Discovering the Experiences of New Registered Nurses in

establishing their Professional Identity in Hospital Settings

I. Introduction

The nation faces increase graduates of nursing. Many of which

has the ambition to work abroad and serve our own country for quite

sometime. Most of them also did local working as training ground

then after 1 or 2 years will opted to try their opportunities in different

part of the world. Before having their training, there’s always

memorable start, from the time they entered a certain facility to apply

for the position then to stage of working with colleagues. Many

attitudes had been observed such as trembling, frightened, high level

of anxiety and many others. The question is how an individual at one

time is the same individual at another time in a hospital setting. In the

event of the increase number of graduates there’s also a potentially

dangerous nursing shortage. According to Groom (2003), registered

nurse’s average age is 47 years. This, coupled with the number of

nurses leaving the profession because they are dissatisfied, is

creating a crisis. Although staff shortages have occurred in health

care throughout history, experts believe the developing nursing

shortage is uniquely serious due to a supply shortage and a demand

increase. Issues involved include steep population growth in several

states, a diminished pipeline of new nursing students, an aging work

force, a Baby Boomer bubble that require intense health care

services just as the majority of nurses retire, and broadening health

care job opportunities. (Sigma Theta Tau International, 2001)

Current nursing research supports a disparity between the

idealism and professionalism of the educational process and

professionalism and the actualization of the practice environment,

which leads to nurses leaving the profession. Saarman, Freitas,

Rapps, and Riegel (2008) concluded that the further research is

needed to determine whether nursing eduacational programs have

significant influence on professional socialization when compared

with the workplace. Additional knowledge could help in understanding

this gap and contribute increased retention in nursing. Saarman et.al.

concluded that quantitative research would be useful to examine

professional nurse characteristics. Such an approach would allow

data to define the entity rather than to test a preconceived definition.

The development of professional of professional identity is an

importatnt process in nursing profession (Secrest, Norwood &

Keatley, 2003). Historically nurses have found difficulty in defining

nursing and distinguishing it from other health care disciplines.

According to Secrest et. al., no literature has been found describing

what being a nurse means to an individual.

According from Patricia Benner, Novice to Expert’s theory, in

the acquisition and development of a skill, a student passes through

five levels of proficiency: novice, advanced beginner, competent,

proficient, and expert. These different levels reflect changes in three

general aspects of skilled performance: (1) One is a movement from

reliance on abstract principles to the use of past concrete experience

as paradigms. (2) The second is a change in the learner's perception

of the demand situation, in which the situation is seen less and less

as a compilation of equally relevant bits, and more and more as a

complete whole in which only certain parts are relevant. (3) The third

is a passage from detached observation to involved performer. The

performer no longer stands outside the situation but is now engaged

in the situation.

Nursing is a kind of occupation delivering services to

individuals, families, and societies of all conditions. High level job

satisfaction is important for nurses in order to their services delivery

quality be high as well. In the literature, it is declared that in case

individuals have high work satisfaction, behaviors such as being

active at work, pursuing new goals and establishing good

relationships are observed. On the other hand, in case of being

unsatisfied , problems may arise such as slowing down the work

pace, being late for work or not attending at work, resigning of work,

starting to complain, being critical (Asti and Pektekin, 1194; Kacel et.

al., 2005; Rambuer et. al.,2005; Fako-Thabo, 2000)

II. Analysis and Discussion of Concept in Relation to Nursing

Several critical points emerged from the data in joining the

profession of nursing. Various passage points were experienced by

new nurses as they negotiated joining the nursing profession. Within

all of these passages, relationships were identified as paramount to a

successful transition. Themes of responsibility, continued learning,

and perfection were pervasive during all passages and were noted by

newly graduate nurses as being integral components of professional

identity.

In this study, I have been through this experience like most of

our newly nurse did. Finding a niche, a place where individuals’

values and skills successfully fit with the people with whom they work

and the environment within which they practice. It also means

negotiating the transition from school to work. Developing a sense of

what it means to be a nurse, what the position requires, and how

nursing compares to other health care professions is involved in this

transition. Nurses in this study identified the importance of “fitting in”.

Fitting in involved a sense of family, being happy, feeling

professional, delivering quality care to patients and families, and

feeling that their capabilities or skills were compatible with those

required in the practice.

All nurses entering in a certain facility or institution completed

an orientation process when they began working in their particular

area. Some felt it was a good experience, whereas others have

negative feelings. A critical factor that determined the orientation’s

success was the relationship nurses had with their preceptor.

Participants often felt that their preceptor was difficult to work with.

Preceptors were mostly described as, “testing your authority to see if

you will back down. There is a lot of testing that goes on to see if you

really know what you are doing.” Nurses also experienced that their

preceptor leaving them alone in situations in which they did not feel

comfortable. Nurses described differences in orientation based on

which shift was worked. “good” preceptors were identified; however

they were far outnumbered by “bad’ preceptors. Hence, a “payback”

system in which nurses tend to repeat the bad experiences they had

as new graduates when they become preceptors

Nurses felt more comfortable with longer orientations and

observation from attentive preceptors. The importance of a good

orientation process was stressed as a solid foundation for entering

the profession throughout the data. When orientation process were

not successfully negotiated, voluntary or involuntary termination,

feelings of anger and failure resulted. Positive factors identified

included helpful and informative preceptors, teamwork, life

experiences, and time. Lack of support from the system and the

individual preceptors were negative factors frequently encountered.

Throughout the data collection and analysis, the researcher

wrote data discussing her reactions, impressions and ideas about

codes and possible themes so that the context of interactions would

remain intact. Both during and after collection of information, the

researcher analyzed the data inductively and identified the themes

that helped organize data and lead to subsequent collection.

III. Synthesis and Conclusion

Conceptual Framework of New Nurses and Professional Identity

Passing the Licensure

Examination

Job Application

Orientation Finding a Niche

Moving on

Satisfied Unsatisfied Fitting in Increasing Skills

The significance of this study rests in situational influences on

the construction of identity, the need for balance and support in the

practice environment, passage points in the first 3 years of practice,

and the organizational need to support nursing empowerment and

voice.

IV. Bibliography

Denise Depoliti, “Exploring How New Registered Nurses Construct Professional Identity in Hospital Settings”, The Journal of Continuing Educationin Nursing, June 2008, p. 255

Zehra Golbasi, “Relationships between coping strategies, individual characteristics and job satisfaction in a sample of hospital nurses: Cross-sectional questionnaire survey”, Writing for International Publication, January 2009, p. 105-111

Guldal Guleryuz, “The mediating effect of job satisfaction between emotional intelligence and organizational commitment of nurses: A questionnaire survey” Writing for International Publication, January 2009, p. 121-130

Benner, P. (1984). “From novice to expert: Excellence and power in clinical nursing practice” Menlo Park: Addison-Wesley, pp. 13-34.

Siliman University

Dumaguete City

In Partial Fulfillment of the Requirement

A Concept paper:

Discovering the Experiences of

New Registered Nurses in

Establishing their Professional Identity

in Hospital Settings

Prepared to:

Prof. Abalos

Prepared by:

Niña Alma M. Bianson

February 2009