Tiffaney Cayton

Degree Name

Master of Science in Nursing (MSN)

Document Type

Major Paper


Zvart Onanian School of Nursing



Date of Original Version



Background: The COVID-19 pandemic has affected the nursing field and how nurses care for their patients. Recent nursing shortages in critical care are causing organizations to depend on new graduate nurses to fill these needs. The critical care environment's safety depends on nurses' ability to provide safe, quality care in a demanding, complex environment and current orientation processes do not adequately support this influx of new graduate nurses entering critical care.

Purpose/Specific Aims: This quality improvement project aimed to identify new graduate and experienced precepting nurses'™ perceived barriers and facilitators regarding the orientation process within the critical care setting.

Methods: Two open-ended surveys were distributed to collect qualitative data from both experienced precepting nurses and new graduate nurses on the perceived barriers and facilitators of new graduate orientation. Responses were inductively coded to identify themes of barriers and facilitators. Deductive coding was used to identify recommendation themes. The AACN's Synergy Model was used as a theoretical framework to guide this project and synthesize the data.

Results: Seven new graduate nurses and 13 experienced precepting nurses responded. Four facilitator themes (teamwork/collaboration, favorable outcomes, symbiosis, and rewards/motivation) and five barrier themes (time management, lack of experience, character, orientation process, and demand/stress) emerged. Recommendation themes associated with the orientation process and transition processes emerged after analysis.

Conclusion: The results of this project provide a transparent direction for improving the orientation process which can assist in cultivating a tailored orientation experience beneficial to the preceptor, novice nurse, patient, multidisciplinary team, and organization. With this information, healthcare organizations can endorse policies and procedures to advocate for a successful transition for the new graduate nurses, ensuring better patient care, improved staff satisfaction and retention, and decreased healthcare costs.

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