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

New graduate nurses entering intensive care units (ICUs) directly after graduation often face challenges in clinical decision-making, contributing to a sense of uncertainty-the inability to predict the outcome of a patient situation. Although uncertainty has been studied in other healthcare contexts, it remains underexplored among new graduate nurses in the ICU.

To explore the experience of uncertainty among new graduate nurses working in ICUs.

This qualitative interpretive descriptive study was guided by a theory of uncertainty, which examines its conditions, causes, manifestations, remediation strategies and consequences. Semi-structured interviews were conducted with new graduate nurses with < 2 years of ICU experience, and data were analysed using a constant comparative method.

Participants' experiences of uncertainty formed part of an iterative, experiential learning process. Uncertainty arose primarily from unfamiliar or critical patient situations and was exacerbated by the nursing team's scrutiny. In response, new graduate nurses engaged in self-questioning about both clinical situations and their own competence. To mitigate uncertainty, they relied on personal knowledge, team expertise and available resources.

Uncertainty among new graduate nurses in the ICU is shaped not only by clinical complexity but also by interpersonal dynamics. The nursing team plays a significant role in both supporting and intensifying feelings of uncertainty. New graduate nurses question the trajectory of patient care and their role and legitimacy within the ICU environment.

This study highlights the multifaceted nature of uncertainty among new graduate nurses in intensive care. Targeted support strategies-such as mentorship, structured feedback and reflective learning opportunities-are essential to foster confidence, clinical competence and professional integration.