Reality shock in newly graduated critical care nurses and its association with missed nursing care: The mediating role of caring ability

Objectives: This study is a report assessing the intermediary role of caring ability in the association between reality shock in newly graduated nurses and missed nursing care. Research Methodology/Design: This descriptive study involved 286 newly graduated nurses working in various critical care units. Three standardized scales were used to collect data, including the Missed Nursing Care Scale, the Environmental Reality Shock-Related Issues and Concerns (ERS-RIC) Scale, and the Caring Ability Inventory (CAI). The Hayes' PROCESS macro in SPSS (Model 4) was utilized to perform mediation testing. The data was collected from March 2022 to July 2022.Setting: Critical care units in seven Philippine hospitals.Results: Newly graduated critical care nurses reported moderate levels of reality shock (mean symbolscript 50.31). Reality shock was directly associated with missed nursing care (13 symbolscript 0.0493, p symbolscript 0.0066). Caring ability partially mediated the association between reality shock and missed nursing care through caring ability (13 symbolscript 0.0042, SE symbolscript 0.0027). Conclusions: Newly graduated critical care nurses experience reality shock during the initial two years of employment. Reality shock diminishes the caring abilities of the newly graduated nurses, leading to a higher incidence of missed nursing care. Implications for Clinical Practice: Institutional strategies aimed at facilitating a smooth transition for newly graduated nurses should be prioritized to prevent a decline in their caring abilities and ultimately reduce compromises in nursing care.