School of Nursing, College of Health and Medicine, University of Tasmania, Alexandria, New South Wales, Australia.
School of Nursing and Midwifery, The University of Sydney, Camperdown, New South Wales, Australia.
Nurs Crit Care. 2024 May;29(3):536-544. doi: 10.1111/nicc.12965. Epub 2023 Aug 16.
Shortage and retention of experienced nurses are crucial matters and internationally acknowledged, particularly in specialty areas such as Critical Care.
To explore the experiences of registered nurses in their first and fourth years of practice in an adult intensive care unit.
This descriptive phenomenological study was conducted over 4 years. Eligible participants were interviewed at two different points in their career. Ten registered nurses were interviewed after three to 6 months of employment in an adult intensive care unit (Phase One). Five of the same participants were interviewed in their fourth year of practice (Phase Two).
Findings related to factors influencing the participants' choice of specialty and their retention are reported in this paper. Two themes emerged from Phase One: a unique environment, positive and negative emotions, unclear expectations, and the journey of a registered nurse. Two themes generated from data collected in Phase Two included a unique environment and being a proficient nurse. In both phases, nurses considered the Intensive Care Unit a stimulating learning environment.
This paper highlights that the registered nurse's perception of the Intensive Care Unit and Intensive Care Nursing influenced their choice of specialty, and learning opportunities influenced their decision to remain in the Intensive Care Unit.
The findings of this study inform action areas for healthcare organizations and nursing managers. Challenges, learning opportunities and the nature of critical care nursing should be considered target areas for organizations to promote and develop as part of critical care nurses' retention strategies. Education not only for new graduate nurses but also for all registered nurses should be ongoing.
经验丰富的护士短缺和流失是一个至关重要的问题，这在国际上得到了广泛认可，尤其是在重症监护等专业领域。
探讨注册护士在成人重症监护病房工作的头三年和第四年的工作经验。
本研究为描述性现象学研究，历时 4 年。在职业生涯的两个不同阶段对符合条件的参与者进行了访谈。10 名注册护士在成人重症监护病房工作 3 至 6 个月后（第 1 阶段）接受了访谈。其中 5 名相同的参与者在工作第四年（第 2 阶段）接受了访谈。
本文报告了影响参与者选择专业和留任的因素。第 1 阶段出现了两个主题：独特的环境、积极和消极的情绪、不明确的期望以及注册护士的成长历程。第 2 阶段从数据中得出了两个主题：独特的环境和成为熟练的护士。在这两个阶段，护士都认为重症监护病房是一个刺激的学习环境。
本文强调了注册护士对重症监护病房和重症监护护理的看法影响了他们对专业的选择，而学习机会则影响了他们留在重症监护病房的决定。
本研究结果为医疗机构和护理管理人员提供了行动方向。挑战、学习机会和重症护理的性质应被视为组织的重点领域，作为重症护理护士留任策略的一部分加以推广和发展。不仅应为新毕业的护士，而且应为所有注册护士提供持续的教育。
