Background: Novice nurses (newly qualified within the first 3-year period of professional practice after registration) must first face the reality and complexity of caring for high-acuity patients in the critical care setting, which can be an unfamiliar and demanding environment. The successful transition from education to professional practice of novice nurses hired for intensive care must be supported.Aim: To explore Polish novice nurses' readiness to practice in an intensive care unit (ICU). Our study objectives included investigating pre-registration preparation for work in an ICU, identifying the most needed competencies to work in an ICU, and analysing organizational aspects of the professional orientation period.Study design: A qualitative phenomenology design was applied.Methods: We conducted qualitative content analysis based on individual semistructured in-depth interviews. Study recruitment was performed using a purposeful and network sampling strategy. The final number of participants was 17 Polish novice nurses. Results:The majority of responders replied that they were not prepared to work in an ICU after graduation. Professional orientation was planned-generally for a period of 3 months; however, in most places it was shortened. The respondents identified the five competencies most needed to work in an ICU: communication, teamwork, professional self-confidence, and knowledge and its practical use. Their enhancement could be achieved through simulations during both pre-registration and professional training. Conclusion:Analysis of the novice nurses' orientation period revealed many difficulties that indicated a lack of readiness to practice in an ICU after graduation. Identifying novice nurses' strengths and weaknesses regarding clinical competence is important to guide the design of orientation programmes in ICU settings and nursing education programmes.Relevance to clinical practice: Readiness for ICU work may be improved by enriching education with simulations that enable training in the practical use of knowledge and
Background Novice nurses’ responsibilities are greater than what their actual level of competence can cope with. This can cause increased levels of stress, which many studies have shown is a factor resulting in reduced self-esteem, which affects not only the well-being of nurses but also the quality of care provided. Aims To investigate the relationship between the self-assessment of nursing competencies and self-esteem among novice nurses and the moderation role of the sociodemographic variables and intention to leave the nursing profession on this relationship. Material and methods A correlational cross-sectional study was performed using an online questionnaire. The study was conducted between July and October 2019 among 122 novice nurses. The study tool consisted of the Rosenberg Self-Esteem Scale, the Nurse Professional Competence Scale-Short Version, and metrics. Calculations were performed using SPSS Statistics, version 25. To approach research questions hierarchical multiple regression was performed. Results The self-esteem level of novice nurses have been identified as low. Novice nurses who declared their willingness to leave their profession had a higher level of self-esteem than nurses who did not declare this willingness. The highest-rated competencies were in the fields of nursing care and value-based nursing care, while the lowest were in the areas of development, leadership, and the organisation of nursing care. Correlations between postgraduate education and competencies in the majority subscales were revealed. The results showed a negative correlation between self-esteem and all subscales of the competence scale. Seniority and postgraduate education were important moderators in the relationship between some competence subscales and self-esteem. Conclusion Novice nurses present a low level of self-esteem. Nurses with a higher competence level showed lower self-esteem. Developing competencies at the beginning of one’s nursing practice, which is crucial for patients’ outcomes, should be accompanied by the strengthening of novice nurses’ self-esteem. KEY MESSAGES Novice nurses with a higher level of self-esteem more often declared their willingness to leave their profession. The results showed a negative correlation between self-esteem and all subscales of the competence scale. Seniority and postgraduate education are important moderators in the relationship between some competence subscales and self-esteem.
Cel pracy. Celem pracy jest prezentacja opieki pielęgniarskiej nad pacjentem pediatrycznym ze skrajną niewydolnością krążenia, wspomaganego urządzeniem do Pozaustrojowej Oksygenacji Krwi (ECMO) na Oddziale Intensywnej Terapii i Opieki Pooperacyjnej (ITiOP) na podstawie ICNP®. Materiał i metody. W pracy wykorzystano metodę indywidualnego przypadku w oparciu o techniki: analizę dokumentacji medycznej, obserwację oraz pomiar parametrów życiowych. Wyniki. Najczęstszym i najgroźniejszym problemem pielęgnacyjnym mogącym wystąpić podczas terapii w skrajnej niewydolności krążenia jest ryzyko zaburzenia funkcji serca [10037314]. W takiej sytuacji często jedyną metodą ratującą życie jest wspomaganie układu krążeniowego i oddechowego metodą ECMO. Kolejnym problemem pielęgnacyjnym jest ryzyko odleżyny [10027337]. Głównym celem opieki pielęgniarskiej jest niedopuszczenie do jej powstania, poprzez minimalizowanie czynników ryzyka oraz monitorowanie stanu skóry pacjenta. W analizowanym przypadku zidentyfikowano również problem ryzyka krwotoku [10017268] na skutek konieczności leczenia heparyną. Celem opieki jest minimalizowanie ryzyka oraz ewentualnych skutków krwawienia. Z uwagi na sprawowanie opieki nad noworodkiem, bardzo ważne jest w planowaniu działań, uwzględnienie również potrzeb i problemów opiekunów. Jednym ze zdiagnozowanych problemów jest stres opiekuna [10024773]. Wnioski. Opieka pielęgniarska nad pacjentem pediatrycznym ze skrajną niewydolnością krążenia wspieranego aparaturą ECMO, z uwagi na wpływ krążenia krwi na funkcjonowanie całego organizmu, nie skupia się wyłącznie na problemach związanych z układem krążenia. Słowa kluczowe: ECMO, ICNP, intensywna terapia, opieka pooperacyjna, niewydolność krążenia, opieka pielęgniarska ABSTRACT DESIGNING
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