Authentic Identity: A Visual Grounded Theory of Construction and Sustainability of Professional Identity in Adult Nursing

The (de) construction of aspiration in nursing and the social, cultural, economic, and philosophical ramifications to personal and professional agency is the focus of this thesis. Professional socialisation within adult nursing is recognised as problematic, with dissonance arising from numerous factors, including that of being an unrecognised discipline (Cummings, 2017) with unrealistic expectations (Traynor, 2013b), whilst being a marginalised workforce struggling to recruit and retain (Goodman, 2015, 2016). What this research has investigated is ‘how do pre-registration adult nursing students construct and sustain their professional identity’ despite this dissonance? Visual grounded theory, combining constructivist grounded theory and visual research, is the method through which this study is undertaken. Research participation informed by collaboration with 11 pre-registration undergraduate adult nursing students sourced through purposive sampling (10 female and 1 male). All of whom were engaged on a three-year professional programme of study with the University of Northampton, working towards either a Diploma or Bachelor of Science (Honours) Adult Nursing, alongside professional registration with the Nursing and Midwifery Council (NMC). Each participant engaged in photo elicitation interviews on three occasions during their nurse education: with a fourth interview, a minimum of 5 years post-registration as a nurse. These interviews lasted between 30 minutes to 2 and a half hours; data transcribed and analysed using a constructivist grounded theory framework modified to incorporate analysis of visual imagery provided by participants (Konecki, 2011; Charmaz, 2014; Saldaña, 2016). A visual grounded theory informing (de) construction of aspiration in adult nursing explores how sustaining a professional identity is informed by a personal belief system of ‘what is means to be a (adult) nurse’. In the current climate reliance on personal agency to inform professional identity and its practice is short-lived; the ramifications of which need addressing for a nursing profession in a workforce crisis. This visual grounded theory proposes revisiting aspiration and its critical resilience to construct and sustain a legitimate identity, that reflects an authentic image of nursing to inspire nursing recruitment; and more importantly to aid retention recognising when students and registrants alike say ‘nursing is no longer for them…’ to effect change before it’s too late.