Senior registered nurses working with new graduate nurses in the intensive care unit: a narrative inquiry

Abstract

Introduction: The experiences and perceptions of new graduate nurses (NGNs) as they transition into professional practice and intensive care units (ICUs) abounds in the literature. However, there is a dearth of literature exploring the experiences of senior registered nurses (SRNs) who work with NGNs in ICUs. Aims: The aim of this inquiry was to contribute to nursing knowledge by examining SRNs’ stories of experience around the complexity of enabling development of NGNs whilst working in clinical or team leading roles in ICU. Thus, allowing the SRNs’ voice to be heard in the literature. Methods: Narrative Inquiry methodology, underpinned by Dewey’s theory of experience, was used to examine the experiences of five SRNs in one Level 6 ICU. This was achieved by engaging SRNs in individual conversations then co-composing the final individual narrative accounts with participants, whilst remaining immersed in the three-dimensional space of temporality, sociality and place. Thematic analysis methods actively identified two overarching threads that resonated across all five narrative accounts. Results: The first thread, ‘Reverberations’, contained five minor threads: ‘We Carry Them’, ‘It’s Dangerous Here’, ‘Patrolling Like a Surf Lifesaver’, ‘Enjoyable Moments’ and ‘Survival Mode’. The second thread, ‘Caring’, contained three minor threads: ‘I’ve Been There’, ‘They Must Ask Questions’ and ‘Not In My Backyard’. Analysis identified SRNs’ workload and level of patient surveillance increased when working with NGNs in the ICU, leading to perceptions of feeling stressed, pressured and overwhelmed. Yet an obligation prevailed to support and care for NGNs, perceived by participant SRNs as not yet possessing the clinical skills to independently care for critically ill patients in the dangerous ICU environment Conclusion: There are significant implications for health care organisations to increase resources to alleviate SRNs’ substantial workload and recognise their essential role in supporting NGNs while simultaneously sustaining quality ICU patient care.