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

2019 ◽  
Vol 33 (4) ◽  
pp. 428-444
Author(s):  
Brandi Vanderspank-Wright ◽  
Michelle Lalonde ◽  
Cheryl Anne Smith ◽  
Sandra Wong ◽  
Jamie Anne Bentz

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.

2021 ◽  
Author(s):  
◽  
Joanne Greenlees-Rae

<p>The purpose of this study was to understand influences on new graduate nurses’ confidence in their nursing practice. Confidence is a self-belief that an affirmative outcome will be achieved in a situation, and is influenced by factors individual to each person. New graduate nurses commence nursing practice feeling somewhat confident or not confident at all, and this feeling of confidence changes and evolves over their first year of practice as they navigate transition from a nursing student to a professional nursing role. Being confident is an important attribute of a nurse as it assists nurses to make decisions in their practice to achieve the outcomes they, or their patients and families and/or whanau require. Being confident will assist new graduate nurses to perform clinically, and to help them to face any challenges in their practice.  This study used the principles of Appreciative Inquiry as a methodology. Appreciative Inquiry is a flexible and positive approach to research, placing an emphasis on dialogue, collaboration and affirmation. It sought to discover what was working well with regards to confidence and its influences for the new graduate nurse. Utilising the elements of Appreciative Inquiry, I have analysed the dialogue of nine new graduate nurses who shared their stories of their nursing practice. Five themes were identified: firstly understanding confidence and the subthemes of self-awareness, knowing confidence, defining confidence, reflection, self-doubt, over-confidence, and feigning confidence; secondly developing a professional identity with the subtheme of resilience; thirdly relationships with the subthemes of collegial relationships, culture of the environment, the patients’ influence, feedback, and trust; and the fourth theme of developing learning and experience with the subthemes of learning and knowledge, experience, and critical thinking and decision making, and finally the fifth theme of looking to the future.  The study dialogue identifies influences on the nurses’ confidence, and their reflective practice particular to each nurse which consistently permeate their nursing practice. Recommendations are made for further nursing practice, education and research.</p>


2021 ◽  
Author(s):  
Rajkiran Ghatora

Canadian nurse leaders have called for academic and practice organizations to address ongoing issues in undergraduate nursing education and the new graduate nurse transition to the nursing role in the practice setting. The purpose of this study was to explore Canadian nurse leaders’ perspectives of the potential value of academic-practice organization partnerships in facilitating a positive transition experience for Canadian new graduate nurses. An exploratory qualitative descriptive approach was employed using semi-structured interviews and conventional content analysis. Nurse leader participants reported value in academic and practice organizations communicating and collaborating to address matters contributing to the new graduate nurse transition to the practice setting. Implications for practice, education, policy and research are explored.


2021 ◽  
pp. RTNP-D-21-00014
Author(s):  
Michelle Lalonde ◽  
Cheryl Anne Smith ◽  
Sandra Wong ◽  
Jamie Anne Bentz ◽  
Brandi Vanderspank-Wright

Background and PurposeTo address the nursing shortage, it is increasingly common for hospitals to hire new graduate nurses into intensive care units (ICU). New graduates in intensive care likely experience needs beyond those of their peers outside of critical care contexts. Yet, relatively little is known about the experiences of this unique population. The purpose of this study was to explore the transition experience of a cohort of new graduate nurses in the ICU over a 2-year period.MethodsA longitudinal mixed-methods convergent design using a purposive and convenience sample of new graduate nurses working in an ICU. Surveys were administered and in-depth qualitative interviews were conducted at four points in time over a 2-year period.ResultsParticipants identified a number of skills that remained difficult, as well as less comfort in performing a number of nursing interventions, over the four time points. In addition, they highlighted a decline in their perception of receiving encouragement and feedback from their manager. Participants identified that a lack of confidence was a barrier to transition and that improved orientation and work environment could further support them in their journey. Certain aspects of their work environment, such as peer support, were identified as most satisfying, whereas the environment and system were least satisfying.Implications for PracticeThe results provide a greater understanding of the transition experienced by new graduate nurses in the ICU. In addition, the results may provide the ICU leadership team with potential areas to further support the transition of new graduates within this critical care environment.


2021 ◽  
Author(s):  
◽  
Joanne Greenlees-Rae

<p>The purpose of this study was to understand influences on new graduate nurses’ confidence in their nursing practice. Confidence is a self-belief that an affirmative outcome will be achieved in a situation, and is influenced by factors individual to each person. New graduate nurses commence nursing practice feeling somewhat confident or not confident at all, and this feeling of confidence changes and evolves over their first year of practice as they navigate transition from a nursing student to a professional nursing role. Being confident is an important attribute of a nurse as it assists nurses to make decisions in their practice to achieve the outcomes they, or their patients and families and/or whanau require. Being confident will assist new graduate nurses to perform clinically, and to help them to face any challenges in their practice.  This study used the principles of Appreciative Inquiry as a methodology. Appreciative Inquiry is a flexible and positive approach to research, placing an emphasis on dialogue, collaboration and affirmation. It sought to discover what was working well with regards to confidence and its influences for the new graduate nurse. Utilising the elements of Appreciative Inquiry, I have analysed the dialogue of nine new graduate nurses who shared their stories of their nursing practice. Five themes were identified: firstly understanding confidence and the subthemes of self-awareness, knowing confidence, defining confidence, reflection, self-doubt, over-confidence, and feigning confidence; secondly developing a professional identity with the subtheme of resilience; thirdly relationships with the subthemes of collegial relationships, culture of the environment, the patients’ influence, feedback, and trust; and the fourth theme of developing learning and experience with the subthemes of learning and knowledge, experience, and critical thinking and decision making, and finally the fifth theme of looking to the future.  The study dialogue identifies influences on the nurses’ confidence, and their reflective practice particular to each nurse which consistently permeate their nursing practice. Recommendations are made for further nursing practice, education and research.</p>


2015 ◽  
Vol 21 (2) ◽  
pp. 75-79
Author(s):  
Jeanne Merkle Sorrell ◽  
Christine Szweda

Hospitals are increasingly implementing residencies to help ensure that new graduate nurses are prepared to provide safe and effective care. At the Cleveland Clinic, a docudrama focused on ethical concerns in living with dementia was implemented into a 6-month pilot new graduate nurse residency program. Outcomes suggest that the docudrama helped nurse residents gain empathy and understanding through stepping into the lives of families experiencing dementia.


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