Should I Stay Or Should I Go? Towards an Understanding of Leaving Nursing
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It is widely claimed that nurses are leaving the profession in large numbers. This is often cited as a result of a decline in commitment. However, in this thesis I argue that these commonplace understandings are mistaken. Through a qualitative analysis of in-depth interviews with 28 practising and ex-nurses, I paint a complex picture of how individual nurses’ range of commitments need to be understood within the broader contexts and discourses of British nursing, workplaces and society. Participants in this study demonstrate powerful and conflicting feelings towards their work. A passionate commitment, often rooted in a concern for the welfare of others, is reinforced by the intense personal rewards that nursing offers, and a dominant occupational discourse of total commitment. This commitment demands a high level of physical and emotional endurance, a willingness to prioritise nursing over all else, and to sacrifice one’s own needs in the service of others. However, these positive feelings are often accompanied by intense negative feelings of frustration, fear and powerlessness centring on participants’ inability to fulfil their working commitments, and to balance them with other commitments in their lives. This thesis centres on the premise that nursing involves a life on the boundaries, a place of uncertainty and conflict as well as of challenge and opportunity. Nurses frequently find themselves caught on the boundaries between conflicting ideas and commitments, trying to fulfil expectations that are mutually exclusive. At the same time, they are faced with the task of negotiating their own boundaries in order to function in a world of limitless demands. Within a working role that has no clear boundaries they must seek to establish the nature and scope of their responsibilities in order to function. In an occupation that demands limitless commitment, they must negotiate the boundaries between their commitment to nursing and to other roles beyond the sphere of work. They must also negotiate the boundaries of the self, determining the extent to which they are willing or able to give of themselves, balancing expectations of the super-nurse with the limits imposed by being human. These negotiations occur in an environment of constant change, of conflicting ideals and high stakes where there are often no right answers. The task is further complicated by the organisational limits to nurses’ authority, by a persistent discourse of the submissive and obedient nurse, and by the risks involved in challenging a dominant discourse of strength and coping. The complexity of nurses’ situation leads them to adopt a range of survival strategies. Some stay and endure, while others seek respite in new posts or specialities. Those who lose hope may take advantage of childbearing to slip out unnoticed. Contrary to the popular belief in a mass exodus of nurses indicating a loss of commitment, it is often those with a powerful sense of commitment to caring for others who find the strength to leave nursing and seek satisfaction in other fields of work.