Student nurse professionalism: repertoires and discourses used by university students and their lecturers

Jackson, Sue (2017) Student nurse professionalism: repertoires and discourses used by university students and their lecturers. Doctoral thesis, Northumbria University.

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Abstract

Professionalism can be a complex concept to define (McLachlan et al. 2002; Finn et al. 2009). Within nursing, the majority of studies have explored professionalism within the clinical environment, and very few examine how student nurses construct their talk regarding professionalism while they study at university, highlighting this as a distinct gap in the knowledge and understanding. The aim of this study was to uncover the discourses used by student nurses and lecturers, and offer insight into the influences on student professional language from within and outside of the nursing profession and offer an appreciation of the processes of language (discourse) adoption.

The theoretical position adopted was social constructionism, where it is assumed we jointly construct our world on shared assumptions and that language is central to this process (Potter and Wetherell 2009).

The methodological approach employed was Discourse and Social Psychology (DASP) (Potter and Wetherell 1987). Seventeen (17) interviews were conducted. Eight (8) of which were one-off interviews with lecturers. Seven (7) students from adult, child and mental health nursing were interviewed multiple times over the three years of their nursing programme. FIGURE 1 presents an overview of the research process.

The analysis suggested that participants drew upon a number of interpretative repertoires and memes. These led to the identification of discursive threads, which were proposed as entangled within discursive knots, serving to position students and lecturers within a dynamic process of professional discourse development. The theoretical perspectives of Foucault, Goffman, Bourdieu and Harre informed the interpretation of the talk.

Initially, students were positioned in a place of high surveillance through authoritative language used by lecturers. This position informed the discursive know of 'separation' which serves to maintain student nurses as 'different' and ‘special’, and to distance them from other university students. Clinical practice experience was seen as influencing students’ talk when back in University, emphasising differences. The discursive knot of 'maintaining quality and credibility' questions the 'real' place of nursing and the credibility of lecturers, and brings about a positioning of students that influences agency. The final discursive know of 'permission' is located in the talk of lecturers and final-year student nurses only. This knot illustrates students adopting the discourses of the registered nurse, including the surveillance talk used by lecturers to first-year students. This suggests that final-year students 'become' enforcers and protectors of 'difference'.

This study highlights the intricacies and complexities of the 'professionalism discourses' woven into the talk of lecturers and nursing students, and their spread via both the overt and hidden curricula. Indeed, the adoption of the 'permission' discourse by third-year students suggests the perpetuation of a discourse via a socialisation process. The discursive 'knots' seem to function to instill, maintain and perpetuate wider discourses. The 'separation' and 'permission' knots may be viewed as serving to 'other' to maintain the 'specialness' of the profession, while the 'maintaining quality and credibility' knot may indicate tensions related to academic and clinical professional sub-groups and sites of knowledge development.

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