Role Transition and the Interaction of Relational and Social Identity: New Nursing Roles in the English NHS

Abstract

Our study provides an analysis of role transition, examining how macro-level influences and micro-level practice interact in framing role transition, with a focus upon professional identity. Empirically, we examine the case of nurses in the English NHS, for whom government ‘modernization’ policy has opened up a new occupational position in the delivery of genetics services within a professional bureaucracy. We track the experiences of the nurses through their recruitment to, enactment of, and progress on from, the new genetics role over two years. Our qualitative interview-based study encompasses six comparative cases. Analysis draws upon two linked literatures — role and identity, and sociology of professions — to examine the tension between the identity expected by the profession and the role expected by government policy-makers. While policy encourages reconfiguration of roles and relationships to support the new, less-bounded role, concerns aligned to professional identity mean that inter-professional competition between doctors and nurses, and intra-professional competition within nursing itself, constrain the enactment of the new role. Through our empirical study, we develop literature on role transition through its application to a professionalized context, and sociology of professions literature, within which issues of identity are relatively neglected. Our study demonstrates that the emphasis of identity within a professional bureaucracy lies at the collective level.