If we develop it, will they stay?

If we develop it, will they stay?

Aims and Background: New graduates nurses (NGNs) are being placed in acute and complex neonatal intensive care units (NICUs). The NGNs transition experiences are varied around Australia and inadequate support could lead to high attrition of NGNs in NICUs (Alsalamah & Fawaz, 2023). To effectively support new graduates, it is essential for nurse educators to understand the new graduate experiences and their preparedness for working in NICUs. A qualitative systematic review was undertaken to identify evidence around nurses’ perceptions, challenges, facilitators, and barriers they experienced during their first 12 months in NICU.

Methods: Five databases were searched to identify studies about new graduate nurses and transition programs. The review included studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, and qualitative components of studies using mixed method designs. The review followed principles of meta-aggregation in line with the JBI approach and it followed the methods established in the a priori protocol. Methodological quality assessment was based on representation of participants’ voices and congruence between research methodology, research question and analysis of data.

Results: Three qualitative studies were included in the review. The narratives of 27 new graduate nurses generated 39 findings that formed 8 categories based on similarity of meaning. Two synthesized findings were generated from these categories: (i) feeling unprepared (ii) Job satisfaction despite challenges. Feeling unprepared included the lack of neonatal specific content in undergraduate training and inconsistent clinical support. Nurses reported job satisfaction despite challenges such as stress caused by their lack of knowledge and attitudes from staff.

Conclusions: To our knowledge this is the first systematic review investigating new graduate experiences in the NICU. The review highlighted the complexities of experiences faced by NGNs in the NICU setting. In particular, the findings highlighted that NGNs were unprepared and lacked confidence due to the specialised knowledge and skills required to work in NICUs. It is timely to consider how we can create supportive work and learning environments for these new graduates. Further research exploring interventions that can effectively transition new graduates to NICU practice is recommended.

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