Case Studies and Answers

Zerwekh: Nursing Today: Transition and Trends, 11th Edition Case Studies and Answers

Chapter 1: Role Transitions

Case Study 1

• P. graduated from nursing school 1 month ago and passed the NCLEX

® Exam last week and has always dreamed of becoming a nurse and is excited to begin this new career. J.P.'s ultimate goal is to work in the critical care field. To gain the necessary experience, J.P. accepted a position on a busy medical telemetry unit. Before the first day, J.P bought new scrubs to replace the nursing school uniform, books on critical care nursing, new shoes, and a stethoscope. Then J.P reviewed the notes from classes, knowing that she would soon be entering the "real world" of nursing. J.P felt prepared to step into this new role and confident in the nursing education.After the first month, J.P felt physically sick when driving to work feeling overwhelmed with nursing responsibilities, constantly double-checking everything to make sure tasks were completed accurately she began to doubt having the ability to perform in the nursing role competently. Her mentor assured J.P that these were normal issues experienced by almost all nurses during the transition period into nursing. When the unit manager questioned J.P about the amount of overtime that had accumulated, J.P burst into tears.A.What are some of the indicators that J.P was initially in the "honeymoon" phase of reality shock?Correct Answer The purchases and preparation J.P made prior to the first day of work and the high career goals before working as a new nurse.B.How did J.P manifest characteristics of the "shock and rejection" phase?Correct Answer Feeling physically sick and overwhelmed, doubting her ability, and constantly double-checking everything, being extremely emotional.C.What steps could J.P take to adapt to her new environment successfully and cope with the reality shock?Correct Answer The most successful nurses are those that "make a lot of waves." If J.P took the initiative to make changes, openly verbalize feelings, and worked toward improving the current system, it might make the transition easier.Copyright © 2023 by Elsevier, Inc. All rights reserved.Case Solutions For Nursing Today 11e JoAnn Zerwekh, Ashley Zerwekh Garneau (All Chapters, 100% Original Verified, A+ Grade) 1 / 4

Case Studies and Answers Case Study 2 Assignment: During one of your clinical rotations, interview a nurse on the unit who has graduated within the last 4 to 5 years. Ask the nurse about his or her experiences with the phases of reality shock (honeymoon, shock and rejection, and recovery). Use the following outline for your interview.A.Honeymoon I.How did you feel when you graduated from nursing school?II.What did you do to prepare for your first nursing position?B.Shock and rejection I.Did you have any physical problems during your first year as a nurse—for example, fatigue, an upset stomach, or a lot of minor aches and pains?II.Did any events occur to make you feel uncertain or question your decision to become a nurse?B.Recovery I.When did you begin to feel good about your career as a nurse?II.What events made you feel good and supported your decision to become a nurse?Bring your findings back to class for discussion.A.What themes emerge from the discussion on the honeymoon phase?

Correct Answer Focus on identifying students' own perceptions of nursing versus those of the experienced nurses. Guide students to recognize signs of the honeymoon phase with their own understanding of how the transition will occur.B.What themes emerge from the discussion on the shock and rejection phase?

Correct Answer This exercise allows students to understand that the experienced and competent nurses they see on the units also experienced phases of reality shock during their own transitions. Identify key themes and relate them to Table 1-1 in the textbook.C.What key themes arose from the discussion on recovery?

Correct Answer Focus on students' ability to identify key events that prompted the nurse to begin recovery. Discuss how students will know that the recovery phase is occurring during their own transition.Copyright © 2023 by Elsevier, Inc. All rights reserved.

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Case Studies and Answers D.Which coping strategies did the interviewed nurses use during their transition? Which were most frequently used? Which were most effective?Correct Answer Assessment: Write down the coping strategies, keeping a tally of frequency. Discuss why each strategy was (or was not) effective.Case Study 3 In your last semester of nursing school, you note that your clinical instructor changes teaching tactics. No one looks over your shoulder any longer during every assessment, you are allowed more freedom to perform assessments and make clinical judgments, the clinical hours coincide with normal shift hours, and you are allowed to volunteer to perform nursing procedures with staff nurses. Although this makes you nervous, you realize that this is necessary for your transition into nursing practice.A.Identify strategies used by the instructor to assist you in your transition.

Correct Answer Allowed independence, scheduled your clinical hours similar to normal shifts, allowed you to volunteer to perform nursing procedures.B.What other steps could the clinical instructor take to assist your transition to nursing?

Correct Answer Realistic patient assignments, more critical thinking challenges, requested clinical experience in your areas of interest, requested feedback on clinical performance from the instructor or nurse.C.What strategies does your nursing program use to assist students to transition into realistic nursing practice?

Correct Answer

Assessment: Student should look at their own clinical nursing experiences and

identify methods used to assist the transition.D.Identify a support system that can assist you during the transition period.

Correct Answer Copyright © 2023 by Elsevier, Inc. All rights reserved.

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Case Studies and Answers Assessment: Students should identify available support systems, including family (if appropriate), husband, wife, boyfriend, girlfriend, significant other, friends, and mentor-preceptor.Case Study 4 Three orthopedic staff nurses at a local hospital went out to dinner after their busy shift.The discussion shifted from talking about their horrible day to how they each arrived at this specific point in their lives. Each nurse's story started with their decision to become a nurse.

• is a 45-year-old married parent of two who decided to go back to school 10 years ago

when the position at a local business was eliminated. Initially, L. thought that becoming a nurse would provide a way to maintain the lifestyle and support the family. L.’s first position was as an emergency room nurse at an inner-city hospital, that lasted 2 months before L.’s spouse threatened a divorce if, “You didn't slow down”. Bouncing from different units in various hospitals, L. came to this present position 4 years ago.

• is a 23-year-old new nurse with 1 year of experience on the orthopedic unit. C.’s story

included the decision to become a nurse in high school when taking a vocational class. C.described having a lot of trouble going from high school and being a straight A student to the university setting, where C. thought about dropping out several times. That is when C.met a fiancé a month after graduation, and their wedding is in 2 weeks.

• is a 30-year-old divorced parent of three who described taking a long time to work

through nursing school. T. decided to go to nursing school a month after the divorce but had to support the children at the same time. T. just bought a home and plans to go back to school for a graduate degree next fall.A.What transitions have each of these nurses experienced in their stories?

Correct Answer Students should be able to identify positive and negative transitions in each nurse's story.B.Which nurse is most likely to have experienced reality shock during the transition from student to nurse?Correct Answer Create a compare and contrast discussion in which students justify their responses.Allow students to expand on the given content to explore possibilities in each story.(For example, what difference could it make if T.'s initiated the divorce rather than coming as a complete surprise? What if each nurse had a strong support system? No support system?) C.Everybody has a story. Which story best represents your own experiences?

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