The "professional becoming" of newly-qualified nurses in the English NHS

Roe, Bridget (2016) The "professional becoming" of newly-qualified nurses in the English NHS. PhD thesis, University of Nottingham.

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This thesis develops new empirical insights on the socialisation of English National Health Service (NHS) newly-qualified nurses as they enter the workplace. The NHS continues to face financial and human resource constraints on ensuring the quality and safety of patient care. Nurses are the largest professional group within the NHS, and their recruitment and retention has been problematic which has implications for the ability of organisations to deliver high quality care. Nursing has a turbulent history where changes to education and recent scandals have also raised questions about the quality and safety of care delivered by newly-qualified nurses. Within this context, Preceptorship has been introduced to improve retention and quality by supporting the transition from education into the workforce through several months of support and blended learning. This study focuses on the implementation and operationalisation of one NHS Trusts’ Preceptorship programme.

Although professional socialisation has been studied extensively, there has been limited empirical research that mutually accounts for the post-qualification period and new membership of an organisation. Nursing Preceptorship is a useful case because it seeks to develop professionals’ skills and knowledge whilst aligning nurses to organisational expectations. In this thesis, socialisation is theorised as ‘professional becoming’, where knowledge, skills, customs and values acquired through education are enmeshed with those of the organisation as an everyday learning activity. This highlights the possibility for professional and organisational expectations to co-produce the professional identity and practice of newly-qualified nurses during Preceptorship.

Taking a ‘practice perspective’ on learning, the study focuses on the experiences of newly-qualified nurses over an eight month period. First, the study shows how particular organisational and managerial imperatives influenced the design and operationalisation of the programme. Second, it shows how the newly-qualified nurses interacted within the programme in the classroom environment where these organisational expectations were articulated and promoted as part of the induction process. The study shows how managers had to ‘sell’ the scheme through constructing nurses as unsafe or inexperienced. Third, it shows how the nurses continued their professional socialisation in clinical settings through interacting with the Preceptors and other clinical peers to develop their learning and challenge the assumptions promoted by the organisation.

The study depicts a period of post-qualification socialisation where the contemporary pressures of healthcare, via the Preceptorship programme, seeks to mould nurses to meet the expectations and needs of the organisation. At the same time, resource constraints make it equally difficult for Preceptorship to fulfil this aspiration, and nurses develop other strategies to develop their clinical knowledge and skills. The study also develops additional insights on the processes of post-qualification socialisation that centre on the interplay between emotion in everyday learning, positioning in the hierarchy and reflexive identity formation. Although appearing to be socialised into the organisation, the nurses retained fidelity to an aspirational, professional version of a nurse. This thesis thus develops a more holistic understanding into the ‘professional becoming’ of newly-qualified nurses during the Preceptorship period.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Waring, Justin
Crompton, Amanda J.
Rowley, Emma
Keywords: Nurses, In-service training, Nursing, study and teaching, England
Subjects: R Medicine > RT Nursing
Faculties/Schools: UK Campuses > Faculty of Social Sciences, Law and Education > Nottingham University Business School
Item ID: 37701
Depositing User: Roe, Bridget
Date Deposited: 14 Dec 2016 06:40
Last Modified: 18 Oct 2019 04:30

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