In keeping with the tenets of ethnography the findings from the study has led to a series of ethnographic hypotheses, and sufficient information about the construction of nurses’ professional identity in the workplace. This has enabled the postulation of an ethnographic theoretical framework. The framework will require further testing, and validation by studying nurses professional identity using SIT, and ethnographic processes in relation to other nursing activities, and other case contexts. What is presented in this final section of the Chapter is the emergent theoretical framework from this study.
140 | P a g e In this study the interactions of nurses with nurses in two professional activities have been extensively investigated in one case context. Through the application of ethnography in
conjunction with SIT the elements of group performance, social identity, and self-categorisation have enabled identification of the constitution, and the performance of professional identity. Consideration, and insights into internal influences, and external factors that determine the development of the nursing group have enable construction of the emergent theoretical framework (Tables 12, and 13).
Table 12: Social Identity Framework for Nurses’ Professional Identity SIT Constructs Intent
Group
Performance Motivation Many professional activities in nursing are aimed at developing the collective behaviours These activities are frequently led by senior nurses; Motivations are often focused on conformity of participants
through communication strategies of which storytelling is specifically significant
Goals Reinforce the ability of the professional nurse to manage complex work situations
Promote a philosophy of patient centeredness or the
centrality of the patient to all activities of the nurse, including the valued notion of patient advocacy
Norms To enact, and promote the nursing prototype which includes: The acceptance of complexity, and uncertainty of nurses’
work.
The valuing of the senior or experienced nurse as the aspired prototype.
The importance of the nurse collective through the salience of the concept of the nursing team
The significance of the team to ensure support for each other. Normalisation of work complexity often through storytelling,
and humour.
Group efficacy In the threat to volitional control, nurses’ will seek to maintain their group efficacy, and not always follow the organisational directive
Nurses’ commitment is first to the nursing group Social
Identities Identity Salience The salience of team is significant to the development of professional identity Much of the development of nurses’ professional identity can
be attributed to salient communications specifically storytelling
Conformity to specific professional activities contribute positively to the development of professional identity Nested Identities The clinical unit where a nurse works is a nested identity
These nested groups significantly impact on the development of a nurse’s professional identity
Cross cutting
Identities The less formal groups that nurses come in contact with within their work contexts serve to reinforce their salient commitment to the nursing group
Self-
categorisation The development of nurses’ professional identity is a cognitive process that is influenced by the working context of an individual nurse. Specifically the clinical nursing unit, and
141 | P a g e the nurses within that group.
The prototype within nursing is possibly represented through the nurse who is considered by other nurses as experienced When an individual nurse does not conform to the attributes
that are considered the normative fit then self-categorisation with the salient nursing group is faulty.
Self-categorisation is the result of the cognitive choices in relation to the stimuli received by each nurse within the context of their work specifically their clinical unit.
Table 13: Nursing Group Handover, and its Influence on Professional Identity SIT
Constructs Intent Demonstrated Behaviours
Group
Performance: Motivation Unification of the nurses who were rostered for the oncoming shift
Development of a group think Use of humour
Goals organise the oncoming shift, and unify the group
Allocation of patients
Offering of strategies for expected complex situations during the shift Norms Reinforce the need of
team conformity in order to carry out the nursing practice requirements during the shift
Dissemination of non-clinical patient information
Reinforcement of the valued prototype Reinforcement of patient advocacy Group-
efficacy Volitional control of nurses work is reinforced during the handover
The continuation of the meeting regardless of organisational directives The privacy of the environment of the
handover space
The acceptance of interruptions Social
Identities Identity Salience Reinforce the salience of the collective self Identification with the collective self through communication strategies i.e. storytelling
The emphasis on team
The expectation of conformity to the handover process
Nested
Identities Develop a specific nested identity of the nurses rostered to the specific shift
Conformity to the hierarchical structure of the handover process
Respect for the nurse considered experienced (usually those in charge of the shift)
Cross cutting
Identities Involvement in activities with groups that are less salient than that demonstrated in the handover group
Commitment to the nurse collective of the specific clinical nursing unit.
Self-
categorisation An important opportunity for stimuli, that then creates opportunities for self- categorisation within the nursing group
Behaviours that represent mutual performance
Reinforcement of attributes of the aspired prototype
142 | P a g e In Table 12 the Social Identity Framework for Nurses’ professional identity is postulated. In Table 13 Nursing Group Handover, and its influence on Professional Identity is postulated. These frameworks are summarised below, and they will provide a new beginning point for further research. The information presented in Table 12 provides are new framework that
acknowledges the significance social identity attributes to the construction of professional identity within nursing.
The information presented in Table 13 reveals the robustness of the social processes, and interactions embedded in the group handover processes which construct, and sustain nurses professional identity. This finding generated an alternative view to what clinical handover is traditionally considered to be about. The presiding question that arises from this handover framework is, has the true meaning of handover ever really been understood? This activity is significant in its effect on professional identity.
The findings of this study have been discussed in this chapter. The contribution of the research to new knowledge on Nurses’ professional identity is concluded in the next chapter.
143 | P a g e
Chapter 7: Conclusion
In the nursing tradition, professional identity is intrinsically linked to the in-group dynamic. At the outset of this research, the undertaking was to contribute to the existing body of knowledge on nurses’ professional identity, this purpose has been achieved. The particular significance of this research lies in the application of a theoretical perspective SIT, which has not previously been used within the nursing context. Use of this perspective has uncovered some new, and important findings.
The overall aim of this project was to investigate elements that constitute the performance of nurses’ professional identity within a specific work environment. This has produced new insights, and ethnographic hypotheses, and new theoretical frameworks which can now further drive research policy education, and practice.
Major findings of the research include the following points.
SIT provides an effective analytical framework for the examination of the development, and performance of the professional identity of nurse.
The group dynamic has a significant influence, and connection with the development, and affirmation of the professional identity of nurses.
Professional activities such as the group clinical handover provide the sites for the on- going social construction of nurse professional identity.
Professional activities such as the multidisciplinary activity provide sites for the performance of nursing professional identity.
This chapter is organised in relation to three key components these are conclusion in relation to