Accoglimento ed inserimento dell'infermiere novizio : un'indagine nelle "aree critiche" di 10 aziende ospedaliere milanesi

GOAL: this article examined the socialization tactics implemented by the organizational system in intensive care units of ten Hospitals of Milan, in order to help novice nurses to better start their new job. DESIGN: descriptive.Setting: Intensive Care Unit (ICU) in ten hospitals in Milan. OUTCOME MEASUREMENTS: the organizational systems of our sample were interviewed through e-mailed questionnaires. They were asked about which kinds of socialization tactics they plan and implement to help novice nurses to socialize with the new context during the first period in ICUs. RESULT: in most of the ten Hospitals there is a planned process to help novice nurses to socialize with the new context, with congruent assignment and evaluation (the percentage varied from 66% in emergency rooms to 100% in Neurosurgery Intensive Care Units). In every hospital, a novice nurse is assigned to expert nurses who help him/her during the first months. The period in which a novice nurse is in excess in the staff and where He/She depend closely to mentor's supervision varies from one to tree months. The total planned socialization period varied from three to six months but It is never shorter then tree months. The nurses' turn-over is a criticality since it often causes a decrease in the abovementioned periods. The criteria used to chose experts nurses often include clinical experience and good evaluation of their job. In the examined contexts, expert nurses lacked specific qualifications in educational skills or specific training adult education. CONCLUSIONS: a neophyte's socialization process in ICUs is complex. Therefore, it is necessary to plan it carefully. The relationship with the mentor, the group support, a congruent assignment and evaluation are matters of great importance during this period. In the examined contexts, almost all these factors were considered and implemented, but shortage and voluntary turn-over of nursing staff often compromised the full implementation of these socialization tactics. Another feature usually not implemented in the hospital managements interviewed was a specific education of expert nurses, especially in the adult-education field.