At the same time, care complexity is rising. On average, patients are older and have more chronic comorbidities. Care processes—including electronic documentation and more standardized protocols—are becoming more complex, while length of stay is getting shorter.
As a result of this rising complexity, it’s more difficult for nurses to transition to practice, for at least three reasons. First, nurses have more to learn to be considered competent. They must have a richer understanding of pathophysiology, understand a wide range of treatment options, and be prepared to deliver highly complex care. Second, it’s harder for nurses today to learn on the job. There are no more “easy” patients to assign to new graduates as low-stakes learning opportunities. And because there is more to do in less time, nurses have less time to focus and reflect on their own development. Finally, the shortage of experience means there are fewer expert nurses to mentor and provide feedback.