A working identity: pre-professional status in nursing and the ethics of care

The emergence of a working identity, or pre-professional identity (PPI), is an important part of the socialization process for students in higher education and in particular those on vocational programs involving placements within the professional setting. Learning professional roles and workplace cultures are crucial to this process although situations may arise where these aspects may bring about role tension and a sense of conflict. An example of such conflict can occur in the field of nursing where students may find that their professional ethics must override situations where workplace practices or cultures lead to instances of poor patient care, unsafe practices or maltreatment. In such cases, professional codes of practice require nurses, including student nurses, to report these instances to senior colleagues. However, the potentially conflicting demands of being part of a workplace culture while reconciling the
personal and professional requirement to uphold patient safety and ethical standards can give rise to situations where such matters are left unreported. This issue is explored through an examination of student nurse accounts of their decisions to either report or remain silent on matters of poor care or practice. These accounts were drawn from semi-structured interviews and were initially analyzed with a focus on the types and range of justifications and excuses for either reporting or failing to report poor care practices. These accounts are re-analyzed with a focus on the development of PPI in terms of identity, occupational socialization and the ethics of care.