THE LIVED EXPERIENCE OF BECOMING A PROFESSIONAL NURSE FOR ASSOCIATE DEGREE ...

176 Pages·2007·0.41 MB·English

The Pennsylvania State University
The Graduate School
Department of Adult Education

THE LIVED EXPERIENCE OF BECOMING A PROFESSIONAL NURSE FOR
ASSOCIATE DEGREE NURSING GRADUATES:
A PHENOMENOLOGICAL STUDY

A Thesis in
Adult Education
by
Jean L. Hershey

© 2007 Jean L. Hershey

Submitted in Partial Fulfillment
of the Requirements
for the Degree of

Doctor of Education

August, 2007
ii
The thesis of Jean L. Hershey was reviewed and approved* by the following:

Daniele D. Flannery
Associate Professor of Adult Education
Thesis Advisor
Chair of Committee

Patricia A. Cranton
Associate Professor of Adult Education

Samuel W. Monismith
Associate Professor of Health Education

Dennis R. Lott
Adjunct Professor of Education

Ian E. Baptiste
Associate Professor of Adult Education
In Charge of Graduate Programs in Adult Education

*Signatures are on file in the Graduate School
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ABSTRACT
This qualitative study used a hermeneutic phenomenological design to investigate
the lived experience of becoming a professional nurse for associate degree nursing
graduates. The study looked specifically at the process of acquiring a professional
identity for associate degree nursing graduates. The theoretical frameworks of structural
functionalism and reference group theory provided the lens which guided the study.
Structural functionalism is a sociological perspective describing how groups reproduce
themselves by creating members whose behaviors and values correspond to the
established group norms. A reference group is the social group which an individual uses
to define attitudes, beliefs, and values which the individual wishes to emulate and join.
Semi-structured interviews were used to learn the essence of being socialized into the
profession of nursing and taking on a professional nursing identity for the participants.
The major finding which was revealed from this study was that taking on of a
professional identity for the associate degree graduates occurred through an intermeshing
of four processes. The processes include: bringing of one’s self; including past
experiences and personality traits, to the educational programs; learning to become a
nursing student; socializing into the professional nurse role; and internalizing the
professional identity. This finding led to the creation of the Professional Nursing Identity
Model. Additional findings include: family members within healthcare professions are
instrumental in guiding individuals into the profession of nursing; nursing students assess
the attitudes, skills, and behaviors of the professional nurses with whom they interact;
personal development is a byproduct of professional development; and learning to
balance school work and home life while a student is valuable practice for balancing
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similar expectations of the professional nurse. Based on these findings, implications for
nursing and adult education are discussed. Included are suggestions for future research
surrounding professional identity development.
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TABLE OF CONTENTS

LIST OF TABLES ix

LIST OF FIGURES x

ACKNOWLDGEMENTS xi

DEDICATION xiii

Chapter 1. INTRODUCTION 1

Background Information 1
Professional Identity Development of Nursing Students 3
Socialization of the Student Nurse into the Professional Role 4
Educational Pathways for Professional Nurses 6
Differences in Socialization between Associate Degree and
Baccalaureate Degree Students 6
Theoretical Framework 8
Purpose of the Study 10
Problem Statement 11
Research Questions 11
Overview of the Design and Methodology 11
Methodology 12
Participants 14
Data Collection and Analysis 14
Verification 15
Significance of the Study 15
Definition of Terms 17
Assumptions of the Study 19
Limitations of the Study 19
Organization of the Study 20

Chapter 2. REVIEW OF THE LITERATURE 22

Associate Degree Nursing 22
Nursing Education Overview 23
Educational Pathways 23
Historical Overview of Associate Degree Nursing Programs 24
Educational Outcomes of Associate Degree Nursing Programs 25

Theoretical Framework 27
Theoretical Overview – Structural Functionalism 28
Reference Group Theory 32
vi
Application of Theoretical Framework to Professional Identity 35
Development in Adult Learners

Professional Identity 37
Professional Identity – Overview 37
Factors Influencing Professional Identity Development 39
Attitudes and Values of the Professional Nurse 42
Knowledge and Behaviors of the Professional Nurse 43
Professional Identity Literature Related to Student Nurses 45
Professional Values in Nursing Education 47

Socialization Into the Professional Role 48
Socialization Literature Related to Nursing Students 49
Fostering Professionalism in Nursing Students 52
Summary 55

Chapter 3. METHODOLOGY 59

Purpose of the Study 59
Problem Statement 59
Research Design Overview 60
Qualitative Research Paradigm 60
Phenomenology 63
Hermeneutics 65
Research Questions 67
Background of the Researcher 67
Participant Selection Procedures 69
Data Collection and Analysis Procedures 70
Data Collection 70
Data Analysis 74
Verification 74
Credibility 74
Dependability 75
Confirmability 76
Transferability 76
Summary 77

Chapter 4. RESEARCH FINDINGS 78

Participant Profile 78
Katie 79
Mary 79
Beth 80
Carly 81
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Jacquelyn 82
Jamie 83
Sarah 83
Grace 84
Adrienne 85
Greg 86
Research Findings 89
Bringing One’s Self to the Nursing Program 89
Past Experiences 90

Work Experiences or Connecting with Others
in the Healthcare Field 90
Defining Moments 93
Innate Qualities and Personality Traits 94
Academic Achievement 94
Motivation 95
Altruistic and Caring Attitude 96
Learning to Become a Student Nurse 98
Nursing School Culture 98
Instructor Influence 102
Positive Student/Instructor Experiences 103
Negative Student/Instructor Experiences 104
Finding a Balance 106
Socializing into the Professional Role through Connecting with
Reference Group Members 107
Positive Role Modeling 110
Instructors 110
Staff Nurses 113
Negative Role Modeling 115
Instructors 115
Staff Nurses 116
Internalizing the Professional Identity 117
Meaning of Professionalism 118
Practicing as a Professional Nurse 119
Personal Development 120
Growth and Maturity 121
Esteem Building 122
Pride 123
Interconnectedness of the Four Processes 124
Summary 128

Chapter 5 DISCUSSION AND CONCLUSIONS 129

Relevant Findings 129
Professional Identity Model 130
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Finding 1: Processes Involved in the Acquisition of a Professional
Identity for Associate Degree Graduates 131
Finding 2: Family Members within the Healthcare Disciplines are
Instrumental in Guiding Individuals into the Profession of Nursing 137
Finding 3: Nursing Students Assess the Attitudes, Skills, and
Behaviors of the Professional Nurse 138
Finding 4: Personal Development is a byproduct of Professional
Identity Development 139
Finding 5: Learning to be an Associate Degree Nurse Serves as
Practice for the Role of the Professional Nurse 140
Implications for Practice 141
Nursing 141
Adult Education 142
Suggestions for Future Research 144
Summary 146
Reflections and Closing Thoughts 146

Reference List 148

Appendix A: Recruitment Letter 158

Appendix B: Informed Consent 160

Appendix C: Interview Guide 162
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LIST OF TABLES

Table 1: Participant’s Profile 88

Table 2: Processes and Sub-themes 89
x
LIST OF FIGURES

Professional Nursing Identity Model 127