Abstract:

Nursing and midwifery services are estimated to comprise over 80% of the health care services in most countries, and within the nursing profession global mobility of the workforce is well recognized. In March 2016 there were 692,550 nurses and midwives on the United Kingdom (UK) Nursing and Midwifery Council (NMC) register. Organization for Economic Co-operation and Development (OECD) statistics from 2015 assert that 21.7% of UK nurses were born abroad and the UK exported the highest number of nurses amongst OECD nations, with more than 50,000 British nurses working in other OECD nations, and others working outside the OECD. Across the European Union (EU), only Luxembourg, Ireland and Estonia are more dependent on nurses from overseas. Nurse education curricula aim to prepare students to practise nursing within this global workforce; to care for multi-cultural clients; to understand global health trends; and to work effectively with multi-cultural colleagues.

If nursing is acknowledged as a globally transferable profession, one could assume it to be under-pinned by an internationally recognizable and transferable identity. Evidence suggests, however, that nursing identity is unclear and poorly defined in a global context. It may be suggested that nurses, though globally numerous, display limited exertion of power and influence upon the profession’s development, leading one to question the extent to which they are merely ‘pawns in the game’ of healthcare progression, and subject to external manipulation of their identity and thus their role in healthcare provision.

Internationalization initiatives in nurse education, aiming to promote nursing competence for increasingly diverse client groups, and also to create a more globally mobile workforce, offer a valuable opportunity to explore nursing identity as it may be defined for global practice. Findings from such exploration may inform development of an authentic, contemporary identity for nursing, applicable for the diversities of twenty-first century practice.

This study presents a qualitative interpretation of the impact upon nursing identity of international educational initiatives in nurse education, through the analysis of data from a purposive sample of UK nursing academics, international post-graduate nursing students and UK undergraduate nursing students. Study data was elicited via one- to-one interviews, and data analysis was undertaken with reference to theoretical concepts developed by Bourdieu and Carper.

Findings demonstrate a continuing manipulation and control of nursing identity by influential forces exterior to the profession, and limited exercise of power and control by nurses themselves. International educational experience does, however, contribute to the achievement of transformational personal knowing within participants, which has the potential to empower them for more confident participation in the future development of professional identity.

Study findings reveal a need for more international research to reveal globally relevant identity definition(s) for nursing, and propose additions for international educational initiatives for nursing.

Keywords:

Nursing, professional identity, internationalization, nurse education.