A Narrative Approach to Understanding the Experience of Becoming and Being a Nurse: Professional Identity Formation and Transition to Practice

Abstract

Purpose: The purpose of this study was to explore the narrative accounts of new graduate nurses reflecting upon their transition to practice and professional identity formation in order to identify how experiences of becoming and being nurses may inform nursing education, policy, and practice with relation to recruitment and retention of nurses.

Background: There is a global shortage of nurses, further exacerbated by a greater desire to leave the profession since the COVID-19 pandemic. As nursing students transition into the roles of new graduate nurses, they begin to form stronger role-oriented identities. These have been associated with greater job satisfaction and indicative of retention. Individual characteristics and factors such as gender, previous health care experience, sense of teamwork, communication, and self-image are antecedents for a strong sense of professional identity while contentious relationships with colleagues and burnout are detrimental to the professional socialization required to establish role-oriented identity. Professional identity development in new nurses is an understudied phenomenon and insights may inform strategies to recruit and retain nurses.

Method: We used a narrative inquiry approach to understand individuals’ experiences. We conducted interviews with five new nurses who had graduated from a school of nursing in Ontario with an average of 20 months of experience. We completed two interviews with each participant with an emphasis on gathering narrative accounts of experiences of becoming and being a nurse.

Results: Four themes were identified: (1) Entering into the world of nursing: Nurses reflected upon influential events and individuals at the beginning of their journeys. (2) Journey to become a nurse: Nurses reported an evolution of skills and confidence. (3) Learning alongside others: Nurses noted influential therapeutic relationships with patients and instructors as vital in establishing professional identity. (4) Embodying nursing: Nurses shared challenges in separating professional identity from self-concept and maintaining balance in their lives.

Conclusion: Supportive individuals and experiences are essential in inspiring and supporting new graduate transitions, which overall influence the evolution of professional identity of new nurses and, in turn, recruitment, and retention. These findings will be of interest to educational institutions and a variety of practice settings to support successful new graduate transitions and staff retention.