Transition experiences of newly qualified registered graduate nurses employed in a Neonatal Intensive Care Unit

Objective: To explore the experiences of newly qualified registered graduate nurses’ clinical and professional learning experiences, during their first six-months of post registration employment within a graduate nurse transition program in a Neonatal Intensive Care Unit (NICU). Method: Narrative inquiry with thematic analysis was used to explore the newly qualified registered graduate nurses’ accounts via semi-structured interviews, conducted between January 2018 – January 2019, of their clinical and professional learning during their employment in the Neonatal Intensive Care Unit. Setting: In total, eight newly qualified registered graduate nurses employed at two Western Australian Hospitals sites were recruited. Findings: Themes identified included: feeling unprepared; experiences of horizontal violence; the need for a supportive structural environment and seeking feedback. Participants reported overwhelming feelings of stress, emotional exhaustion, concerns for patient safety and for some, fear of early career burnout. Conclusion: In this study, newly qualified registered graduate nurses were clinically underprepared for entering a Neonatal Intensive Care Unit with all participants reporting high levels of psychosocial distress. This was further compounded by a lack of structured support, horizontal violence, and inadequate or no regular feedback from preceptors, resulting from a negative workplace culture and poor educator behaviours. Recommendations for improving the experiences of newly qualified registered graduate nurses employed in the Neonatal Intensive Care are discussed.