Date of Award

December 2013

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Nursing

First Advisor

Karen Morin

Keywords

Critical Care, New Graduates, Orientation, Transition

Abstract

The concept of new graduate nurses working in critical care for some healthcare systems remains a fairly new concept. Often new graduate nurses begin their orientation in critical care with minimal to no critical care experience. Orientation for the new graduate nurses can be challenging as for years new graduate nurses were not allowed to work in critical care until they had a minimum of one year of nursing experience. Currently new graduate nurses beginning employment in critical care are faced with revisiting basic nursing and learning critical care nursing at the same time. In order for critical care units to provide orientation programs that are sensitive to the needs of new graduate nurses, it is important to know what they experience as they transition from student nurse to staff nurse during orientation into critical care.

Using qualitative methods, a convenience sample of 10 new graduate nurses hired to work in critical care were recruited and interviewed during the first two weeks of their orientation into critical care and again a few weeks after they started to care for critical care patients independently. Audio recordings of the interviews were transcribed and validated for accuracy. Interpretive analysis of the transcripts sought to identify major patterns and themes. Two stages with four themes emerged from the data analysis. In the first stage, titled The Beginning, new graduate nurses experienced feeling anxious and overwhelmed, became fearful of making a mistake that could harm a patient, experienced the "light bulb went on", followed by a time of learning and learning some more. The second stage, "Moving On", new graduate nurses moved toward caring for critical care patients independently. Although they started feeling anxious, they acknowledged their resources should they need help, and they were confident in their ability to care for two stable critical care patients independently. New graduate nurse experienced moving through two emergent stages as they transitioned from student nurse to staff nurse in critical care, similar to what others found. However, the emotional experiences highlighted in this study are new and add a new dimension to understanding their experiences. As sample size became an issue during the study, findings and conclusions are considered preliminary.

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