New Graduate Nurses' Experiences of Decision-Making Uncertainty in Intensive Care: An Interpretive Description

Area of Science:

• Nursing Education
• Critical Care Nursing
• Professional Development

Background:

• New graduate nurses in ICUs face significant challenges with clinical decision-making and uncertainty.
• The experience of uncertainty among novice ICU nurses is underexplored.
• Uncertainty impacts new nurses' ability to predict patient outcomes.

Purpose of the Study:

• To explore the lived experience of uncertainty among new graduate nurses in intensive care units.
• To understand the conditions, causes, manifestations, and consequences of uncertainty in this population.

Main Methods:

• Qualitative interpretive descriptive study.
• Semi-structured interviews with nurses having less than two years of ICU experience.
• Constant comparative analysis of interview data.

Main Results:

• Uncertainty is an iterative part of the experiential learning process for new ICU nurses.
• Unfamiliar or critical patient situations and team scrutiny exacerbate uncertainty.
• Nurses utilized self-questioning, personal knowledge, team expertise, and resources to mitigate uncertainty.

Conclusions:

• Uncertainty in new ICU nurses is influenced by clinical complexity and interpersonal dynamics, particularly team interactions.
• The nursing team can either support or intensify feelings of uncertainty.
• New graduate nurses question patient care trajectories and their own legitimacy within the ICU.