Running head: RECOGNIZING THE CHALLENGES OF ROLE TRANSITION

Recognizing the Challenges of Role Transition

Sarah Scott
Athabasca University
Exploration of Professional Nursing Practice
NURS 250
Adrienne Weare
July 9, 2016
Recognizing the Challenges of Role Transition
I have been a licensed practical nurse for 14 years, and in the field of healthcare for
nearly 20. Most of my career has been in long term care, but I did spend close to 3 years in acute
care as well. I currently work in a long term care facility where I attend to all aspects of nursing
care for 22 residents. I also supervise 3 continuing care aids in their provision of care. Although
I have access to an RN who is often merely on-call, I am expected to work independently and
seek input only when absolutely necessary. I value the independence and well roundedness that
this position has given me: I administer medications and treatments, but I also make care plans
and conduct reviews with residents next of kin, among other things. Supervising is also

something I value in this position, as I feel it is something that I need constant experience in,
since I am not a natural leader.
While I value the responsibility I have in my current role, it is also frustrating that there is
such a gap between the wage of an LPN and the wage of a registered nurse. As a senior LPN, in
the absence of an RN I am often in charge of 2 other care areas and am required to provide
direction to fellow employees when necessary. I receive no additional pay for this responsibility
however.
Another area of frustration is the impact that decisions made by managers with no
nursing background (and therefore little insight) have on my provision of care. I am often left to
deal with the poor decisions that are made without input from nurses. Sometimes this means
having to try to justify these decisions to family members who feel that our efforts are
inadequate, other times it means feeling moral stress about some issue that management has
chosen to ignore, after I have attempted to advocate for the resident. However; this could change
when I become an RN if I want to take on a management role. Otherwise, I dont predict much
improvement, as my managers tend to place little value on the input from direct care staff.
Despite this, I have developed qualities as a nurse in this position that I am proud of.
My assessment skills are a direct result of my LTC experience. In this setting we have
few tools to rely on for our judgement calls, so experience plays a large factor. Because I
possess strong assessment skills, I dont feel inferior about other skills that I have become rusty
on because I know that I can refresh those skills without much difficulty, if I am conscientious,
whereas assessment skills develop over time.
Another skill that I have, is prioritization. In my current role I am expected to provide all
nursing care (except for routine personal care) for 22 residents, while also supervising 3

RECOGNIZING THE CHALLENGES OF ROLE TRANSITION

continuing care assistants, dealing with any emergent situations, and various administrative tasks
(booking appointments, processing orders and conducting care plans). Some days, this means I
am pulled in many directions. I have learned to adapt quickly, maintain my composure, and to
delegate where appropriate.
Lastly, in the past couple years in particular, I have been focusing on providing teaching
at every opportunity. Our doctor makes weekly visits, and is often rushed. As a result, he often
gives orders without actually speaking to the resident. I have learned to weave teaching into
daily activities. I have noticed that residents tend to be intimidated by the doctor and are more
likely to ask me questions than they would him.
I believe that there is always room for improvement in my practice as an LPN. One thing
that I have slowly worked on over the course of my career is my communication skills. I have
dramatically improved in the area, but still find that I can sound too unprofessional or unpolished
in my communication with other members of the multidisciplinary team or family members. I
was always a very shy person, so communication has always been my flaw, but I will expect
more of myself as I transition.
Another characteristic that needs work, is my reluctance to delegate. I find it difficult to
justify it unless I am getting behind in my work. I believe it is due to a fear of being considered
lazy by my co-workers, whom I wish to respect me. It can become a problem when I start
getting busy: I wait too long to ask for assistance (at the cost of my own stress level, not at the
cost of resident care). I know as an RN I must be proficient at delegation-not only being
comfortable in doing so, but in knowing what can or cant be delegated. This will be especially
important should I decide to return to acute care.

RECOGNIZING THE CHALLENGES OF ROLE TRANSITION

I anticipate that transitioning to an RN role will be somewhat challenging. For one thing,
I would expect that I will have less time to interact with residents/clients than I do as an LPN. It
was also mentioned as an area for concern among other LPNs transitioning to RN (Melrose &
Wishart, 2013). I feel that I will be expected to provide more detailed care for a patient that I
actually know less, which does concern me. Since beginning the post LPN to BN program, I
can now start to see a slight difference between LPNs and RNs. For instance, I can understand
why an LPN would be best suited for predictable outcomes, where an RN would be more
prepared for acute or emergent alterations, because RNs learn more physiology theory than we
LPNs do. In this sense, I will be a new nurse: I will be expected to carry on with acute
situations, and assessments will include following through. Another concern about transitioning
is that there will no longer be the security of knowing that someone else will have a final answer
for me, should I need to rely on her, instead I will eventually be someone elses final answer.
As I progress through my degree I am absorbing information and am therefore slowly
evolving I quietly include some of this new knowledge into my LPN practice, but no one expects
it from me, but once I finish my education and become an RN, there will be an abrupt change
where I will be expected to perform as an RN-a new graduate, and shed my identity as an LPN.
Also, once this occurs, I fear my nursing experience (as an LPN) will no longer be valued, much
like the nurse who wants to have LPN and RN on her name tag (Melrose & Wishart, 2013), I
wish my experience as an LPN could still be tied to my new role as an RN, and that the years as
an LPN would be deemed relevant to my RN role.
The entire process of the planned change of transitioning to RN , for me, is best
described, by Lewins change model: unfreezing, moving, and refreezing (Koernig Blais &
Hayes, 2011, p. 257). Unfreezing occurred when I recognized that it was my desire to further my

RECOGNIZING THE CHALLENGES OF ROLE TRANSITION

studies, finding the motivation to do so by reflecting on the fact that, though I was 39 when I
began the process I would still have many years left in the workforce, and the years spent
studying would pass, whether I was in school or not. Moving is now taking place. I am in
school, and every course I complete in this degree literally moves me closer to the goal of
becoming an RN. Additionally, at work I am constantly reflecting on what I learn and
anticipating how it is going to affect my future as an RN, and how I can improve as an LPN in
the meantime. Unfreezing will occur over the course of my initial experience as an RN: I will
experience pressure in the form of an unfamiliar role with higher expectations placed on me by
myself as well as others, but I will eventually find my own identity as an RN, as I did when I
transitioned from CCA to LPN.

RECOGNIZING THE CHALLENGES OF ROLE TRANSITION

References
Koernig Blais, K., & Hayes, J. S. (2011). Change process. In M. Connor (Ed.), Professional
nursing practice concepts and prospectives (6th ed., pp. 253-269). Upper Saddle River,
NJ: Pearson.
Melrose, S., & Wishart, P. M. (2013). Resisting reaching out and re-imagining to independence
LPNs transitioning towards BNs and beyond. International Journal of Nursing
Education Scholarship, 10(1), 107-113. http://dx.doi.org/10.1515/ijnes.2012-0033