, reality shock is a recurring worry, especially for just graduated nurses. Reality shock typically appears three to six months after these nurses start working, presenting as a perceived disconnect between their learnt practical abilities and what the clinical setting requires. The phrase "transition shock" has recently gained popularity as a way to describe graduates' feelings of bewilderment, loss, and disorientation as they adjust to the new duties, expectations, and performance requirements that come with being practitioners as opposed to students [Duchscher, 2019]. The first year of work is a crucial time for recently minted nurses to establish their career paths. As a result, the first phase has a significant impact on their long-term career growth and pleasure. In addition to endangering these nurses' ability to advance in their careers and raising their turnover rate [Yang et al, 2024], failing to manage reality shock during this transitional period has a substantial financial impact on the organisation. Reality shock among recently graduated nurses can be caused by a variety of factors, including low competence and self-efficacy [4], the heavy burden of patient care [Epstein et al, 2020], poor communication skills for managing patients' psychological needs, and difficulties striking a balance between work and personal obligations [Epstein et al, 2020]. Additionally, the start of night shifts, which are usually performed at a period of increased susceptibility to reality shock, makes these graduates' struggles much worse [Kubo et al, 2022]. Thus, it becomes vital for freshly minted nurses to accustom themselves to night shifts as a critical method for avoiding reality shock. Nurse rosters come in several formats. One sort of shift divides the day into three shifts, each lasting eight hours. A other kind splits the day into two shifts: nurses work 12-hour shifts, day shift workers work 8-hour shifts, and night shift workers perform 16-hour shifts from late at night to early in the morning [Kubo et al, 2022]. Whichever kind they are, nurses who work night shifts must adjust to a different pace of life than their colleagues who work during the day. As a result, shift workers frequently suffer from sleep disorders that are marked by reduced sleep duration and poor quality of sleep, which are linked to irregular sleeping patterns and insufficient downtime in between shifts [12–14]. Notably, many freshly graduated nurses, particularly those used to night shifts, also report sleep difficulties due to abnormalities in their sleepwake cycle [Han, Kim, Lee & Lim, 2019]. As a result, nurses who work night shifts frequently experience cognitive deterioration and decreased productivity [Han, Kim, Lee & Lim, 2019]. In addition, nurses working night hours usually have more patients to attend to than those working day shifts. For recently graduated nurses, who must independently assess patient care requirements and priorities on their own, this increased workload presents a unique difficulty. Furthermore, because night shifts need lower staffing, recently minted nurses must choose whether concerns are serious enough to report and discuss with senior colleagues. For recently graduated nurses, night shift work therefore entails significant and onerous obligations. A number of programs have been put in place to assist recently graduated nurses with their transition. These programs include the introduction of preceptors, who offer crucial psychological and physical resources, and simulation training, which improves clinical abilities. Nurses and organisations can benefit from the introduction of strategies that have been associated to higher competency, self-confidence, and work satisfaction [Han, Kim, Lee & Lim, 2019], as well as a lower turnover rate among freshly graduating nurses. Nevertheless, little study has been done to date on initiatives designed expressly to help recently graduated nurses transition to night work. Graduating students can perform orientation shifts at some Japanese hospitals with senior nurses as supplementary staff over numerous night shifts. They will get step-by-step guidance until they are able to function independently. However, the effectiveness of these orientation programs is still unknown, and there hasn't been much development in the way of night shift support services. In the lack of such support programs, recently graduated nurses are forced to adjust to night shifts by using personal coping mechanisms, which are frequently found to be insufficient in reducing sleep disruptions and weariness [Han, Kim, Lee & Lim, 2019]. To create a support program that will help freshly graduated nurses adjust to working nights without difficulty, it is critical to comprehend the unique difficulties that they will encounter. Nevertheless, only a small number of studies have focused on the difficulties and experiences recently graduated nurses have when working night hours. Determining the necessary level of preparedness for night shifts is made easier by recognising the difficulties faced by recently graduated nurses. Furthermore, defining this preparedness makes it possible to create supporting policies that will improve their ability to adjust to working at night. By putting such a program into place, the strain of working night hours for recently graduated nurses may be reduced, which reduces the likelihood of turnover and reality shock. Therefore,the researcher sought to investigate  the challenges newly inductrinated nurses encounter during night shifts in General hospital Umuahia, Abia State.

Statement of the problem

The healthcare system depends heavily on recently minted nurses, yet there are many obstacles to overcome when they go from classroom instruction to clinical practice, particularly while working night hours. Although night hours are essential to providing patients with care around-the-clock, they pose particular challenges for inexperienced nurses. These difficulties may have a major impact on their productivity, general job satisfaction, and well-being (Lin et al., 2019). During night shifts, tiredness from disturbed sleep patterns, inadequate mentoring, and restricted access to resources and support systems are the main problems experienced by recently graduated nurses (Baumberger-Henry, 2021). Fatigue can impair cognitive processes and increase the likelihood of errors in patient care, which puts nurses and patients at risk (Scott et al., 2019). Fatigue can also be made worse by irregular sleep habits. Furthermore, the lack of seasoned personnel during night shifts makes novice nurses feel alone and unsupported, which raises their anxiety and stress levels even further (Andrews & Djukic, 2020). The lack of resources and support services at night adds to this feeling of isolation, making it more challenging for recently graduated nurses to handle complex patient cases (Manookian, Cheraghi, & Nasrabadi, 2020). The confluence of these elements may result in early career attrition, burnout, and job discontent; research indicates that freshly graduated nurses experience a high turnover rate in their first year of work (Hutchinson et al., 2020). Healthcare organisations run the danger of losing skilled nurses if these problems are not resolved, especially at a time when nurse shortages are already a major worldwide issue. Hence, the study investigate the challenges newly inductrinated nurses encounter during night shifts in General hospital Umuahia, Abia State.

1.3 Objective of the study

The broad objective of the study is to investigate the challenges newly inductrinated nurses encounter during night shifts in General hospital Umuahia, Abia State. The specific objectives is as follows

To identify the physical challenges newly inductrinated nurses face during night shifts

To examine the impact of night shift work on the mental well-being of newly inductrinated nurses.

To investigate the coping strategies employed by newly inductrinated nurses in managing the challenges associated with night shifts

1.4 Research questions

The following questions have been prepared to guide the study

What are  the physical challenges newly inductrinated nurses face during night shifts?

What is the impact of night shift work on the mental well-being of newly inductrinated nurses?

What are the coping strategies employed by newly inductrinated nurses in managing the challenges associated with night shifts?

1.5 Significance of the study

Findings of the study will be significant to hospital administrators and managers as they will gain a deeper understanding of the unique stressors that affect newly graduated nurses on night shifts. This knowledge can inform policies and interventions to create a more supportive work environment. Improvements in supervision, mentorship programs, and the availability of resources can reduce job-related stress, lower turnover rates, and promote better patient care.  Findings of the study will also be significant to the academic community as it will contribute to the existing literature, add to library resources and serve as a guide to future academic researchers.

1.6 Scope of the study

The study focus on the challenges newly inductrinated nurses encounter during night shifts in General hospital Umuahia, Abia State. Empirically, the study will identify the physical challenges newly inductrinated nurses face during night shifts, examine the impact of night shift work on the mental well-being of newly inductrinated nurses and investigate the coping strategies employed by newly inductrinated nurses in managing the challenges associated with night shifts.

Geographically, the study will be delimited to General hospital Umuahia, Abia State

1.7 Limitation of the study

Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. The significant constraint are: 

Time: The researcher encountered time constraint as the researcher had to carry out this research along side other academic activities such as attending lectures and other educational activities required of her.

Finance: The researcher incurred more financial expenses in carrying out this study such as typesetting, printing, sourcing for relevant materials, literature, or information and in the data collection process.

Availability of Materials: The researcher encountered challenges in sourcing for literature in this study. The scarcity of literature on the subject due to the nature of the discourse was a limitation to this study.

1.8 Definition of terms

Newly Graduated Nurses: Nurses who have recently completed their formal education and training in nursing and are transitioning into professional practice, typically within the first year of employment.

Night Shifts: A work schedule that typically starts in the evening and ends in the morning, usually between 7 p.m. and 7 a.m. Night shifts are part of the rotating shifts that nurses may be required to work in hospitals and other healthcare settings.

Fatigue: A state of physical and mental exhaustion caused by prolonged work hours, lack of rest, and disruption of normal sleep patterns, which can impair a nurse's ability to perform effectively.

Supervision: The guidance and oversight provided by more experienced nursing staff or healthcare managers to assist newly graduated nurses in their professional duties, especially in clinical decision-making and patient care.

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