Insufficiently supported in handling responsibility and demands: Findings from a qualitative study of newly graduated nurses

AIMS AND OBJECTIVES: To explore newly graduated registered nurses' experiences and how they manage complex patient situations. BACKGROUND: Newly graduated registered nurses' working in acute care hospital settings are challenged by managing complex patient situations in rapidly changing clinical contexts involving increased patient acuity, comorbidities and staffing shortages. DESIGN: Qualitative study design. METHODS: Data were collected using focus groups interviews of a total of 16 newly graduated registered nurses with clinical work experience of 6 months of direct patient care in an acute care hospital setting. Analyses were conducted using qualitative content analysis. COREQ reporting guidelines were used. RESULTS: The analysis resulted in the overarching theme “Not being sufficiently prepared and supported to meet responsibilities and demands.” The theme included three categories: “Responsibility is not in proportion to competence,” “Lack of medical competence and experience complicates patient safety” and “Strives for control to manage and organise nursing care.” CONCLUSION: The results show that newly graduated registered nurses' are not sufficiently supported for the level of responsibility and the demands placed on them when providing nursing in complex patient situations in acute care hospital settings. If they are given sole responsibility for multiple complex patient situations, patient safety may be compromised. RELEVANCE TO PRACTICE: Special attention need to be paid to NGRNs support to medical competence in the areas of assessing, planning, prioritizing, leading, and distributing nursing care in daily clinical settings for at least their first year of professional work.