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Challenging graduate nurses' transition: Care of the deteriorating patient
Author(s) -
Della Ratta Carol
Publication year - 2016
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.13358
Subject(s) - nursing , qualitative research , acute care , lived experience , phenomenology (philosophy) , psychology , interpretative phenomenological analysis , transition (genetics) , perspective (graphical) , identity (music) , medicine , hermeneutic phenomenology , health care , medical education , social science , philosophy , artificial intelligence , psychoanalysis , economic growth , chemistry , sociology , computer science , acoustics , biochemistry , epistemology , physics , economics , gene
Aim and objective To explore graduate nurses' experiences of caring for deteriorating patients during the first year of practice. Background Hospital‐based transition programmes have been established to ease graduate nurse transition. Despite this, novice nurses persistently cite caring for deteriorating patients as a clinical challenge. Few studies have explored the unique needs of novice nurses during such encounters, even less research has been undertaken from their perspective. Design Qualitative interpretive phenomenological analysis. Method One‐on‐one, semi‐structured, in‐depth, audio‐recorded interviews were conducted between July–November 2014. A purposive sample of eight novice nurses working in acute care, ICU and the ED was recruited through the use of flyers. Results Three major patterns with related themes illuminate the experience of caring for deteriorating patients as it is lived by graduate nurses. Dwelling with uncertainty occurred during initial encounters with deteriorating patients with its deeply felt impact upon these novices causing them to question their capability of becoming a nurse. ‘Success’ or ‘failure’ of their performance during these encounters extended to their view of themselves as nurses and impacted transition. Building me up was influenced by participants’ expressed need for and importance of trusted relationships with preceptors, nurse colleagues and/or educators as they learned to care for deteriorating patients. A new lifeline: Salient being emerged as change in participants’ identity and increased self‐understanding as professional nurses. Conclusion Caring for deteriorating patients impacted graduate nurses because they viewed such encounters to be ‘high stakes’ not only for their patient but also for themselves. Crucial to their development were trusted relationships with preceptors, nurse colleagues and/or educators. Relevance to clinical practice The findings identify needs of graduate nurses' during a high‐stakes patient encounter and shed light upon one aspect of transition. Clinical leaders may use the findings from this study to improve preceptor development and transition programme curricula.