Stress Coping and Psychological Resilience Development in Newly Licensed Registered Nurses During the Transition to Independent ICU Practice: A Descriptive Qualitative Study

Background: The transition from the intensive care unit (ICU) to independent practice is highly stressful for newly licensed registered nurses (NLRNs), who need to navigate complex clinical demands while growing professionally under high-risk conditions. Although psychological resilience is acknowledged as a critical factor for successful adaptation, the specific processes through which NLRNs cope with transitional stressors and develop such resilience are still inadequately understood. Objective: This study aimed to explore the stress coping mechanisms and psychological resilience experiences of NLRNs during their transition to independent practice in ICU. Methods: Descriptive qualitative study was conducted using purposive sampling. Between April and September 2024, 22 NLRNs were selected from the First Affiliated Hospital of Xiamen University in Xiamen. NVivo 12 was employed to systematically organize and code the interview data. The data were analyzed and thematically condensed through the application of content analysis methods. Results: Five themes and fifteen sub-themes emerged from the analysis: 1) deconstruction and reconstruction of identity, 2) the gap between know and do, 3) ethical dilemmas and emotional labor, 4) organizational socialization, and 5) turning point and "metamorphosis". Conclusion: The process of stress coping and resilience development among NLRNs transitioning to the ICU could be characterized as a "challenge-adaptation-growth" framework. By actively engaging with various stressors, NLRNs were able to cultivate resilience, which was marked by emotional adaptability, cognitive flexibility, and social connectedness. This development not only aided in their personal growth but also enhanced their professional value.