Abstract
Problem: New graduate nurses (NGNs) in the intensive care unit (ICU) experience a readiness to-practice gap when providing end-of-life (EOL) care.
Research Question: What is the effect of differences in timing EOL education in an ICU NGN’s first year and their self-efficacy to provide EOL care, emotional exhaustion, and reality shock?
Design: This pilot study used a complex experimental mixed methods design with the qualitative strand embedded after the quantitative intervention.
Methods: Pre- and post-intervention data were collected from 135 nurse residents (62 ICU nurses), 34 of whom were trained within 4 months of practice and 28 of whom were trained at 8- 12 months. Measures for EOL care self-efficacy, reality shock, emotional exhaustion, and demographic information were collected. Seven participants were interviewed after all participants completed the intervention.
Analysis: Paired t-tests were conducted to evaluate the intervention effects. Independent t-tests evaluated the timing effect of the intervention. Correlation analyses were conducted to evaluate relationships between the three outcome measures. Multiple regression tests evaluated the factors’ effects on outcomes. Qualitative data were analyzed using thematic analysis, and those results were integrated with the quantitative results.
Results: The early group demonstrated a significantly greater improvement in self-efficacy scores compared to the late group after intervention (early M = .59 vs. late M = .19, p = .013), along with a significant improvement in their reality shock scores. Emotional exhaustion scores did not differ significantly within or between groups. Self-efficacy was significantly negatively correlated with reality shock, whereas emotional exhaustion was positively correlated with reality shock. Qualitative analysis revealed several themes and generally supported early education.
Conclusions: This pilot study suggests that early EOL care education is preferable for NGNs despite transition shock and early education may significantly influence their self-efficacy to provide EOL care and experience of reality shock.
Date of publication
Summer 5-2025
Document Type
Dissertation
Language
english
Persistent identifier
http://hdl.handle.net/10950/4862
Committee members
Dr. Barbara McAlister, Dr. Huaxin Song, Dr. Jessica Peterson
Degree
Ph.D. in Nursing
Recommended Citation
Harrison, Annelies J., "TIMING END-OF-LIFE CARE EDUCATION FOR NEW GRADUATE ICU NURSES" (2025). Nursing Theses and Dissertations. Paper 149.
http://hdl.handle.net/10950/4862