Professional identity in nursing: UK students' explanations for poor standards of care

Traynor, Michael; Buus, Niels

doi:10.1016/j.socscimed.2016.08.024

Cited by 43 publications

(40 citation statements)

References 16 publications

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“…The two‐stage screening process resulted in 92 studies included in the scoping review . Of these, 57 investigated PIF in medical students and/or residents, 26 involved nurse trainees (associate, bachelor, graduate and nurse managers), and nine involved counselling or psychology undergraduate or graduate students …”

Section: Resultsmentioning

confidence: 99%

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Is research on professional identity formation biased? Early insights from a scoping review and metasynthesis

et al. 2019

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OBJECTIVE Despite a recent surge in literature identifying professional identity formation (PIF) as a key process in physician development, the empiric study of PIF in medicine remains in its infancy. To gain insight about PIF, the authors examined the medical literature and that of two other helping professions.METHODS The authors conducted a scoping review and qualitative metasynthesis of PIF in medicine, nursing and counselling/psychology. For the scoping review, four databases were searched using a combination of keywords to identify empiric studies on PIF in trainees. After a two-step screening process, thematic analysis was used to conduct the metasynthesis on screened articles. RESULTSA total of 7451 titles and abstracts were screened; 92 studies were included in the scoping review. Saturation was reached in the qualitative metasynthesis after reviewing 29 articles.CONCLUSION The metasynthesis revealed three inter-related PIF themes across the helping professions: the importance of clinical experience, the role of trainees' expectations of what a helping professional is or should be, and the impact of broader professional culture and systems on PIF. Upon reflection, most striking was that only 10 of the 92 articles examined trainee's sociocultural data, such as race, ethnicity, gender, sexual orientation, age and socioeconomic status, in a robust way and included them in their analysis and interpretation. This raises the question of whether conceptions of PIF suffer from sociocultural bias, thereby disadvantaging trainees from diverse populations and preserving the status quo of an historically white, male medical culture.Professional identity formation (PIF) in medicine focuses attention on the career-long process of becoming a clinician. 1,2 PIF can be thought of as a double helix: the individual and the profession form parallel strands that become intertwined. Each strand must bend in order to accommodate the other; however, this burden of bending and changing to accommodate seems to fall more acutely on the individual strand, with the profession's strand remaining more fixed. PIF frequently involves experimentation, change and uncertainty, and ideally results in the successful reconciliation of conflicting ideals, values and roles. Although successful formation of a professional identity has been linked to career success 3 and creativity at work, 4 a mismatch between an individual's internal bearings and the roles and expectations of the profession can create anxiety, frustration and feelings of inadequacy, and can result in the individual leaving the profession. 5 The role of culture, race, socioeconomic status and gender might be expected to be critical components of the individual strand, and could prove to be important confounders in the study of this complex process.We set out to gain an understanding of the current state of the PIF literature in medicine by conducting a scoping review and metasynthesis of the literature across three of the helping professions (medicine, nursing and counselling/ p...

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Section: Resultsmentioning

confidence: 99%

“…Of these, 57 investigated PIF in medical students and/or residents, 26 involved nurse trainees (associate, bachelor, graduate and nurse managers), and nine involved counselling or psychology undergraduate or graduate students . Three of the studies had a mixed‐methods design, six were quantitative and 83 were qualitative …”

Section: Resultsmentioning

confidence: 99%

Is research on professional identity formation biased? Early insights from a scoping review and metasynthesis

et al. 2019

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“…Nursing education is crucial in preparing the future workforce to be more focused on the nurses’ role by increasing professional identity (Traynor & Buus ). The … transition from vocational training (at the school of nursing level) to academic education (at the university level) occurred in Italy in the last 20 years and has contributed to increasing nursing identity, making nurses aware of the role ambiguities imposed in daily care.…”

Section: Discussionmentioning

confidence: 99%

Non‐nursing tasks as experienced by nurses: a descriptive qualitative study

Grosso¹,

Tonet²,

Bernard³

et al. 2019

International Nursing Review

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Background Different concepts have been used to date (e.g. non‐nursing tasks, organizational work) to define tasks performed by clinical nurses other than nursing care. However, the true essence of nursing work is still poorly understood mostly because nurses are lacking an appropriate lexicon to describe their practice. Aims To describe non‐nursing tasks as experienced by nurses, exploring antecedents and consequences as perceived in daily practice. Methods A descriptive qualitative study from 2015 to 2016. A purposeful sample of nurses was approached. Semi‐structured interviews were used, and content analysis was performed on audio‐recorded and verbatim‐transcribed interviews. Findings A total of 22 nurses participated, the majority of whom were female (16; 72.7%) and their average age was 42.6 years. The concept of ‘Non‐nursing tasks’ is limited in describing what nurses experience in daily practice; the concept of ‘Being out of the nursing role’ emerged as being fully descriptive of the nurses’ experience and this can occur in two dimensions: outside and inside the role of other healthcare professions. The first dimension includes administrative work separating nurses from patients. The second dimension was reported to happen in proximity to patients but in three different directions towards professions requiring: (a) less education (e.g. healthcare assistants), (b) the same amount of education at university level (e.g. physiotherapists), and (c) higher education at university level as compared to nurses, thus performing activities expected by physicians. Antecedents of ‘Being out of the nursing role’ have been identified at the organizational, individual and educational levels; their consequences have been reported at the patient, professional and organizational levels. Conclusion Nurses play various non‐nursing roles, below, above and in the horizontal levels, both inside and outside other healthcare professionals’ role, mainly as a result of their felt moral obligation to offer the best to their patients, the organization's demand to nurses and the imprinting of nursing education. Implications for nursing/health policy Strategies at the nursing professional and policy levels are needed aimed at (a) supporting nurses in optimizing their professional identity, (b) sharing their sense of moral obligation towards patients with other healthcare professionals, and (c) implementing models of care based on interprofessional cooperation.

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“…This was quickly followed by revelations of failure at the Vale of Leven (MacLean, ), at Winterbourne View (Phelvin, ), Morecambe Bay (Walsh, ) and in Wales (Andrews & Butler, ). Healthcare and the state of professional caring in the UK are under significant scrutiny, with nursing care particularly implicated (Traynor & Buus, ). In 2018, a possible new nadir was reached with publication of the “Gosport Report” in the UK detailing the possible “shortening of the lives” of some 600 or more older people in a hospital (Darbyshire & Ion, , ).…”

Section: Is Poor Care a Significant Problem?mentioning

confidence: 99%

Failure to report poor care as a breach of moral and professional expectation

Ion

Olivier

Darbyshire³

2019

Nursing Inquiry

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Cases of poor care have been documented across the world. Contrary to professional requirements, evidence indicates that these sometimes go unaddressed. For patients, the outcomes of this inaction are invariably negative. Previous work has either focused on why poor care occurs and what might be done to prevent it, or on the reasons why those who are witness to it find it difficult to raise their concerns. Here, we build on this work but specifically foreground the responsibilities of registrants and students who witness poor care. Acknowledging the challenges associated with raising concerns, we make the case that failure to address poor care is a breach of moral expectation, professional requirement and, sometimes, legal frameworks. We argue that reporting will be more likely to take place if those who wish to enter the profession have a realistic view of the challenges they may encounter. When nurses are provided with robust and applied education on ethics, when “real‐world” cases and exemplars are used in practice and when steps are taken to develop and encourage individual moral courage, we may begin to see positive change. Ultimately however, significant change is only likely to take place where practice cultures invite and welcome feedback, promote critical reflection, and where strong, clear leadership support is shown by those in positions of influence across organisations.

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Professional identity in nursing: UK students' explanations for poor standards of care

Cited by 43 publications

References 16 publications

Is research on professional identity formation biased? Early insights from a scoping review and metasynthesis

Is research on professional identity formation biased? Early insights from a scoping review and metasynthesis

Non‐nursing tasks as experienced by nurses: a descriptive qualitative study

Failure to report poor care as a breach of moral and professional expectation

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