Fresh Faces to ICU Aces: Boosting Confidence and Retention for New Graduate Nurses in Intensive Care

Introduction: In 2022, the intensive care division experienced an increased nurse turnover of 21.9% compared to a 13.1% organizational benchmark, and a first-year retention rate of 76% for new graduate nurses. In 2023, the division hired seven times more new graduate nurses than pre-pandemic. Leaders identified gaps in critical thinking, specialty-specific knowledge, and practice among new graduate nurses. The established enterprise new graduate residency program did not successfully bridge the gap from new graduate novice to intensive care nurse.Purpose: To provide an in-person, post-orientation new graduate nurse residency program to increase confidence, personal wellness, and first year retention.Method: Learning needs assessment of new graduate nurses revealed gaps in six key areas: patient experience, infection prevention, pulmonary care, pharmacology, hemodynamics, and neurology. Intensive care division leadership developed a six-session in-person program to foster inter-unit collaboration. Program featured didactic sessions, wellness activities, and hands-on skill training, emphasizing nurse-sensitive indicators and low-volume, high-risk skills. Sessions led by a multidisciplinary team of subject matter experts, unit leaders, certified nurses, and physicians. To evaluate confidence and participant feedback, participants completed a Likert scale and free text survey pre and post-sessions and 6 months after program completion.Findings: On average, confidence increased from 61% to 83% and boosted to 88% six months post-residency program. Participants indicated an increased connection to peers, self-confidence in providing critical care and feeling supported by leadership. First year retention rate of program participants was 96%. Leaders found participants experienced a positive shift in the culture of inquiry, including the organization's high-reliability tools and tactics.Conclusions and Implications for Practice: This initiative improved nurse confidence, promoted a healthy environment for personal and professional development and retention. This framework is translatable to other specialties that have an increase in new graduate team members.