An analysis of the factors affecting the transition period to professional roles for newly graduated nurses in Turkey.

BACKGROUND: For the majority of newly graduated nurses, the transition to professional roles in their lives may be stressful. Common reasons for this include feelings of insufficiency with regard to clinical skills, fears of making mistakes, increased responsibilities and insufficient guidance. AIM: To identify the factors affecting the transition period of newly graduated nurses. METHODS: This study was designed and carried out as a descriptive and a cross-sectional study of three cohorts of newly graduated students. The study was implemented at a military education and research hospital in Ankara, Turkey. The population consisted of 234 (89%) of newly graduated nurses. For evaluating data, the SPSS 15.0 program was used. The paired samples t-test and the Mann-Whitney U-test were employed to compare the participants' perceptions about the transition period based on certain variables. RESULTS: It is found that 54.7% of nurses surveyed have the intent to quit the profession. More than half of the participants stated that their expectations were met through working with a preceptor nurse (58.73%). Furthermore, almost half of the newly graduated nurses experienced and expressed disappointment in the first year of their professional lives. CONCLUSIONS: The findings indicate that newly graduated nurses experience some difficulty during this period of transition, but assistance from experienced nurses facilitates the transition period. IMPLICATIONS FOR NURSING PRACTICE AND RESEARCH: In order to increase work quality and satisfaction levels of new graduates, support programs must be initialized and their effectiveness must be evaluated regularly by clinical administrators and educators.

Comparison of responses to histamine by constant-flow and constant-pressure perfusion methods in the rabbit isolated kidney preparation.

1. Reproducibility and sensitivity of responses of isolated perfused rabbit renal vascular bed to bolus administration of histamine was compared for the conditions of constant-flow and constant-pressure perfusion by Krebs-Henseleit solution. Two other vasoactive agents (noradrenaline and angiotensin II) were also tested in the same preparation for comparison with the effect of histamine. 2. In constant-pressure mode, different hydrostatic pressures were also employed for the analysis of time-effect phenomena. 3. Drug responses were recorded by computer and were evaluated as changes of perfusion pressure or flow, to correspond to drug activities at the resistance vessels and, also, change of organ weight, as effects on exchange and capacitance functions of the circulation. Both parameters were also recorded on a Grass polygraph. 4. Reproducibility and sensitivity of responses to vasoactive agents (histamine, noradrenaline, angiotensin II) were significantly low in the constant-flow conditions, compared to constant-pressure mode. 5. Responsivity also deviated for different perfusion pressures of constant-pressure mode and 80-100 mm H2O pressure was found to be the most convenient value. 6. It is concluded that constant-flow and constant-pressure conditions provide different hydrodynamic conditions. In constant-flow methodology, when the predetermined perfusion rate is not tolerated by the vascular bed, excessive flow in the circulation would lead to depression of vasoactivity, failing pharmacodynamic equilibria and loss of responsivity. Structural deviation of the vascular bed would also be expected due to differences of organ specimen and, probably, result in the variation of responsivity of constant-flow perfusion procedure.

Complement (C3, C4) and C-reactive protein responses to cardiopulmonary bypass and protamine administration.

Complement activation has been deemed responsible for the damaging effects of cardiopulmonary bypass (CPB) in patients undergoing open heart surgery. We studied C3, C4 and C-reactive protein (CRP) in 22 patients undergoing CPB. In Group 1 (11 patients), protamine was given intravenously and in Group 2 (11 patients), via the aortic root after CPB. Significant decreases were observed in C3 and C4 during CPB in both groups indicating complement activation primarily by the classic pathway. Protamine did not lead to further activation of the complement system. In both groups, C3 levels gradually returned toward baseline within 24 hours but C4 levels were still lower than baseline 24 hours postoperatively. CPB and protamine administration did not cause any significant changes in CRP levels, but CRP increased abruptly 24 hours after operation. Although activation of complement system during CPB is expected to invoke an acute phase response, we conclude that this period is not long enough to induce an increased production of CRP in response to tissue injury or inflammation.