**1. Introduction**

New graduate registered nurses (RNs) face stressful challenges learning their role as novice nurses. New nurses entering into clinical practice can face daunting issues: complex environments with advanced medical technology, high patient-to-nurse ratios requiring high-level skills, the need to advocate for patients and their families while delivering safe, quality care, and extending respect and compassion to individuals and their families. New graduate nurses may struggle with critical thinking skills, patient needs identification, and prioritization of patient care needs [1].

Without appropriate support, many new graduate RNs may experience stress, fatigue, anxiety, and burnout [2–5] and may leave the profession due to difficulty adapting to their role [6]. The stress of role transition accounts for up to 30% attrition of new graduate nurses in their first year [6], and up to 57% in their second year [7].

Undoubtedly, the well-documented stress of role transition is compounded when met with the severe strain of a global pandemic, and as cases of illness rise, the need for a robust workforce becomes paramount. Emerging evidence suggests that nurses have increased risk of stress, depression and burnout during COVID-19, with younger, less experienced female nurses at increased risk for mental health issues [8]. Providing appropriate support and resources during this transition is imperative to the satisfaction and retention of new graduate nurses; however, doing so is highly dependent on understanding the experiences of these key personnel during times of extreme stress. A recent meta-analysis found that a

**Citation:** Naylor, H.; Hadenfeldt, C.; Timmons, P. Novice Nurses' Experiences Caring for Acutely Ill Patients during a Pandemic. *Nurs. Rep.* **2021**, *11*, 382–394. https:// doi.org/10.3390/nursrep11020037

Academic Editors: Richard Gray and Sonia Udod

Received: 7 May 2021 Accepted: 25 May 2021 Published: 27 May 2021

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barrier to implementing appropriate interventions is lack of understanding of what staff and organizations need during pandemics to support their mental health [9].

While prior studies document Severe Acute Respiratory Syndrome (SARS) pandemic effects on nursing students [10], and the psychological impact on experienced nurses caring for COVID-19 patients in China [11], the current study captures the experience of novice nurses managing the stress of their professional role transition in a variety of settings during the COVID-19 pandemic which has not been previously reported. Heung and colleagues [10] suggested that working during a pandemic reinforced a strong sense of professional identity for nursing students in Hong Kong, China, during the peak of SARS. The study by Sun and associates [11] found that nurses with a median of 3.5 years of work experience similarly adapted to negative and positive emotions as well as personal growth in response to caring for patients with COVID-19. The purpose of this study was to describe the experience of novice nurses with less than two years experience working in acute care settings during a pandemic.
