New Graduate Nurse Transition Into the Intensive Care Unit: Qualitative Insights From a Longitudinal Study—Part 1

Abstract

Background and PurposePatients admitted to intensive care units (ICUs) are critically ill and suffer from life-threatening sickness of injury. To work in ICU, registered nurses require additional knowledge and skills. While practices regarding the hire of new graduate nurses (NGNs) into settings such as the ICU vary, it is common that NGNs are being hired. However, NGNs in general, are at a higher risk for turnover within the profession as compared to their more experienced colleagues. NGNs in ICU settings may be at higher risk of turnover due to the complexity of the care context. It is of particular importance that the experiences of NGNs in ICU be explored with the intent of identifying what these nurses experience but also to consider how they can be best supported during a period of transition. This manuscript reports the findings from a mixed design study that sought to understand the transition of a cohort of NGNs over a period of 2 years.MethodsThis study used both a purposive and convenience sample of NGNs. The qualitative component incorporated Thorne's (2016) interpretive description. Face-to-faceinterviews were completed.ResultsFive themes were identified: an emotional transition, a social transition, a transitioning mindset, transitioning through firsts, and transitioning with confidence. Within each theme, there is a distinct difference and elements of transition were evident. Findings demonstrate that the NGNs appeared to be more confident in their skills and in their nursing practice over time. Findings from this study provide important insight into the experiences of NGNs in ICUs.

Intensive care as a specialty of choice for registered nurses: A descriptive phenomenological study

“…Thus, they felt confident and progressed to the next level. This transition with confidence also resonates with previous studies 10,26 . Some participants disclosed that gaining knowledge over time made them feel accepted and trusted among the team, and as a result, they felt satisfied and more comfortable.…”

“…This transition with confidence also resonates with previous studies. 10,26 Some participants disclosed that gaining knowledge over time made them feel accepted and trusted among the team, and as a result, they felt satisfied and more comfortable. This is also highlighted in a qualitative systematic review by Elias and Day, 6 where developing relationships seemed to be an important aspect of the new graduate nurse journey.…”

Culturally-sensitive moral distress experiences of intensive care nurses: A scoping review

“…A review of the literature reveals that nurses who start work in the ICU or who transfer to the ICU from another unit do not feel qualified and encounter difficulties in providing care to intensive care patients, 55,56 although such feelings decrease as they gain experience in intensive care and feel more qualified. 56,57 The participants in the included articles had 1-38 years of professional experience, suggesting that they considered themselves qualified and thus less susceptible to moral distress from this source.…”