Professional identity transitions, violations and reconciliations among new nurses in low- and middle-income countries

Datos Bibliográficos

ID21258060
AutoresDaniel Mbuthia (0000-0003-0021-305X, Kenya Medical Research Institute, autor de correspondencia), Daniel Waweru Mbuthia, Gerry Mcgivern (0000-0002-0440-0787, University of Warwick), Mike English (0000-0002-7427-0826, Kenya Medical Research Institute), Sharon Brownie (0000-0001-7204-2451, Waikato Institute of Technology), Debra Jackson (0000-0001-5252-5325, The University of Sydney), David Gathara (0000-0002-0958-0713, Kenya Medical Research Institute), Jacinta Nzinga (0000-0001-8394-8857, Kenya Medical Research Institute)
Año2021
Volumen1
Páginas100024
Fecha de publicación2021-12-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaSSM - Qualitative Research in Health (JOURNAL)
Identificadores de la revistaISSN: 2667-3215 • E-ISSN: 2667-3215
EditorialElsevier BV (PUBLISHER)
DOI10.1016/j.ssmqr.2021.100024
OpenAlexW4200252749
IdiomaEN
Citas recibidas2
Referencias citadas49

We examine how new nurses construct their professional identity in Low- and Middle-Income Countries (LMICs) when they enter clinical practice and encounter practical norms violating procedural standards. We conducted interviews and focus group discussions with 47 Kenyan nurses. We describe new nurses experiencing ‘shock’ entering nursing practice (working and learning alone while responsible for many patients and doing ‘dirty work’), which contrasted with their idealized image and expectations of nursing and prior training. We explain this transition using theory about identity and identity work, which we argue elucidates nurses' experiences in LMICs. We suggest that nurses' transition into clinical practice violated pre-existing expectations for their professional identities, which then triggered identity work of ‘toughening up’, ‘maturing through experience’, and ‘learning practical norms’. Through this identity work, and finally experiencing satisfaction from caring for and nursing patients back to health, some nurses were able to restore their valued professional identity. Our findings highlight the need for professional educators and healthcare policymakers in LMICs to reconsider the way new healthcare workers are prepared for and socialized into professional practice, acknowledging that nursing practice is often very different to training. We argue for developing formative spaces in which health professionals can safely discuss practical norms deviating from procedural standards. Drawing on such conversations, practical norms benefitting the quality and safety in resource constrained contexts might then be incorporated into care standards and ways found to address practical norms harming of patient care

Formative assessment · Health care · Pedagogy · Political science · Professional development · Public relations · Global Maternal and Child Health · Interprofessional Education and Collaboration · Law · Medicine · Nursing · Nursing education and management · Psychology