Part 2: New Graduate Nurse Transition Into the Intensive Care Unit: Summative Insights From a Longitudinal Mixed-Methods Study

Res Theory Nurs Pract. 2021 Sep 13:RTNP-D-21-00014. doi: 10.1891/RTNP-D-21-00014. Online ahead of print.

Abstract

Background and purpose: To 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.

Methods: A 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.

Results: Participants 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 practice: The 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.

Keywords: critical care; intensive care unit; interview; new graduate nurse; qualitative; quantitative; survey; transition.