An exploration of participants' experience of an intensive care nursing transition to specialty practice program

Intensive care as a specialty of choice for registered nurses: A descriptive phenomenological study

BACKGROUND

Shortage and retention of experienced nurses are crucial matters and internationally acknowledged, particularly in specialty areas such as Critical Care.

AIM

To explore the experiences of registered nurses in their first and fourth years of practice in an adult intensive care unit.

STUDY DESIGN

This descriptive phenomenological study was conducted over 4 years. Eligible participants were interviewed at two different points in their career. Ten registered nurses were interviewed after three to 6 months of employment in an adult intensive care unit (Phase One). Five of the same participants were interviewed in their fourth year of practice (Phase Two).

FINDINGS

Findings related to factors influencing the participants' choice of specialty and their retention are reported in this paper. Two themes emerged from Phase One: a unique environment, positive and negative emotions, unclear expectations, and the journey of a registered nurse. Two themes generated from data collected in Phase Two included a unique environment and being a proficient nurse. In both phases, nurses considered the Intensive Care Unit a stimulating learning environment.

CONCLUSIONS

This paper highlights that the registered nurse's perception of the Intensive Care Unit and Intensive Care Nursing influenced their choice of specialty, and learning opportunities influenced their decision to remain in the Intensive Care Unit.

RELEVANCE TO CLINICAL PRACTICE

The findings of this study inform action areas for healthcare organizations and nursing managers. Challenges, learning opportunities and the nature of critical care nursing should be considered target areas for organizations to promote and develop as part of critical care nurses' retention strategies. Education not only for new graduate nurses but also for all registered nurses should be ongoing.

The experience of nurses moving into forensic mental health employment: A qualitative study

While forensic mental health has seen considerable growth over the last two decades, little is known about the experience of registered nurses working in these environments. This study used a qualitative descriptive approach and interviewed 11 registered nurses to explore the interpersonal experiences of transition into a forensic mental health hospital. The data revealed three themes. 'Observing what's safe' examined nurses' ability to maintain safety in the context of inconsistent practices among colleagues. 'Navigating cliques and divisions' focused on nurses' sense of belonging and adapting to professional and personal groups. Finally, 'gaining management support' reflected nurses' experiences of engagement with management. This study provides new insight into nurses' experience of adapting to employment in forensic mental health settings and highlights the importance of positive support strategies for workplace transition.

The impact of the COVID-19 pandemic on the perioperative transition to specialty practice program

AIM

To understand how the COVID-19 pandemic impacted nurse educators' and novice nurses' experience with the perioperative transition to specialty practice program.

DESIGN

A qualitative descriptive study.

METHODS

Semi-structured interviews were conducted with five perioperative nurse educators and five perioperative transition to specialty practice program participants from a major metropolitan health service in Melbourne. Data were collected between April and July 2021. Interviews were audio-recorded and transcribed verbatim, and data were analysed using reflexive thematic analysis.

RESULTS

Five themes were identified. The value of the perioperative transition to specialty practice program in supporting novice nurses was recognized in the theme 'Nurturing our novices'. Widespread changes to clinical practice were demonstrated in the theme 'Every day is different', including changes to elective surgery, redeployment of staff and the transmission risk of COVID-19. 'The perils and joys of online learning' revealed both challenges and benefits of transitioning theoretical education from face-to-face to online delivery. 'Roller coaster of emotions' represented the heightened emotions participants experienced due to the COVID-19 pandemic. 'Looking back to move forward' encompassed participants' reflections on the year, considering the challenges, adaptive strategies and the future of perioperative nursing education.

CONCLUSION

The perioperative transition to specialty practice program was significantly impacted by the COVID-19 pandemic. Participants needed to adapt to rapid and frequent changes, which contributed to feelings of emotional distress, affected consolidation of clinical learning and reduced engagement with theoretical education.

IMPACT

Perioperative nurses should acknowledge that opportunities for learning were decreased for transition to specialty practice program participants during the pandemic. Ongoing support and education should be provided, to nurture the future generation of perioperative nurses.

Evidence-Based Critical Care Education for Oncology Nurses

BACKGROUND

Advances in medical care for oncology patients have heightened the complexity of this patient population, leading to an increased need for lifesaving, critical care. Yet, there is a lack of literature on education to prepare nurses to provide care to critically ill oncology patients.

OBJECTIVES

The purpose of this quality improvement project was to evaluate oncology nurses' mastery of basic and oncology-specific critical care knowledge after an evidence-based supplemental training intervention.

METHODS

An 8-hour supplemental training intervention was developed to increase oncology nurses' knowledge about basic and oncology critical care by addressing score deficiencies noted on the Basic Knowledge Assessment Tool (9r version). Seventeen oncology nurses completed the supplemental training intervention. The Basic Knowledge Assessment Tool and an Oncology Knowledge Survey were administered pre and post supplemental training, and significant changes were detected with Wilcoxon signed rank tests.

RESULTS

Mean total Basic Knowledge Assessment Tool scores significantly improved from 65.7 before initial course to 73.7 post supplemental training (P = .002). Oncology Knowledge Survey total scores increased from 75.3% to 80.9%, which was a statistically significant improvement (P = .039).

CONCLUSIONS

Critical care training is imperative for oncology nurses preparing to care for high-acuity oncology patients. Adequate knowledge of basic and oncology-specific critical care is important to prevent adverse events and improve outcomes for this complex patient population.

Thai trauma nurses' knowledge of neuroprotective nursing care of traumatic brain injury patients: A survey study

Thai trauma nurses play a vital role in neuroprotective nursing care of patients with moderate or severe traumatic brain injury. Nurses' knowledge of the evidence underpinning initial neuroprotective nursing care vital to safe and high-quality patient care. However, the current state of knowledge of Thai trauma nurses is poorly understood. In this study, we investigated Thai nurses' knowledge of neuroprotective nursing care of patients with moderate or severe traumatic brain injury. Data were collected by a survey, comprising a section on participant characteristics and series of multiple-choice questions. All registered nurses (n = 22) and nursing assistants (n = 13) from the trauma ward of a regional Thai hospital were invited to participate: the response rate was 100%. Participants had limited knowledge of carbon dioxide monitoring; causes and implications of hypercapnia; mean arterial pressure and cerebral perfusion pressure targets; management of sedatives and analgesics; and management of hyperthermia. Improving their knowledge focusing on knowledge deficits through educational training and implementation of evidence-based practice is essential to improve the safety and quality of care for Thai patients with moderate or severe traumatic brain injury.