School of Nursing, University of Notre Dame Australia, Sydney, NSW, Australia.
J Clin Nurs. 2021 Nov;30(21-22):3314-3329. doi: 10.1111/jocn.15844. Epub 2021 May 22.
To report a qualitative inquiry exploring senior registered nurses' stories of experience working with new graduate nurses in the intensive care unit.
While new graduate nurses' perceptions of transitioning into professional practice in the intensive care unit have been examined, few studies have explored the experiences of the senior registered nurses working alongside them.
A narrative inquiry methodology informed by Dewey's (1938) theory of experience.
Individual in-depth, unstructured, interactive interviews were conducted with five senior registered nurses. The inquirer co-composed individual narrative accounts with each participant. Narrative inquiry's three commonplaces of temporality, sociality and place formed the lens of analysis. Thematic analysis identified two overarching threads that resonated across the narrative accounts. This inquiry adheres to COREQ checklist reporting.
The overarching threads 'Reverberations' and 'Caring' depict the experiences of senior registered nurses. 'It's Dangerous', 'Patrolling Like Surf Lifesavers', 'We Carry Them', 'Survival Mode' and 'Enjoyable Moments' are minor threads describing the challenges, while 'I've Been There', 'They Must Ask Questions' and 'Not In My Backyard' reveal their insights.
Working with new graduate nurses increased senior registered nurses' patient surveillance and workload, contributing to stress, pressure and feeling overwhelmed. However, senior registered nurses felt an obligation to care for new graduate nurses, who they perceived as still acquiring the skills to autonomously care for critically ill patients. Therefore, senior registered nurses require support themselves.
Senior registered nurses perceive workplace constraints as impeding their capacity to provide sufficient support and surveillance to new graduate nurses. The gap between new graduate nurses' clinical capacity and patients' needs underpins senior registered nurses' recommendation that new graduate nurses should not be placed in intensive care units unless additional workforce support is provided, safeguarding their development as well as patient safety.
报告一项定性研究,探讨资深注册护士在重症监护病房与新毕业护士一起工作的经验故事。
虽然已经研究了新毕业护士在重症监护病房过渡到专业实践的看法,但很少有研究探讨与他们一起工作的资深注册护士的经验。
受杜威(Dewey)(1938)经验理论启发的叙事探究方法。
对五名资深注册护士进行了单独深入、非结构化、互动式访谈。调查员与每位参与者共同创作个人叙事。叙事探究的三个共同点,即时间性、社会性和地点,构成了分析的视角。主题分析确定了两个贯穿整个叙事的总体主题。本研究遵循 COREQ 报告清单。
两个总体主题“反响”和“关怀”描绘了资深注册护士的经验。“这很危险”、“像冲浪救生员一样巡逻”、“我们带着他们”、“生存模式”和“愉快的时刻”是描述挑战的次要主题,而“我经历过”、“他们必须提问”和“不在我的后院”则揭示了他们的见解。
与新毕业护士一起工作增加了资深注册护士对患者的监测和工作量,导致压力、紧张和不知所措。然而,资深注册护士感到有责任照顾新毕业护士,他们认为新毕业护士仍在获得自主照顾重症患者的技能。因此,资深注册护士需要自我支持。
资深注册护士认为工作场所的限制阻碍了他们为新毕业护士提供足够支持和监测的能力。新毕业护士的临床能力与患者需求之间的差距是资深注册护士建议新毕业护士除非提供额外的劳动力支持,否则不应在重症监护病房工作的基础,这既能保障他们的发展,又能保障患者的安全。