Reality shock refers to a situation whereby new nurses face the challenge of implementing the ideal within a constrained work environment. New nurses may become disenchanted during the reality shock period. According to Nagelkerk (2006, p. 15), there are four phases of reality shock, which are the honeymoon, shock, recovery, and resolution phases. Each of the four phases has various characteristics. For instance, nurses in the honeymoon stage are excited by completing their training and are pleased with being real nurses, are enthusiastic, focused on learning work routines and perfecting their skills, and have high energy levels (“Critical Thinking”, 2016). Nurses in the shock phase exhibit anger, moral outrage, frustration, disappointment, disillusionment, and confusion. They may also realize that their values are not similar to requirements of real nursing and may also feel discouraged by their failure to grasp all the information as fast as they would have wished to. The recovery phase is characterized by factors such as reduced stress, enhanced ability to understand all the information required for the role, and a returned sense of humor among the new nurses (“Critical Thinking”, 2016). In the resolution phase, new nurses may define the type of professionals they want to become, may adopt values and beliefs that less than ideal to fit with their co-workers, and may flee their work and return to school or seek other jobs.
Matt is experiencing the shock phase of a reality shock. He has just experienced the honeymoon phase through his orientation to the surgical-medical unit of the hospital. However, he has now been asked to take care of ten patients, something he feels he does not have the ability to. He is confused as he does not know how best to deal with the different patients he is asked to provide with care. Additionally, he is frustrated and feels that he did not receive adequate help from the nurse charge.

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There are various things that the preceptor can do to help Matt through the shock phase. For instance, he could encourage Matt to focus on the good things that happened during the shift rather than those that went wrong. Some of the good things that Matt could concentrate on include his ability to infuse a patient with blood, to administer a PRN sedative to the confused patient, and to access the confused patient and make arrangements for the patient’s x-ray. The preceptor can also encourage Matt by letting him know that as a learner, he is not expected to be proficient at performing all skills. The preceptor should also be a good listener and should encourage Matt to speak freely about the things he feels should change. Additionally, the preceptor should help Matt to focus on the things he has learned and can perform independently, such as infusing patients with blood.

Matt lacks various qualities of a successful healthcare professional. For example, he lacks empathy, which is the ability to understand what others, especially his patients, are feeling or experiencing. He does not seek to understand what the confused patient is experiencing, and he quickly administers a PRN sedative. He also lacks the ability to multitask excellently. He is overwhelmed by the provision of healthcare to only two patients. Matt needs to improve his communication skills, especially his listening skills, to improve his empathy. He should listen to patients more to identify their problems and experiences and determine the best ways of addressing such challenges and experiences. He should also obtain as much information as possible on how to perform the various clinical tasks to improve his ability to perform them concurrently. He should also seek as much experience as possible in the performance of the different clinical tasks as practice makes perfect.

  • Critical Thinking. (2016). Retrieved 8 April 2016, from
  • Nagelkerk, J. (2006). Leadership and Nursing Care Management (3rd ed.). Elsevier Health Sciences.