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‘Critical Care Nurses’ professional identity constructions in an Australian Intensive Care Unit: Contextual and Contingent (awarded 2017)

Professional identity is informed by the experience of being a member of a professional group and undertaking work activities within a specific jurisdiction. Despite an ideology of professionalism within nursing degrees, professional identity among nurses is often marked by ambiguity. This thesis uses a social constructionist approach and ethnographic methods to explore professional identity among Critical Care Nurses (CCNs). The research aimed to build an in-depth understanding how CCNs construct professional identity in the context of their practice. The research was conducted in a single Intensive Care Unit (ICU) in Australia over a six-month period. Data were collected from participant observation of 13 CCNs and semi-structured interviews with 8 CCNs.

Thematic analysis found CCNs construct professional identity through subjective meaning making and boundary work within and across dynamic professional boundaries. CCNs attached meanings to particular actions, symbols, rituals and utilisation of artefacts to construct their professional identity, and these were then used to negotiate boundaries of difference between themselves, other nurses and other health professions. CCNs’ experiences of professional identity are contingent due to contextual influences that shape and constrain their meaning making during work interactions.

These findings provide new theoretical and empirical knowledge of the contextual construction of professional identity. This contributes to a deeper understanding of the subjectivity of CCNs’ professional identities, and thus, offers the basis for comparative studies of professional identity between nursing specialties, and nursing and other health care professions. Given that a strong sense of professional identity appears to increase worker satisfaction, barriers to professional identity development among CCNs have implications for lived experiences and may help explain high levels of worker turnover in this nursing speciality.

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