Loss Of Professional Identity Research Articles

Career transition plans of veterinarians in clinical practice.

Gain an understanding of the career transition plans of veterinarians in clinical practice. Veterinary members of the Veterinary Information Network (VIN) working as small animal clinicians. An electronic survey distributed via the VIN data collection portal. A total of 1,256 responses from veterinarians in clinical practice were analyzed, with 61% indicating they plan to decrease their clinical work, and 31% to stop entirely within the next 5 years. The most common reasons for these choices were to have more free time for oneself and/or family/friends (76%), to maintain good health (59%), and feeling burned out (50%). Factors that might entice them to retain their current number of clinical hours included reduced workload or shorter hours (42%), financial incentivization (38%), and improved working conditions (26%). Concerns related to retirement were common with 47% of participants in our study reported feeling concerned about the loss of professional identity, 34% reported concern about reduced social connections, and 28% reported concern as to how they would fill their time. The reported desire to reduce/stop one's clinical work within the next 5 years by 42% of veterinarians ≤44 years of age, with burnout a primary predictor, offers insights into the necessity of change at the organizational, systemic (versus individual) level. The fact that many participants reported concerns related to retirement and 32% reported that they did not have adequate retirement information suggests a need for supportive services to help ensure a successful transition.

'Stolen Time'-Delivering Nursing at the Bottom of a Hierarchy: An Ethnographic Study of Barriers and Facilitators for Evidence-Based Nursing for Patients with Community-Acquired Pneumonia.

The research has reported a high prevalence of low-quality and missed care for patients with community-acquired pneumonia (CAP). Optimised nursing treatment and care will benefit CAP patients. The aim of this study was to describe the barriers and facilitators influencing registered nurses’ (RNs’) adherence to evidence-based guideline (EBG) recommendations for nursing care (NC) for older patients admitted with CAP. Semi-structured focus group interviews (n = 2), field observations (n = 14), and individual follow-up interviews (n = 10) were conducted in three medical units and analysed by a qualitative content analysis. We found a main theme: ‘‘stolen time’—delivering nursing at the bottom of a hierarchy’, and three themes: (1) ‘under the dominance of stronger paradigms’, (2) ‘the loss of professional identity’, and (3) ‘the power of leadership’. These themes, each comprising two to three subthemes, illustrated that RNs’ adherence to EBG recommendations was strongly influenced by the individual RN’s professionalism and professional identity; contextual barriers, including the interdisciplinary team, organisational structure, culture, and evaluation of the NC; and the nurse manager’s leadership skills. This study identified central factors that may help RNs to understand the underlying dynamics in a healthcare setting hindering and facilitating the performance of NC and make them better equipped for changing practices.

Pregnant women's experiences with sick leave caused by low back pain. A qualitative study.

In Scandinavia, women of childbearing age represent nearly 50% of the overall workforce. Two-thirds of these women spend a considerable time on sick leave during their pregnancies. Low back pain accounts for a significant portion of all pregnancy-related sick leave. However, pregnant women's experiences with pain-induced sick leave remains unexplored. The study aimed to investigate women's experiences with sick leave in relation to pregnancy-induced low back pain. An inductive, qualitative study based on semi-structured, in-depth, face-to-face interviews with 19 purposefully selected Danish women. Interviews were analysed by means of thematic content analysis. The analysis revealed 4 categories: (1) Stuck in a diagnosis, (2) Inflexibility of the labour market, (3) Adapting to reduced capacity for work, and (4) Being socially excluded. The women's experiences revolved around disruption of their physical functioning and expected capacity for work, a loss of professional identity, and a sense of inflexibility and exclusion from important relationships at work. Our findings illuminate the possibilities for workplace adjustments with the intention of reducing time spent on sick leave, maintaining pregnant women's affiliation with their workplace, and a need to explore the role of healthcare professionals in addressing women's supportive needs in relation to sick leave.

Thriving in an expanding service landscape: Experiences of occupational therapists working in generic mental health roles within non-government organisations in Australia.

Occupational therapists are an integral part of Australian mental health services. Recent changes in the mental health sector mean that increasing numbers of occupational therapists now work in generic, non-profession-specific roles in non-government organisations. Previous research has identified a range of challenges faced by occupational therapists in generic roles, including reduced satisfaction and loss of professional identity. An exploration of potentially positive aspects and strategies that assist occupational therapists to succeed and flourish within generic roles is lacking. The aim of this study was to explore what assists occupational therapists to thrive within generic roles in Australia's non-government mental health sector. Semi-structured, in-depth interviews were conducted with 12 occupational therapists working in generic mental health roles across three non-government organisations spanning three Australian states. Data were analysed thematically using constant comparative analysis. Thriving was supported in three domains. First, occupational therapists facilitated their own thriving by keeping their occupational therapy lens, and managing ambiguity. Second, workplaces were supportive when their values aligned with occupational therapy core values, they recognised and valued the occupational therapy contribution, and their roles allowed opportunities for therapists to use their profession-specific skills. Third, the broader occupational therapy profession assisted thriving through preparation, validation and ongoing inclusion. Despite some challenges, occupational therapists can and do thrive in generic non-government mental health roles. The preliminary framework of thriving provides valuable insights for those developing university curricula, those providing continuing professional development opportunities and for individual occupational therapists entering this expanding area of practice. Findings also provide insights into how individuals, academic curricula and the profession can respond and adapt to systemic transformations occurring in mental health service delivery.

The importance of self-care for naturopaths with grief from the loss of their patients: an informal case study

Naturopaths may encounter people with life-limiting illnesses who pass away whilst in their clinical care. The loss of clients due to death can be traumatic. This article explores a practitioner's experience of grief as a naturopathic clinician and illustrates the negative impact of insufficient recognition of personal needs, and the risk of burnout, compassion fatigue and bereavement maladjustment that can inevitably lead to poor personal health, onset of disease and loss of professional identity and practice. Self-care and professional support that enables naturopaths to emotionally process intense experiences, recognise boundaries and limits, express gratitude, and re-charge can improve personal insight, ensure ongoing compassionate care of patients, and enrich clinical practice enjoyment. In the context of providing naturopathy, self-care plays a crucial role in continued engagement, interest and satisfaction. It may also help to prevent complications including post-traumatic stress syndrome.

Reflecting on a Common Core and the Variability of Social Work Definitions: “Theme and Its Interpretations” by Foucault

ABSTRACTThe assumed impossibility of forming a widely accepted view of social work is explained on the one hand by the contesting nature of social work definitions and on the other by a loss of professional identity since the 1960s. The aim of the article is to elaborate a third explanation based on the hypothesis that social workers adhere to their differing interpretations of common social work themes. The argument for this article is designed from Foucault’s idea of a “thematic realm which reveals a set of possible interpretations.” To reach the aim, we address the question of why Bartlett, who explicitly adheres to an individual view of a common social work theme, emphasizes her specific interpretation of what she identifies as the social work focus. By generalizing the answer to this question, a hypothesis on the motives for defining social work in terms of individual views of a common social work theme is developed. It is argued that the lack of a widely accepted view of social work is a consequence of social work being defined by individual social workers based on ideas beyond their immediate conscious control. Suggestions are made on how to educate social workers to reflect on their unexamined motives for adhering to dissimilar interpretations of social work common themes.

Professional accountants in Spain: a comparative study of ethical and professional values

ABSTRACTThe loss of professional identity and a greater orientation towards commercial goals on the part of professional accountants have been considered as one of the main causes of the financial scandals. This ‘deprofessionalization’ has focused on auditors, with few studies analysing other accounting professionals. This study, carried out among more than 800 members of the Consejo General de Economistas, analyses the differences in the professional identity and values as well as the ethical judgment of accounting professionals employed in a company, accounting and tax advisors and external auditors. The results of this paper reinforce the importance of the accreditation and regulation of the professional accountant. Further, findings suggest important measures to be taken by professional corporations and public law institutions to improve commitment to the profession as well as the ethical and professional values of the professional accountants in different work settings.

What Is a Good Death?

What Is a Good Death?

Response to ‘Containment lost’ by Andrew Briggs

ABSTRACTThis is a response to Andrew Briggs’ paper presented to the ACP Conference in June 2017. Briggs’ paper, sobering, pessimistic and challenging, looks at the emotional pressures on child psychotherapists in Child and Adolescent Mental Health Services (CAMHS) as a result of the imposition of the internal market in the NHS. He posits that this has caused the loss of organisational containment, not just for child psychotherapists, but for all those clinicians who work in CAMHS. Briggs writes that this loss of containment is evident in clinicians’ experience of meaninglessness in their work and that this meaninglessness may lead to the despair of the death instinct. For Briggs, this goes along with the loss of professional identity as a once favoured discipline. He compares this fall from grace to Satan’s as described in Milton’s Paradise Lost. If, as he suggests, there has been a strong sense of being the favoured discipline, then maybe a dependence had grown in the profession whereby this loss now feels like a terrible abandonment. The author of this response sees hope amidst the despondency being forced upon workers in the NHS and makes the case for us to engage and resist in a number of practical ways.

Faculty Experiences of Merger and Organizational Change in a Social Work Program

Social work programs are experiencing unprecedented organizational changes due to budget cuts, dwindling resources, global, and technological challenges. However, there is limited information in the literature about the merger experiences of faculty in social work programs. On one hand undergoing merger and reorganization provides the opportunity to reorganize, reprioritize, re-assess, develop strategies, and explore previously untapped opportunities for social work programs. Conversely, merger experiences have caused frustration, intention to quit, confusion, and loss of professional identity for social work faculty. In this article the authors utilize a journaling method and sense-making approach of the merger experiences of some of the faculty members of a social work program in the United States. The authors suggest a framework to understand how the faculty confronted the challenges, overcame the pitfalls, and maximized the opportunities offered during the merger and organizational change process.

“I Am Standing Still”: The Impact of Immigration Regulations on the Career Aspirations of Wives of International Students in the USA

This paper utilizes Institutional Ethnography, a feminist research method, to examine the impact of immigration policies on the professional aspirations and career trajectory of wives of international students. The research process included interviews with thirtytwo wives who came to the US on a F-2 visa, along with analysis of immigration policies. Immigration regulations, which prohibit wives from accessing educational and employment opportunities, are reported to be a significant problem. F-2 wives not only confront the loss of professional identity but also irreparable damage to their long-term career prospects. The opaque organization of immigration regulations makes it very difficult for them to make an informed decision about the consequences of moving to the United States. The findings of this study contribute to the growing body of feminist research on how the migration practices of the US state contain hidden gender biases.

Let the buyer beware! Loss of professional identity in mental health nursing

Let the buyer beware! Loss of professional identity in mental health nursing

Mental Health Nursing in Australia: Resilience as a Means of Sustaining the Specialty

As a concept, resilience is continuing to attract considerable attention and its importance across various life domains is increasingly recognised. Few studies, however, have defined or considered the notion of the group or collective resilience of a profession, including the capacity of that profession to withstand adversity and continue to develop positively in the face of change. This article considers the notion of resilience from the perspective of the specialty of mental health nursing, including the ways the specialty has adapted— and continues to develop—to changes experienced since deinstitutionalisation. Insights are drawn from a national Delphi study undertaken in Australia to develop a Scope of Practice for Mental Health Nurses, with responses used as a springboard to consider the impact of the perceived loss of professional identity on the collective resilience of the profession. Recommendations for a way forward for the profession are considered, including the ways in which a collective professional resilience could be developed to sustain and strengthen the professional identity of mental health nursing in Australia and across the globe.

Burnout entre médicos da Saúde da Família: os desafios da transformação do trabalho

The scope of this paper is to understand how conflicts with the institution and disagreements regarding team members'attributions are interpreted by Family Healthcare physicians from the burnout perspective. Qualitative research was conducted with 24 doctors in Recife between August 2005 and November 2006 based on management evaluation (geographic access, conflicts within the team, between teams and the District, between the team and the community and public violence in the area), and four teams were selected in each of the six Health Districts. Semi-structured interviews were then conducted. An enormous discrepancy between the expectations of physicians and the reality of the workplace was detected. They reject the institutional consultation priority and demands for productivity. They suffer from what they consider loss of professional identity, with nurses attributions questioning the historic essence of their practice. There is discredit concerning change and a desire to abandon the profession, especially amongst those with the highest expectations concerning conversion of the model. A broad set of elements was detected that favor simultaneous exhaustion and professional inefficiency and provoke negative attitudes, stressing the need for promoting health in the workplace.

Art therapy in the postmodern world: Findings from a comparative study across the UK, Russia and Latvia

This is a comparative study of the development of art therapy in the UK, Russia and Latvia. The study is triggered by the belief that important learning can take place from fostering shared understanding and respecting differences across practices within a postmodern world that bears the danger of fragmentation and the loss of professional identity. Following a discussion of key postmodern ideas within art and arts therapies and historical references to the development of art therapy in the three countries studied, this paper provides an opportunity for empirically-based comparisons of practice. In particular, a questionnaire, originally developed by Karkou (1998), was disseminated to all practicing art therapists in the UK, Russian and Latvian specialists using art and art therapy methods, Russian graduates and Latvian students of the first training program in art therapy ( Nazarova, 2008; Martinsone, 2009). Collected information relating to work environments, client groups and therapeutic trends were statistically analyzed in order to identify differences across countries. Mutual interactions and ‘cultural borrowing’ were also found and discussed primarily with regard to therapeutic trends. Despite methodological limitations, the study opens the way for future collaborations on the basis of informed understanding of art therapy practices across countries.

“Liberal Education Has Failed”: Reading Like an Engineer in 1960s America

“Liberal Education Has Failed”Reading Like an Engineer in 1960s America Matthew H. Wisnioski (bio) Engineers are the chief revolutionaries of our time. . . . When engineers in greater numbers come to know explicitly what they are doing, when they recognize their dedication, they can join with alert humanists to shape a new humanism which will speak for and to a global democratic culture. —Lynn White1 By its very nature, engineering is a normative practice. Engineers distinguish themselves from scientists and—as this essay investigates—perhaps also from humanists by building their imaginary world—the ought of technology—into the real world.2 But the mind’s eye of the engineer sees not [End Page 753] only diagrams, equations, and models of things. What engineers know is also formed by malleable assumptions about how society works, how it worked in the past, and how it will or will not change as a result of their interventions. How they know, moreover, comes not simply through cultural osmosis, on the job acculturation, or from the various familial relations, private organizations, and media that contribute to an individual’s worldview; rather, since the turn of the twentieth century, to a significant degree engineers’ social knowledge has been designed. Like diagrams, equations, and models, it has been instilled through credentialed training in the reading of social texts, sometimes guided by engineering faculty and at other times by specialists in the humanities and social sciences. Even among engineering educators, the normative dimension of this training often fails to attract serious deliberation. Engineering faculty consider the humanities and social sciences a necessary, but comparatively small, time commitment for fostering communication skills, good citizenship, and cultural finishing, while students often view such knowledge as irrelevant to their future careers. Nonetheless, for almost as long as engineering careers in the United States have begun in the academy, reformers have targeted the humanities and social-science elements of their curricula to reinvent who engineers should be. The Mann report of 1918, A Study of Engineering Education, the first national study of engineering education, called for “humanistic” coursework, particularly the study of writings by prominent engineers, to instill “humane intelligence” and the “professional spirit.”3 Similarly, during the Great Depression, Robert Doherty developed his social-relations curriculum to mold engineers as agents of change.4 As David Noble has shown, the strongest call for enhanced social knowledge in the curricula of the 1920s and 1930s came from corporate employers who were convinced that a “liberal education gives power over men.”5 Yet another wave of reform, initiated by H. P. Hammond’s reports of 1940 and 1944, produced a new humanistic-social division within the American Society for Engineering Education (ASEE) to promote coursework that would help the young engineer “reach his own decisions in meeting the problems of his study, his work and his life; and, equally important, skill in learning from doing this.”6 Educators in the [End Page 754] burgeoning cold war research university—some trained in engineering disciplines, others in English and history—modulated these claims into “general education” for democratic citizenship. This half-century of pedagogical change altered the manner in which engineering students encountered Plato’s Republic, Marlowe’s Dr. Faustus, and the like. But to the consternation of reformers, most engineers—preoccupied by an explosion in the scale and scope of scientific research—retained the view that the nontechnical was noncritical, and hence students followed their lead. Then, in the late 1960s, business-as-usual threatened to be upended as America’s culture wars challenged engineers’ foundational assumptions about technology and society. A shake-up in engineering curricula began unassumingly when design advocates during the early 1960s responded to what they saw as an overemphasis on scientific training and a consequent loss of professional identity. Humanistic-social pedagogy appeared to be entering yet another turn in the cycle. But, sparked by the profession’s transformation in the cold war military-industrial complex and a flourishing of cultural criticism that gave the system its name, by 1967, reform had taken on an encompassing urgency. Engineers across the profession came to fear that they were losing authority over technology, and that this had as much to...

The Predicament of Osteopathic Postdoctoral Education

The growth of colleges of osteopathic medicine (COMs) during the past 20 years has been a catalyst for change and has created new challenges in osteopathic medicine. None of these challenges is more daunting than the task of sustaining an osteopathic graduate medical education (OGME) system that has suffered during this period of rapid development. Notable trends within the osteopathic medicine community since 1990 include allopathic residency programs obtaining OGME accreditation, COM graduates bypassing OGME, repeated major changes in American Osteopathic Association (AOA) accreditation policies, a growing dependence on Accreditation Council for Graduate Medical Education programs to train osteopathic graduates, and a lessening of options for the AOA to effectively direct its OGME system. The predicament is whether COMs can continue to grow without resulting in the demise of the OGME system and a loss of professional identity.

Academic Advising During Program Discontinuance

Academic program closure is explored and student advising needs that emerged in 3 stages of program decline and discontinuation are identified. Data from interviews and advising communication of 20 graduate students enrolled in a master of education program targeted for discontinuation were qualitatively analyzed within a framework of an organizational death model. Findings indicate that program decline and discontinuation require academic advisors to understand and respond to a range of advising needs that vary with the phase of program closure: addressing students' emotional responses of grief, anger, and betrayal as well as managing student concerns over the loss of professional identity and lack of a professional network. Recommendations are offered for faculty advisors caught in the midst of program discontinuation. Relative emphasis: practice, research, theory

Patients with colorectal cancer expressed a loss of adulthood related to a loss of professional and sexual identity, dignity, privacy, independence, and ability to socialise

Rozmovits L, Ziebland S. Expressions of loss of adulthood in the narratives of people with colorectal cancer. Qual Health Res 2004;14:187–203. [OpenUrl][1][Abstract/FREE Full Text][2] Q In patients with colorectal cancer,...

Actual and Preferred Work Activities of Mental Health Occupational Therapists: Congruence or Discrepancy?

The reform of Australian mental health services has resulted in new models of care and changed work practices for all mental health professionals. Occupational therapists today are as likely to be working in multidisciplinary teams performing a range of generic clinical roles as they are to be working in specialist rehabilitation units. These kinds of changes have taken place in other countries, with anecdotal and some empirical evidence that the changes have resulted in concerns about loss of professional identity and roles. This study sought to identify the current work activities carried out by occupational therapists and to determine whether there was a discrepancy between their actual and desired work activities. It was expected that, overall, they would indicate a preference to do more specialist rehabilitation focused work and less generic case management work. A survey of 196 occupational therapists investigated their actual and preferred work activities in 55 specific roles across four broad categories (senior administration, specialist clinical, general clinical and community development). As expected, the participants indicated that they would prefer to be undertaking more specialist rehabilitation oriented work activities than they were actually doing. Contrary to expectations, they also wished to undertake more rather than less generic clinical work activities, to be more engaged in community development work and to take on more senior and administrative roles. They indicated a preference for less rather than more activity on only 5 of the 55 work roles examined. On examining a subset of 113 participants who reported that 50% or more of their time was spent in case management, there was greater evidence of resistance to generic clinical roles. It was therefore concluded that occupational therapists in Australia are seeking to deploy their specialist skills to a greater degree than the current practice environment permits. They have broadly accepted the generic roles required in multidisciplinary community case management, but those who are actually working in these roles are most likely to have reservations about this kind of work.