Guiding novice nurses through resuscitations in the intensive care units: A qualitative descriptive study.

Abstract

Background: Resuscitation in the ICU represents a critical juncture where both junior and experienced nurses are expected to respond effectively. As junior nurses may lack the clinical expertise to contribute optimally in a resuscitation, senior nurses may then be required to guide them while managing the intricacies of a resuscitation. Understanding such clinical teaching experiences is essential to strengthening the intra-professional nursing response to resuscitations.

Aim: The aim of this study was to explore junior and senior nurses' experience of guiding and being guided during resuscitations in the ICUs.

Study design: A qualitative descriptive study was conducted in four ICUs of a tertiary hospital. Ten ICU nurses who have experience with guiding junior nurses or being guided during resuscitations were recruited and interviewed using semi-structured interviews. Interviews were transcribed verbatim and thematically analysed.

Results: Three main themes emerged from the data. First, "Under siege from all sides" highlights the limitations and challenges faced by junior nurses, as observed by senior nurses. Particularly, competency gaps in executing resuscitative procedures resulted in them being under-performing team members during resuscitations. Second, "Acts of guiding" depicted how senior nurses guided junior nurses through passive observation or active participation, with either approach facilitating the junior nurse into the functional roles of a resuscitation. Lastly, "Shouldering guiding responsibilities" espoused the moral quagmire that senior nurses experience when they must manage the complexity of a resuscitation while simultaneously guiding the junior nurse.

Conclusions: This study provides insights on the intra-professional experiences of nurses guiding and being guided during ICU resuscitations. Findings illuminate the need for leadership and clinical teaching capability building among senior nurses to create opportunistic learning during resuscitations for junior nurses.

Relevance to clinical practice: More support is required for junior and senior nurses as they mount an attempt to revive the patient during resuscitations.