Factors that affect the process of professional identity formation in public health nurses

Mika Okura, Miyoko Uza, Hisako Izumi, Masami Ohno, Hidenori Arai, Kazuko Saeki

Department of Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Department of Site Management Organization, Sehma Co., Ltd., Fukui, Japan.
Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Nishihara, Japan.
School of Health Sciences, Sapporo Medical University, Sapporo, Japan.

DOI: 10.4236/ojn.2013.31002                

Abstract

Objective: The aim of this study was to elucidate the process of professional identity formation and the factors that affect the process in public health nurses (PHNs). Methods: We performed an inductive qualitative analysis based on semi-structured interviews and focus group interviews of 65 PHNs. Results: At years 1 - 5, PHNs did not have a professional self-identity. Therefore, it was important for them to recognize the significance of their own work. At years 6 - 10, PHNs acquired self-assurance as a practitioner through feedback from residents. It was important for them to have a better understanding, broader viewpoints and more affection for their own community. At years 11 - 20, PHNs felt ambivalent toward the challenges and heavy responsibilities based on the objective assessment of their jobs and roles. PHNs felt embarrassed by role changes when they became a manager or an expert. It was important for them to become aware of their new role through managerial education and training. However, some PHNs who were unable to establish a clear PHN identity experienced setbacks at each developmental stage. Conclusions: Our data suggest that a differential approach dependent on the stage and level of confidence in an individual’s PHN identity is required for the formation of PHN identity.

Keywords

Professional Identity; Public Health Nurse; Professionalism; Career Development

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Ministry of Health, Labour and Welfare (2008) National report of public health and hygiene administrative occupation. Ministry of Health, Labour and Welfare, Tokyo.
[2]	Yoshioka, K.K. (2008) Strategies for assessing the feasibility to develop new needs-oriented services by public health nurses. Journal of Nursing Management, 16, 284290. doi:10.1111/j.1365-2834.2007.00782.x
[3]	Saeki, K., Izumi, H., Uza, M., et al. (2007) Factors associated with the professional competencies of public health nurses employed by local government agencies in Japan. Public Health Nursing, 24, 449-457. doi:10.1111/j.1525-1446.2007.00655.x
[4]	Okura, M., Saeki, K., Ohno, M., et al. (2005) The image of public health nurses held by public health nurses with 1 2 years of experience and their understanding of the job. Journal of Hokuriku Public Health, 32, 31-37.
[5]	Okura, M., Saeki, K., Ohno, M., et al. (2004) The image of the public health nurse that beginner public health nurses have at the time of employment—The career choice motive and the image of the public health nurse. Journal of Tsuruma Health Science Medicine Kanazawa University, 28, 143-150. (in Japanese)
[6]	Laperriere, H.N. (2008) Developing professional autonomy in advanced nursing practice: The critical analysis of sociopolitical variables. International Journal of Nursing Practice, 14, 391-397. doi:10.1111/j.1440-172X.2008.00700.x
[7]	Fogermoen, M.S. (1997) Professional identity: Values embedded in meaningful nursing practice. Journal of Advanced Nursing, 25, 434-441. doi:10.1046/j.1365-2648.1997.1997025434.x
[8]	Gregg, M.F. and Magilvy, J.K. (2001) Professional identity of Japanese nurses: Bonding into nursing. Nursing and Health Science, 3, 47-55. doi:10.1046/j.1442-2018.2001.00070.x
[9]	Bernardino, E. and Felli, V.E. (2008) Knowledge and power necessary to reconstruct nursing after management changes at a teaching hospital. Revista Latino-Americana de Enfermagem, 16, 1032-1037. doi:10.1590/S0104-11692008000600015
[10]	Spencer, M.L. and Spencer, M.S. (1993) How to perform a behavioral event interview (BEI): The development, introduction, creation and use of competency management. In: Competence at Work: Models for Superior Performance, John Wiley & Sons, Inc., New York, 114-134.
[11]	Glaser, B.G. and Strauss, A.L. (1967) The discovery of grounded theory: Strategies for qualitative research. Aldine, Chicago.
[12]	Benner, P.E. (2000) From novice to expert: Excellence and power in clinical nursing practice commemorative ed. Prentice Hall, Upper Saddle River.
[13]	Dalton, L.M. (2004) Time as a source of conflict: Student nurse experiences of clinical practice in a rural setting. Rural Remote Health, 2, 1-10. http://rh.deakin.edu.au
[14]	Adams, R. (2011) Exploring dual professional identities, the role of the nurse tutor in higher education in the UK: Role complexity and tensions. Journal of Advanced Nursing, 67, 884-892. doi:10.1111/j.1365-2648.2010.05519.x
[15]	Zannini, L., Cattaneo, C., Brugnolli, A., et al. (2011) How do healthcare professionals perceive themselves after a mentoring programme? A qualitative study based on the reflective exercise of “writing a letter to yourself”. Journal of Advanced Nursing, 67, 1800-1810. doi:10.1111/j.1365-2648.2011.05615.x
[16]	Lave, J. and Wenger, E. (1991) Situated learning: Legitimate peripheral participation. Cambridge University Press, Cambridge. doi:10.1017/CBO9780511815355
[17]	Jiang, G., Chen, H., Wang, S., et al. (2011) Learning curves and long-term outcome of simulation-based thoracentesis training for medical students. BMC Medical Education. http://www.biomedcentral.com/1472-6920/11/39
[18]	Evans, L. (2008) Professionalism, professionality and the development of education professionals. British Journal of Educational Studies, 56, 20-38. doi:10.1111/j.1467-8527.2007.00392.x
[19]	Schien, E., Bechhard, R. and Bennis, W. (1978) Organization development. Addison-Wesley Publishing Company, Boston.
[20]	Mizuno-Lewis, S. and McAllister, M. (2006) Taking leave from work: The impact of culture on Japanese female nurses. Journal of Clinical Nursing, 17, 274-281.