The Effect of New Nurses’ Clinical Competence on Career Adaptation

Background New nurses need a certain period of time to adapt to the organization due to a lack of clinical competence, and also immaturity in social skill. The purpose of this study was to evaluate the effects of new nurses’ clinical competence on career adaptation in order to use the results as basic information for developing education programs to improve their adaptability in clinical practice. Method This study employed a descriptive survey to investigate the clinical competence and the career adaptability of new nurses working in a general hospital. The study subjects were 61 new nurses with less than one year of work experience and data was collected from June, 2018 to July, 2019. Data was analyzed using frequency analysis, descriptive statistics, t-test, ANOVA, Pearson’s correlation coefficients, and multiple regression analysis. Results On average, the study subjects have worked for 11.33±1.51 months. In this study, the average clinical competence of new nurses was 2.21±0.61, and career adaptability was 3.00±0.39. The clinical competence of new nurses was positively correlated with career adaptability (r=.453, p<.001). Among the sub-categories of clinical competence, developing professional and legal implementation were found to affect career adaptability (t=2.24, p=.030). Conclusion The clinical competence of the new nurses was shown to positively affect their career adaptability, and it was confirmed that developing professional and legal implementation in the subcategories of clinical competence affected the career adaptability of the new nurses. Thus, it is necessary to establish a program that provides support for new nurses to enable them to build professional identities that they can be proud of.


Introduction
With the recent advances in medical technology and the improvement of people's living and 59 educational standards, interest in quality medical services, as well as demand for high quality 60 nursing care, have increased. Accordingly, nurses must acquire sufficient medical knowledge 61 and competent skills [1]. However, new nurses are facing many challenges in the fast-paced 62 hospital environment while also experiencing high stress and maladjustment [2]. 63 New nurses are those who have graduated from a nursing college in Korea and obtained a 64 nurse's license with working experience of less than 12 months after being employed in a 65 medical institution [3]. New nurses face a lot of stress in their clinical careers after their first 66 year of graduation as they have to deal with the gap between high expectations and reality in 67 the following aspects: their practical skills; demand for knowledge and skills required for 68 nursing work; three-shift working environment; increased responsibility for nursing behavior; 69 subtle interpersonal relationships with colleagues; and formation of interpersonal relationships 70 with patients and caregivers [4,5]. In addition, new nurses need a certain period of time to 71 adapt to the organization due to lack of clinical competence, difficulty in making their own 72 decisions, and immaturity in career adaptability [6]. 73 Clinical competence means the ability to perform the task of obtaining the expected results 74 in the practical working environment, and new nurses are required to secure necessary clinical 75 competence for them to grow into professional nurses and adapt to clinical practice [7]. 76 However, it has been pointed out that the clinical competence of graduated nurses does not 77 meet the demands of the nursing field in the hospital setting, and the maladaptation of new 78 nurses to the nursing field due to lack of clinical competence has a negative effect on job 79 satisfaction and professional identity among clinical nurses, resulting in turnover [3]. The  Career adaptability is the process of accepting the established policy of an organization to 87 which an individual belongs, internalizing the organization's norms and values, and forming a 88 professional identity through the work-related knowledge, skills acquisition, and supportive 89 interrelationships that the organization needs to transform into a productive member of the 90 organization [9]. However, new nurses are overwhelmed by psychological pressures, tensions, 91 and fears associated with the characteristics of nursing work, and they easily make mistakes or 92 errors due to their inexperience. As a result, they lose their self-confidence and self-esteem and    The subjects of this study were new nurses with less than a year of work experience in 121 general wards, intensive care units, and emergency rooms and those who provided direct care 122 to patients in their assigned service department for less than a year.

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They agreed in writing to participate in the research. Excluded in this study were the nurses 124 who did not agree to participate or those who did not provide direct care to patients such as   Each question has a five-point scale, ranging from 1 point for 'Never' to 5 points for 'Always'.

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Higher scores indicate higher career adaptability. In the study conducted by Sohn et al. [2], the 149 Cronbach's α was 0.97, and that of this study was 0.85. 158 159 Statistical analysis 160 The data was analyzed using IBM Statistics 24 program and the two-tail test was conducted at 161 95% level of confidence to determine statistical significance.

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The general characteristics, clinical competence, and degree of career adaptability among 163 the subjects were analyzed through frequency, percentage, mean, and standard deviation.

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The new nurses, who were the subjects of this study, were mostly women (85.2%) and the 178 majority had obtained a bachelor's degree (95.1%) ( Table 1)

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The purpose of this study was to examine the clinical competence and career adaptability as with other departments were extended [25]. Therefore, specific educational programs to reduce 260 conflicts in their roles, which may be caused by the expanded role of new nurses, and practical to develop a program that helps form the professional identity and pride of new nurses.

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The significance of this study may be found in the fact that it provided the basis for