New graduate nurses’ experiences of interactions in the critical care unit
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Farida Saghafi
PhD Candidate, School of Nursing, Australian Catholic University, Sydney; ICU Nurse Educator/ Clinical Nurse Specialist, St Vincent and Mater Health, Crows Nest NSW
Jennifer Hardy
Senior Lecturer and Clinical Practice Co-ordinator, Faculty of Nursing and Midwifery, Sydney Nursing School, University of Sydney, NSW
Sharon Hillege
Senior Lecturer, School of Nursing & Midwifery, College of Health & Science, University of Western Sydney NSW
Abstract
This paper reports on one of the key findings from a recent descriptive phenomenological study on lived experience of ten new graduate nurses (NGNs) in an Intensive Care Unit (ICU) in a major acute care hospital. Interpersonal relationships experienced by NGNs in ICU give rise to diverse thoughts, perceptions and feelings that may have significant impact on their professional development, job satisfaction and retention. The researcher conducted in-depth, semi structured audio-taped interviews to collect the data. Interaction with others as key theme and related subthemes: Interaction with patients, Interaction with other members of the ICU team, who is approachable, and feedback emerged. The NGNs' perception of their ability to interact with others, as part of their professional development, is influenced by both (i) how they see themselves and (ii) how they perceive that others see them.
Keywords
Intensive Care Unit, nursing, graduate nurse, interaction, interprofessional relationship, transition program, confidence
Article Text
As new graduate nurses (NGNs) enter the workplace, they are faced with many demands and challenges (Butler & Hardin-Pierce, 2005). Literature on the issue indicates that new graduate nurses are expected to reach prescribed milestones within a very short timeframe. Other challenges which arise are: persistent criticism about being ill prepared for the real world of clinical nursing practice; reality shock; and unsupportive work environments that do not foster trust (Halfer, 2007; Kramer, 1974; Parker, Plank & Hegney, 2003). These factors impede nurses in accomplishing their work and increase pressure on retention (Laschinger, Finegan, Shamian, & Wilk, 2001). Some of the milestones that need to be achieved, especially in the first six months of the new graduate program are; establishing oneself as a healthcare team member; acclimatising to the new job and organization, developing confidence and competence in clinical skills, and making sense of the role as a nurse relative to other healthcare professionals (Duchscher, 2008; Halfer, 2007). Novice registered nurses in their transition to the professional role in Intensive Care Unit (ICU) have a variety of experiences with patients, families, and health care professionals especially nurse co-workers and doctors. These experiences give rise to diverse thoughts, perceptions and feelings that may negatively impact on NGN's professional development, job satisfaction, and retention.
Despite extensive research on the work experience of NGNs, few studies have addressed the perception of NGNs of interaction with other health professionals and patients in ICU.
In a larger study [PhD], the day-to-day experiences of NGNs in an ICU are explored. The researcher aims to discover what the experience is like for NGNs when they commence in the ICU as well as to explore the changes that occur in their attitudes and experience after 2-3 years of clinical practice in critical care setting. The focus for this paper is to highlight the importance of interaction in the intensive care setting from the new graduate nurses' perspective. For the purpose of this study, interaction represents relationship between NGNs and senior nurses, doctors, patients and their families and the effect it has on the NGNs. The study uses descriptive qualitative methodology.
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