The experience of new nurses beginning critical care practice: An interpretive phenomenologic study

Abstract

New nurses who choose to begin their nursing practice in the Intensive Care Unit (ICU) are faced with many varied experiences. In this interpretive phenomenologic study, the researcher met with and had conversations with eight new nurses who recently completed orientation to their respective ICUs. Ten themes were uncovered and analyzed. Each theme speaks to a particular aspect of the experience lived by the new nurses. Finding a home gives voice to the decisions of the new nurses as they chose to work in an ICU. A few of the hardest things depicts the struggles of the new nurses with organization, with their fears and uncertainties, with the possibility of making mistakes, and with equipment and technology ubiquitous in the ICU. Uncovering the theme of family care led to questions about the new nurses' relationships with the patients' families. Relationships with colleagues presents the associations of the new nurses with preceptors, other nurses and physicians in the ICU? The theme of socialization asks what impact does socialization have on new nurses' experiences in ICU. The importance of team work and the need to depend upon colleagues as teammates in the patient care were voiced. Questions played a vital role in the experience of these new nurses. Their progress in orientation was often gauged by their questions and relationships with colleagues were formed over the activities of questioning. In an ICU, emergencies and deaths were a focus of much anticipation for the new nurses. Many of the participants in this inquiry discussed being watched as a theme of the orientation process. For some, this was a supportive gaze; for others, the watchfulness was experienced as intrusive. The theme of moving on describes the transition experienced by the new nurses as they began to provide their own caring practices in the ICU. This research has implications for the graduate of nursing school beginning to select a work environment, for the experienced nurses who act as preceptors, and for the nurse educator, preparing the student and new graduate for a role in ICU nursing.