Lin Yongxing Patrick, Chan Le Yi Cynthia, Chan Ee-Yuee
Nursing Service, Tan Tock Seng Hospital, Singapore, Singapore.
Clinical Standards & Improvement, Tan Tock Seng Hospital, Singapore, Singapore.
Nurs Crit Care. 2025 Mar;30(2):e13301. doi: 10.1111/nicc.13301.
Resuscitation in the ICU represents a critical juncture where both junior and experienced nurses are expected to respond effectively. As junior nurses may lack the clinical expertise to contribute optimally in a resuscitation, senior nurses may then be required to guide them while managing the intricacies of a resuscitation. Understanding such clinical teaching experiences is essential to strengthening the intra-professional nursing response to resuscitations.
The aim of this study was to explore junior and senior nurses' experience of guiding and being guided during resuscitations in the ICUs.
A qualitative descriptive study was conducted in four ICUs of a tertiary hospital. Ten ICU nurses who have experience with guiding junior nurses or being guided during resuscitations were recruited and interviewed using semi-structured interviews. Interviews were transcribed verbatim and thematically analysed.
Three main themes emerged from the data. First, "Under siege from all sides" highlights the limitations and challenges faced by junior nurses, as observed by senior nurses. Particularly, competency gaps in executing resuscitative procedures resulted in them being under-performing team members during resuscitations. Second, "Acts of guiding" depicted how senior nurses guided junior nurses through passive observation or active participation, with either approach facilitating the junior nurse into the functional roles of a resuscitation. Lastly, "Shouldering guiding responsibilities" espoused the moral quagmire that senior nurses experience when they must manage the complexity of a resuscitation while simultaneously guiding the junior nurse.
This study provides insights on the intra-professional experiences of nurses guiding and being guided during ICU resuscitations. Findings illuminate the need for leadership and clinical teaching capability building among senior nurses to create opportunistic learning during resuscitations for junior nurses.
More support is required for junior and senior nurses as they mount an attempt to revive the patient during resuscitations.
重症监护病房（ICU）的复苏是一个关键时刻，新老护士都需要做出有效的反应。由于新护士可能缺乏在复苏中做出最佳贡献所需的临床专业知识，因此可能需要资深护士在管理复苏的复杂情况时对他们进行指导。了解此类临床教学经验对于加强专业内护理人员对复苏的反应至关重要。
本研究的目的是探讨新老护士在ICU复苏过程中指导与被指导的经验。
在一家三级医院的四个ICU进行了一项定性描述性研究。招募了10名有指导新护士经验或在复苏过程中接受过指导的ICU护士，并使用半结构化访谈进行了访谈。访谈内容逐字记录并进行了主题分析。
数据中出现了三个主要主题。首先，“四面楚歌”突出了资深护士所观察到的新护士面临的局限性和挑战。特别是，在执行复苏程序方面的能力差距导致他们在复苏过程中表现不佳。其次，“指导行为”描述了资深护士如何通过被动观察或积极参与来指导新护士，两种方式都有助于新护士融入复苏的功能性角色。最后，“承担指导责任”揭示了资深护士在必须管理复苏的复杂性同时指导新护士时所经历的道德困境。
本研究提供了关于护士在ICU复苏过程中指导与被指导的专业内经验的见解。研究结果表明，需要加强资深护士的领导能力和临床教学能力建设，以便在复苏过程中为新护士创造机会性学习。
在复苏过程中，新老护士在努力挽救患者生命时需要更多支持。
