Transitioning from Student To ICU New Grad - Interview with Jennifer Hostutler

The first year of a nurse’s career can be either harrowing or rewarding and can determine whether she/he stays or goes. It’s very important for facilities to keep nursing staff. Nurses Announcements Archive

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Specializes in Nephrology, Cardiology, ER, ICU.

Retaining new grad nurses is important to ICUs. However, transitioning from student to functioning staff nurse can be a struggle. This is a topic that frequently comes up for discussion on allnurses.com. We wanted to find out more about this and see what others are doing to make the transition easier and increase new grad retentions.

Recently, Mary Watts, BSN, RN, allnurses.com Content and Community Director sat down with Jennifer Hostutler, PhD, RN, CNS at an AACN/NTI Conference to discuss nurse retention. When asked how she became interested in this topic, Dr. Hostutler replied, "I taught at a university and I noted that some students were excellent in the classroom but had a difficult time once they started a job.”

First Code

She did a qualitative research study about the socialization of the new grads in a critical care environment. This involved nurses who had been in nursing for approximately one year. The nurses shared their stories of struggles and triumphs. At the beginning of the study, all participants talked about their first code and the responses varied from their acknowledgment that "I didn't know what I didn't know,” to one nurse going home and crying, and yet another wondering why she became a nurse.

Dr. Hostutler then had a similar discussion with these nurses after they had experienced several codes and all of them stated that they felt more confident and that they performed better with some experience. The outcome of the code wasn't significant but rather that their expectations changed - as a new grad you are not confident and you are judging yourself. High expectations of new grads might not be realistic. Later, after some more experience, they were more confident.

The Struggle is Real

Mary asked about other struggles that new nurses face as they start their career in an ICU. They discussed that the culture of a unit is important and the unit as a whole must be accepting of new graduates. "I want to challenge experienced nurses to have patience with new nurses. Don't jump in there and do tasks yourself, take the time to let the new grad learn how to do it,” Dr. Hostutler replied.

How to Make the Transition Smoother?

Then they talked about what a new nurse can do to make the transition easier. These are her tips:

  • Remember that you are a new nurse - don't have high expectations or impossible goals
  • You need to be open and have good communication skills
  • Don't set up roadblocks to good communication
  • It's okay to admit you don't know how to do something

Critical care is just that - critical and stressful. In emergent situations, how do new nurses develop coping skills in order to handle the stress load? Dr. Hustutler suggested:

  • Do mock codes
  • Do rapid intubation scenarios
  • Utilize the simulation lab or whatever tools you have
  • "Don't sit back and watch - even if it's not your patient, jump in there"

With experience comes with confidence and you have to repeat these situations to become better at them. Transitioning from student nurse to new grad ICU nurse is stressful. However, with a supportive unit, helpful nurses and a solid orientation, you can be successful.

Here is the complete interview.

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