Novice nurses' readiness to practice in an ICU: A qualitative study

Abstract

Background: Novice nurses (newly qualified within the first 3-year period of professional practice after registration) must first face the reality and complexity of caring for high-acuity patients in the critical care setting, which can be an unfamiliar and demanding environment. The successful transition from education to professional practice of novice nurses hired for intensive care must be supported.

Aim: To explore Polish novice nurses' readiness to practice in an intensive care unit (ICU). Our study objectives included investigating pre-registration preparation for work in an ICU, identifying the most needed competencies to work in an ICU, and analysing organizational aspects of the professional orientation period.

Study design: A qualitative phenomenology design was applied.

Methods: We conducted qualitative content analysis based on individual semi-structured in-depth interviews. Study recruitment was performed using a purposeful and network sampling strategy. The final number of participants was 17 Polish novice nurses.

Results: The majority of responders replied that they were not prepared to work in an ICU after graduation. Professional orientation was planned-generally for a period of 3 months; however, in most places it was shortened. The respondents identified the five competencies most needed to work in an ICU: communication, teamwork, professional self-confidence, and knowledge and its practical use. Their enhancement could be achieved through simulations during both pre-registration and professional training.

Conclusion: Analysis of the novice nurses' orientation period revealed many difficulties that indicated a lack of readiness to practice in an ICU after graduation. Identifying novice nurses' strengths and weaknesses regarding clinical competence is important to guide the design of orientation programmes in ICU settings and nursing education programmes.

Relevance to clinical practice: Readiness for ICU work may be improved by enriching education with simulations that enable training in the practical use of knowledge and critical care procedures. A supportive work environment is crucial during professional orientation.

Keywords: clinical competency in ICU; education and training of ICU nurses; nursing developments; qualitative research.