This grounded theory study provides guidance to nursing educators on the critical topic of formation of professional nursing identity. Formation of professional identity in nursing students is a necessary prerequisite to skilled, ethical, expert nursing practice (Rubin, 2009). The authors of the landmark national study Educating Nurses: A Call for Radical Transformation (Benner, Sutphen, Leonard, & Day, 2010) called for a renewed focus on formation of professional nursing identity in nursing education. Failure to form an identity as an ethical health professional results in incivility, disruptive behaviors in the workplace, lost revenue through lost employees and customers, and harm to patients (Porath & Pearson, 2010; Rosenstein & O’Daniel, 2005; Rubin, 2009). Formation of professional identity enhances personal resilience (Wald et al., 2015), psychological well-being, and job satisfaction (Armitage-Chan & May, 2018).
In response educators in medicine and nursing are giving renewed attention to teaching for formation of professional identity (Bebeau, 2006; Benner et al., 2010; Cruess, et al., 2014; Luparell, 2011; Pellegrino, 2006). There is no theoretical framework that addresses both the process of formation of professional identity and the role of educators in bringing about formation.
Methods:
In this grounded theory study twelve experienced nursing educators from four diverse baccalaureate programs in the southern US were interviewed. Data were analyzed using constant comparative analysis and basic social process, concepts, and relationships were identified. The resulting grounded theory provides a framework to guide nursing education practice for formation of professional identity in nursing students.
Results:
Putting the Pieces Together is the basic social process for formation of professional nursing identity. The final framework consists of three parts.
Entering student identities Developing a professional nursing identity is a process of transformation, of relinquishing an existing identity and forming a new identity. Students come to their nursing education with existing identities that impact their identity formation tasks, either as emerging adults, adults, or adults transitioning from another health care occupation. Students in these groups may also be vulnerable students who require additional faculty support.
Student developmental characteristics Students progress through predictable stages as they learn to think, feel, and act like professional nurses. Student needs evolve as they progress through these stages.
Educator practices Nursing educators influence the process of forming a professional nursing identity by understanding the student on the basis of that student’s entering identity, creating a safe learning environment, providing support appropriate to the student’s level of development, and skillfully using appropriate pedagogies such modeling, reflection, and pedagogical caring.
Conclusion:
Nursing educators lay the foundation for professional nursing identity formation that continues when new graduate nurses enter practice. This grounded theory provides a beginning framework to help nursing educators understand their role in educating for formation of professional nursing identity. Students enter nursing school with individual characteristics that impact their identity formation tasks and then progress through stages of development in learning to think, feel, and act like nurses. Nursing educators need to consider the individual student’s characteristics and developmental stage to create learning environments that support formation of professional nursing identity.