New Graduate Nurse Transition Into the Intensive Care Unit: Qualitative Insights From a Longitudinal Study-Part 1

Nursing specialization in intensive care: A scoping review

INTRODUCTION

Nursing in Intensive Care Units (ICU) presents an additional difficulty due to the highly complex nature of the patients. This implies a demand for training, skills, and management from the nurses attending to this type of patient, which is not currently guaranteed due to the lack of mandatory prior training. Despite the importance of such education and training, there is currently no existing regulation or national or international consensus regarding its mandatory requirement for performing professional activities in ICUs.

OBJECTIVES

The main research question posed is to identify the existing recommendations on specialised nursing care in adult intensive care.

METHODOLOGY

A scoping review was conducted using the databases PubMed, CINAHL, MEDLINE, COCHRANE, CUIDEN, and SciELO. The review included studies in both Spanish and English with varied designs on the topic of study. The quality of the articles was analyzed, achieving moderate to high levels of compliance with quality guidelines.

RESULTS

A sample of N = 25 was selected, divided according to the primary theme of the articles: 40% (n = 10) on the implementation of training programmes in ICUs, 24% (n = 6) on nursing competencies, 16% (n = 4) on the needs identified by ICU staff themselves, and 20% (n = 5) on the clinical specialty of ICU nursing.

CONCLUSIONS

The findings indicate an improvement in both patient outcomes and the functioning of ICUs following appropriate training of nursing staff. A model for an Intensive Care Nursing Specialty in Spain is proposed as a viable option to develop the necessary specific training.

Culturally-sensitive moral distress experiences of intensive care nurses: A scoping review

BACKGROUND

Moral distress is a phenomenon that all nurses experience at different levels and contexts. The level of moral distress can be affected by individual values and the local culture. The sources of the values shape the level of moral distress experienced and the nurses' decisions.

AIM

The present scoping review was conducted to examine the situations that cause moral distress in ICU nurses in different countries.

RESULTS

A scoping review methodology was adopted for the study, in line with the approach of Arksey, and O'Malley Literature was searched within PubMed/Medline, Scopus, Web of Science, and PsycINFO indexed keywords such as "moral distress", "Critical Care Nurse", and "Moral Distress Scale-Revised". Of the 617 identified citations, 12 articles matched the inclusion criteria.

CONCLUSION

The moral distress experienced in countries and regions with similar cultures and geographies was parallel. The situations that cause the most moral distress are futile-care to prolong death, unnecessary tests and treatments, and working with incompetent healthcare personnel.

New graduate nurses and dementia care in acute care: A qualitative study

With the increasing older adult population, new graduate nurses will be providing care for patients with dementia more frequently. The purpose of this qualitative study was to explore the experiences of new graduate nurses when providing care for patients with dementia in acute care environments. We conducted semi-structured interviews with eleven new graduate nurses in Ontario, Canada. Three themes emerged from the thematic analysis: (1) building of vision and values; (2) clashing of vision and values; and (3) making do with what you have. Barriers to providing dementia care in acute care were similar to barriers experienced by non- new graduate nurses reported in the literature, such as challenges with responsive behaviours, maintaining safety and providing psychosocial care. Facilitators identified were supportive colleagues and early exposure to dementia care.