Nursing boundaries and work identity construction among nurses exercising an advanced role: A qualitative study
Research on the deployment of advanced practice nurses (APNs) in healthcare settings highlights significant challenges for APNs transitioning to a broader, less well-defined nursing role in negotiating professional boundaries and a new work identity with other health workers. However, theories of bo...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-08-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844023057985 |
| _version_ | 1797733010265604096 |
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| author | Carolina De Rosis Maria Teixeira Ljiljana Jovic |
| author_facet | Carolina De Rosis Maria Teixeira Ljiljana Jovic |
| author_sort | Carolina De Rosis |
| collection | DOAJ |
| description | Research on the deployment of advanced practice nurses (APNs) in healthcare settings highlights significant challenges for APNs transitioning to a broader, less well-defined nursing role in negotiating professional boundaries and a new work identity with other health workers. However, theories of boundary-work and professional identity have been rarely applied to APNs relationships with general nurses and colleagues in lower professional position such as nursing-assistants. APNs relationships with these colleagues remain poorly understood. This article aims to contribute to addressing this gap. It is based on qualitative research on a pilot-project prefiguring the introduction of APN (pre-APN) in the French Health system entitled the Prefiguration of Clinical Nurse Specialists (PrefICS). Data were collected through field observations and interviews with pre-APNs, general nurses, nursing-assistants, doctors and nursing hierarchy, to assess the implementation of PrefICS project in four hospitals, one health centre and one cancer control centre. The analysis shows that facing the risk of their role being limited to collaborations with doctors, pre-APNs engaged in different forms of boundary-work with general nurses and nursing-assistants, to negotiate new professional relationships with these colleagues. Some pre-APNs presented themselves as resource persons and led activities aimed at developing and sharing nursing knowledges and competencies with general nurses and nursing-assistants. Other pre-APNs shaped their work identity around a reformist role in terms of both the nursing profession and work environments. Pre-APNs boundary work with general nurses and nursing-assistants produced work spaces in which pre-APNs interwove their work identity with these colleagues by negotiating new professional ties and brokering knowledges between different professional worlds. Changes in levels of pre-APN self-categorization reflected different views of the nursing and nursing-assistant professions, from which pre-APNs started building new alliances for a shared reflective work on their practice and about caring. |
| first_indexed | 2024-03-12T12:22:48Z |
| format | Article |
| id | doaj.art-a125ba3492504f80894fdba66f49bdd1 |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-03-12T12:22:48Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-a125ba3492504f80894fdba66f49bdd12023-08-30T05:51:52ZengElsevierHeliyon2405-84402023-08-0198e18590Nursing boundaries and work identity construction among nurses exercising an advanced role: A qualitative studyCarolina De Rosis0Maria Teixeira1Ljiljana Jovic2Researcher University of Paris cité, INSERM ECEVE UMR1123, Paris, France; Université Paris Cité, Inserm, ECEVE, F-75010 Paris, France; Corresponding author. Researcher University of Paris cité, INSERM ECEVE UMR1123, Paris, France.Researcher University of Paris cité, INSERM ECEVE UMR1123, Paris, France; Université Paris Cité, Inserm, ECEVE, F-75010 Paris, FranceResearcher University of Paris cité, INSERM ECEVE UMR1123, Paris, France; Université Paris Cité, Inserm, ECEVE, F-75010 Paris, FranceResearch on the deployment of advanced practice nurses (APNs) in healthcare settings highlights significant challenges for APNs transitioning to a broader, less well-defined nursing role in negotiating professional boundaries and a new work identity with other health workers. However, theories of boundary-work and professional identity have been rarely applied to APNs relationships with general nurses and colleagues in lower professional position such as nursing-assistants. APNs relationships with these colleagues remain poorly understood. This article aims to contribute to addressing this gap. It is based on qualitative research on a pilot-project prefiguring the introduction of APN (pre-APN) in the French Health system entitled the Prefiguration of Clinical Nurse Specialists (PrefICS). Data were collected through field observations and interviews with pre-APNs, general nurses, nursing-assistants, doctors and nursing hierarchy, to assess the implementation of PrefICS project in four hospitals, one health centre and one cancer control centre. The analysis shows that facing the risk of their role being limited to collaborations with doctors, pre-APNs engaged in different forms of boundary-work with general nurses and nursing-assistants, to negotiate new professional relationships with these colleagues. Some pre-APNs presented themselves as resource persons and led activities aimed at developing and sharing nursing knowledges and competencies with general nurses and nursing-assistants. Other pre-APNs shaped their work identity around a reformist role in terms of both the nursing profession and work environments. Pre-APNs boundary work with general nurses and nursing-assistants produced work spaces in which pre-APNs interwove their work identity with these colleagues by negotiating new professional ties and brokering knowledges between different professional worlds. Changes in levels of pre-APN self-categorization reflected different views of the nursing and nursing-assistant professions, from which pre-APNs started building new alliances for a shared reflective work on their practice and about caring.http://www.sciencedirect.com/science/article/pii/S2405844023057985Advanced nursing roleBoundary-workWork identity constructionNursing boundariesSymbolic interactionism |
| spellingShingle | Carolina De Rosis Maria Teixeira Ljiljana Jovic Nursing boundaries and work identity construction among nurses exercising an advanced role: A qualitative study Heliyon Advanced nursing role Boundary-work Work identity construction Nursing boundaries Symbolic interactionism |
| title | Nursing boundaries and work identity construction among nurses exercising an advanced role: A qualitative study |
| title_full | Nursing boundaries and work identity construction among nurses exercising an advanced role: A qualitative study |
| title_fullStr | Nursing boundaries and work identity construction among nurses exercising an advanced role: A qualitative study |
| title_full_unstemmed | Nursing boundaries and work identity construction among nurses exercising an advanced role: A qualitative study |
| title_short | Nursing boundaries and work identity construction among nurses exercising an advanced role: A qualitative study |
| title_sort | nursing boundaries and work identity construction among nurses exercising an advanced role a qualitative study |
| topic | Advanced nursing role Boundary-work Work identity construction Nursing boundaries Symbolic interactionism |
| url | http://www.sciencedirect.com/science/article/pii/S2405844023057985 |
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