Improving Staffing in the ICU with New Graduate Nurses: A Novel Critical Care Fellowship Program


  • Emma Blackmon UC Davis Health
  • Haley Floriano UC Davis Health
  • Sarina Fazio UC Davis Health
  • Amy Doroy UC Davis Health



Critical Care, nursing, new graduate nurse, novice nurse, personnel turnover, internship, residency, nurses, nursing staff


Background: There is a growing shortage of critical care nurses. New graduate nurses (NGN) are increasingly hired into critical care settings, though NGN job turnover is estimated between 18-60% in the first year of practice. The COVID-19 pandemic exacerbated nurse turnover and the need to rapidly train new ICU nurses while also employing effective retention management strategies.

Aim: To highlight the success of a NGN Critical Care Fellowship Program (CCFP) within the existing health system’s NGN Residency Program prior to and during the COVID-19 pandemic.

Methods: The CCFP was launched in 2016 with 7 participating ICUs. The NGNs participate in the medical center’s existing 1-year NGN Residency Program and spend a total of 24 weeks orienting in 3 different ICUs. Orientation concludes based on a performance evaluation and readiness to work independently. NGNs are mentored and supported throughout their first year in practice through monthly debriefing of clinical and preceptor experiences.

Results/Findings: Between 2016-2022, a total of 65 NGNs have participated in the CCFP. Sixty fellows completed orientation and were hired into an adult ICU during their orientation period. Retention of CCFP NGNs after 1 year was 96% (n=48/50), 2 years was 97% (n=33/34) and 3 years was 96% (n=23/24).

Conclusions: Results demonstrate the development of an educationally robust, emotionally compassionate program, concentrated on the development, training and focused support of the NGN can be successfully implemented and sustained over time.




How to Cite

Emma Blackmon, Haley Floriano, Sarina Fazio, & Amy Doroy. (2023). Improving Staffing in the ICU with New Graduate Nurses: A Novel Critical Care Fellowship Program. International Journal of Critical Care, 17(2), 11–22.

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