Nurses’ Lived Experience of Precepting Newly Graduated Nurses in the ICU

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Primary Author:</td>
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Laurie A Kunkel-Jordan, MSN, RN, ANP-BC, CCRN, CNE  </td>
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Co-Principal Investigators/Collaborators:</td>
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Marilyn Bratt, PhD</td>
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Organization:</td>
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Carroll University</td>
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Abstract</h2>
<h3>
Purpose</h3>
<p>The purpose of this study was to describe critical care nurses’ lived experience of precepting newly graduated nurses (NGNs) in the intensive care unit  (ICU). </p>
<h3>
Background</h3>
<p align="left">Newly graduated nurses working in critical care at risk for failure to thrive in clinical practice (Valdez, 2008). Overburdened hospital budgets, increasing patient acuity, and diminishing numbers of experienced intensive care unit nurses to act as preceptors have resulted in the mismanagement of NGN early practice experiences (Bérubé et al., 2012). In turn, low productivity, job dissatisfaction, and demoralization are reflected by strikingly high attrition rates (Badger, 2008; Duchscher, 2008; Friedman, Cooper, Click, & Fitzpatrick, 2011; Laschinger, Wong, & Grau, 2012; McKenna & Green, 2004): Up to 60% of NGNs leave their first job within the first year of practice (Bowles & Candela, 2005; Friedman et al., 2011). Preceptorship is the primary mechanism by which NGNs are transitioned to professional practice in critical care. Review of the literature revealed that several studies aimed at organizational benefits associated with structured NGN critical care preceptorships (Bérubé et al., 2012; DuVall, 2009; Eigsti, 2009; Elmers, 2010; Morris et al., 2009; 2012; Sandeau & Halm, 2010); a few studies explored resultant NGN perceptions (O’Kane, 2011; Reising, 2002; Saghafi, Hardy, & Hillege, 2012); and almost no research aimed primarily at critical care nurse preceptor perspectives. </p>
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Materials & Methods</h3>
<p>Husserlian descriptive phenomenology was employed. Four ICU nurses, experienced in the preceptorship of NGNs, were interviewed using open-ended questions: Interviews were digitally recorded and transcribed verbatim. </p>
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Results</h3>
<p>Preliminary analysis using Colaizzi’s 7 stage framework revealed two, distinct, overarching themes: 1) Ideas that motivate critical care nurse preceptors of NGNs, and 2) Actions carried out by critical care nurse preceptors of NGNs on account of what motivated them. </p>
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Conclusion</h3>
<p>Ensuring the integrity of the critical care nursing workforce, present and future, is dependent upon successful transition and retention of NGNs. Knowledge of the perspectives of critical care nurse preceptors is essential to this purpose.</p>
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<h3>
Bibliography</h3>
<ul>
<li align="left">
Badger, J. M. (2008). Critical care nurse intern program: Addressing psychological reactions related to critical care nursing. Critical Care Nurse, 31(2), 184-187.</li>
<li align="left">
Baumberger-Henry, M. (2012). Registered nurses’ perspectives on the new graduate working in the emergency department or critical care unit. Journal of Continuing Education in Nursing, 43(7), 1-1. doi: 10.3928/00220124-20111115-02</li>
<li align="left">
Bérubé, M., Valiquette, M-P., Laplante, E., Lapage, I., Belmonte, A., Tanquay, N., Lépine, I., Lalonde, L., & Touchette, S. (2012). Nursing residency program: A solution to introduce new grads into critical care more safely while improving accessibility to services. Canadian Journal of Nursing Leadership, 25(1), 50-67.</li>
<li align="left">
Bowles, C. & Candela, L. (2005). First job experiences of recent RN graduates: Improving the work environment. Journal of Nursing Administration, 35(3), 130-137.</li>
<li align="left">
Duchscher, J. B. (2008). A process of becoming: The stages of new nursing graduate professional role transition. The Journal of Continuing Education in Nursing, 39(10), 441-450.</li>
<li align="left">
Duvall, J. J. (2009). From novice to advanced beginner: The critical care internship. Journal for Nurses in Staff Development, 25(1), 25-27.</li>
<li align="left">
Eigsti, J. E. (2009). Graduate nurses' perceptions of a critical care nurse internship program. Journal for Nurses in Staff Development, 25(4), 191-198. doi: 10.1097/NND.0b013e3181ae1450</li>
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Elmers, C. R. (2010) The role of preceptor and nurse leader in developing intensive care unit competency. Critical Care Nursing Quarterly, 33(1), 10-18. doi: 10.1097/CNQ.0b013e3181c8e0a9</li>
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Friedman, M. I., Cooper, A. H., Click, E., & Fitzpatrick, J. J. (2011). Specialized new graduate RN critical care orientation: Retention and financial impact. Nursing Economic$, 29(1), 7-14.</li>
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Laschinger, H. K., Wong, C. A., & Grau, A. L. (2012). The influence of authentic leadership on newly graduated nurses’ experiences of workplace bullying, burnout and retention outcomes: A cross-sectional study. International Journal of Nursing Studies, 49, 1266-1276.</li>
<li align="left">
McKenna, L. G. & Green, C. (2004). Experiences and learning during a graduate nurse program: An examination using a focus group approach. Nurse Education in Practice, 4, 258-263.</li>
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Morris, L. L., Pfeifer, P., Catalano, R., Fortney, R., Nelson, G., Rabito, R., & Harap, R. (2009). Outcome evaluation of a new model of critical care orientation. American Journal of Critical Care, 18(3), 252-259. doi: 10.4037/ajcc2009355</li>
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O’Kane, C. (2011). Newly qualified nurses’ experiences in the intensive care unit. Nursing in Critical Care, 17(1), 44-51.</li>
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Reising, D. L. (2002). Early socialization of new critical care nurses. American Journal of Critical Care, 11(1), 19-26.</li>
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Saghafi, F., Hardy, J. & Hillege, S. (2012). New graduate nurses’ experiences of interactions in the critical care unit. Contemporary Nurse,42(1), 20-27.</li>
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Sandau, K. E. & Halm, M. A. (2010). Preceptor-based orientation programs: Effective for nurse and organizations? American Journal of Critical Care, 19(2), 184-188.</li>
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Valdez, A. M. (2008). Transitioning from novice to competent: What can we learn from the literature about graduate nurses in the emergency setting? Journal of Emergency Nursing, 34(5), 435-440. doi: 10.1016/j.jen2007.07.008</li>
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<p>© Improvement Science Research Network, 2012</p>
<p>The ISRN published this as received and with permission from the author(s).</p>