Work identities of nurses : Between caring and efficiency demands

This paper reports on a comparative qualitative study across four European countries which explored the formation of work identity amongst nurses and other professionals in the field of health care. Within this sector, it identifies trends towards a more flexible, more highly skilled and more mobile workforce. Conversely, however, it is becoming difficult to recruit and retain staff due to increasing workload, decreasing job satisfaction and comparatively low pay. Occupational identity is theorised as a multi‐dimensional phenomenon, with structural, social and individual‐psychological components. A number of emerging common themes across the three dimensions and across the four national settings include structural conflicts between cost efficiency and quality of care, and individual conflicts between the core activity of caring for patients and the increasing demands of administration and other peripheral work. The study identifies a number of strategies used by nurses to balance these conflicting demands. Overall, the professional identity of nurses remains strong, but it is important for policy makers to be aware of the potential negative effects, in terms of staff turnover, mobility and job (dis)satisfaction, of the current state of the health care sector.