Improving Staffing in the ICU with New Graduate Nurses: A Novel Critical Care Fellowship Program

Background: There is a growing shortage of critical care nurses. New graduate nurses (NGN) are increasingly hired into critical care settings, though NGN job turnover is estimated between 18-60% in the first year of practice. The COVID-19 pandemic exacerbated nurse turnover and the need to rapidly train new ICU nurses while also employing effective retention management strategies. Aim: To highlight the success of a NGN Critical Care Fellowship Program (CCFP) within the existing health system’s NGN Residency Program prior to and during the COVID-19 pandemic. Methods: The CCFP was launched in 2016 with 7 participating ICUs. The NGNs participate in the medical center’s existing 1-year NGN Residency Program and spend a total of 24 weeks orienting in 3 different ICUs. Orientation concludes based on a performance evaluation and readiness to work independently. NGNs are mentored and supported throughout their first year in practice through monthly debriefing of clinical and preceptor experiences. Results/Findings: Between 2016-2022, a total of 65 NGNs have participated in the CCFP. Sixty fellows completed orientation and were hired into an adult ICU during their orientation period. Retention of CCFP NGNs after 1 year was 96% (n=48/50), 2 years was 97% (n=33/34) and 3 years was 96% (n=23/24). Conclusions: Results demonstrate the development of an educationally robust, emotionally compassionate program, concentrated on the development, training and focused support of the NGN can be successfully implemented and sustained over time.