Ghana ICU nurses report mentorship gaps, qualitative interview study finds

Newly recruited intensive care nurses at Ghana’s National Referral Hospital described inconsistent access to assigned mentors, limited time for learning procedures and uneven support when shifting to critical care practice. In a qualitative interview study, 12 nurses working in four ICUs at the hospital in Accra said shift mismatches, pairs with general nurses rather than critical care specialists, and a lack of collaborative learning shaped their early experiences. They also described self-directed learning, peer support and regular assessment as ways to adjust.

The findings concern one hospital and 12 participants, so they illustrate experiences at that institution rather than establish their prevalence across Ghana. The study was conducted at the National Referral Hospital in Accra, where participants came from the medical, plastics and reconstructive, cardiothoracic and neurological ICUs. Each of these units had an average capacity of eight beds and provided nursing care around the clock.

The hospital provided specialized services across multiple fields and had a sizable critical care operation, but the article also describes the setting as resource-constrained and notes that it had no institutional-specific mentorship policy or structured protocols guiding mentorship. Participants were newly recruited nurses who were new to the hospital and the ICU environment but had previously worked as general nurses. They had completed the mandatory internship required by their training and had worked in one of the four ICUs for six to 12 months.

The final sample included 12 purposively selected participants, aged 26 to 38 years, whose work experience ranged from seven to 11 months. Participants held either a diploma in nursing or a bachelor’s degree in nursing, and some held both qualifications. Researchers used an exploratory descriptive qualitative design and conducted in-depth, semistructured interviews in English from March to May 2023.

Interviews lasted approximately 30 to 45 minutes and took place in staff restrooms in the ICUs. The guide was pilot tested with similar participants at a teaching hospital in Ghana’s Ashanti Region. Data collection and analysis occurred concurrently: recordings were transcribed verbatim, and transcripts and field notes were examined through reflexive thematic analysis in NVivo 11.

Two researchers independently coded the material before reconciling differences and reviewing the resulting themes. Purposive recruitment continued until meaning saturation was reached at the 12th interview, with redundancy evident after the tenth. Member checking, field journals, reflexive journaling and discussions among the research team supported the study’s procedural rigor.

One of the clearest problems was a mismatch between a novice nurse’s shift and that of the assigned mentor. Some participants initially worked the same schedule but were later separated, with one nurse working mornings while the mentor worked afternoons or nights. When a mentor was on leave, participants sometimes had no designated person available to teach them.

Several turned instead to colleagues or online resources for help. In the accounts, this arrangement reduced opportunities for direct teaching, observation and questions. It also meant that self-directed learning became a practical response to gaps in continuity rather than simply a preferred learning method.

The match between mentor expertise and the newcomer’s learning needs was another central concern. Some participants said they had been assigned to general nurses and wished instead to be paired with senior critical care nurses. They believed guidance from staff with ICU-specific experience would better support the skills they wanted to develop.

One participant described the pairing as unfair because agreed goals and targets were not achieved; another said it was frustrating to enter a new environment without someone to teach the required knowledge. The study did not compare outcomes between different types of pairing, but it documents a perceived mismatch between the expertise participants wanted and the assignments they received. Participants also described a learning environment that was not consistently supportive or collaborative.

Some reported that colleagues appeared reluctant to assist, while others felt stranded when no one was available to answer questions. Corrective feedback after a task was described as largely absent, despite being an expected function of mentoring. The experience was not uniformly negative: a few nurses described mentors who were available, supportive and involved in practical teaching, with some providing constructive feedback that helped them build confidence.

The contrast suggests that relationships varied substantially and that positive support depended on the availability, behavior and expertise of individual mentors. To cope, newly recruited nurses consulted more experienced colleagues and peers, exchanged ideas and searched online for information. Some described carrying out a task and then telling their mentor about it when the mentor became available.

They also discussed a future in which orientation would be structured step by step, mentors would be assigned during that process, and dedicated mentor–mentee time would be protected. Existing orientation lasted from about one to four months and consisted mainly of nurse demonstrations and completion of competencies. Participants wanted staged orientation followed by continuing mentorship rather than an initial period that ended without sustained support.

Regular evaluation and feedback were another recurring request. Participants said periodic assessments would allow mentors and nurse managers to recognize progress, identify areas needing improvement and provide useful feedback. Peer support was also valued as a complementary layer of assistance.

Newly recruited nurses said colleagues and other new recruits helped them share information, solve problems and reduce isolation, sometimes more effectively than the formally assigned mentor. These coping accounts fit the study’s adapted organizational socialization framework, which examines how newcomers learn workplace norms and adjust through organizational effort, feedback seeking, support and peer relationships. The study describes associations in that framework; it does not test the effects of mentorship or peer support experimentally.

The authors recommend structured institutional mentorship protocols, protected time for mentors, competence-based orientation, periodic competence-based assessment, peer mentoring and better coordination of novice and experienced nurses’ shifts. These recommendations arise from participants’ experiences and the study authors’ interpretation of the findings. The evidence remains bounded by the small, single-site sample and cross-sectional qualitative design.

The authors also note possible social-desirability and recall bias and say the results cannot be generalized to other hospitals or used to infer causes. Future research was suggested to include larger and more varied samples, multiple settings and individual characteristics excluded from this analysis, including personality, motivation and prior experience. Within those limits, the study documents how 12 new ICU nurses experienced an already resource-constrained hospital and how they coped when formal mentoring was inconsistent, incomplete or unavailable.

Subject of Research: Experiences and coping strategies of newly recruited ICU nurses at a Ghanaian referral hospital

Article Title: Lived Experiences and Coping Strategies of Newly Recruited ICU Nurses in a Resource‐Constrained Hospital in Ghana

Article References: Konlan, K. D., Koduah, A., & Ampomah, M. O. (2026). Lived Experiences and Coping Strategies of Newly Recruited ICU Nurses in a Resource‐Constrained Hospital in Ghana. Nursing Open, 13(10), Article e70950. https://doi.org/10.1002/nop2.70950

Image Credits: AI Generated

DOI: 10.1002/nop2.70950

Keywords: Ghana, intensive care nursing, new graduate nurses, clinical mentorship, orientation, peer support, qualitative interviews, organizational socialization, nursing education, Accra, Lived, Experiences