The Role Of Physical Design And Informal Communication And Learning In Reducing Stress And Gaining Competency Among New Nurse Graduates

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Graduate nurses experience a tremendous amount of stress as they transition from a student to a practicing nurse. Much of this stress can be attributed to a feeling of not having learned enough to function independently. While various formal learning strategies, such as graduate nurse orientation programs, have been implemented to solve this problem, not much attention has been paid to the potential of informal opportunities for learning. This study examined how components of the nursing unit ecosystem, including culture, organizational factors, technology, and particularly the physical layout, influenced communication and opportunities for informal learning, stress, and the gaining of nursing competencies during the formal orienting period. Five different data collection methods were used, including systematic observation of communication and interaction patterns, a survey of organizational climate and opportunities for informal learning, self-recorded blood pressure, competency ratings, and focused interviews. The physical environment, particularly backstage areas and clear sightlines within the nursing station, fostered opportunities for informal communication and on-the-job learning; as well as relationships among nurses that contributed to effective collaboration. A combination of factors was found to influence the GN learning experience including past experiences, unit culture, personal learning style, unit layout, and interaction with staff. The gaining of competencies was not associated with a reduction in stress, suggesting that other factors, particularly staffing levels, had more of an impact on stress than nursing competencies per se. The extent to which other social, organizational, and personal factors interact with staffing levels to produce stress or mitigate its effects deserves further study.
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