Contemporary Factors Influencing Professional Identity in Acute Care Nurses: An Integrative Review.

Abstract

Aim: To explore the current state of the science on influencing factors of acute care nursing professional identity.

Design: Integrative review.

Methods: Data were collected and screened using Covidence systematic review software, adhering to pre-defined inclusion criteria. The Critical Appraisal Skills Programme checklist was used for critical appraisal, and content analysis was applied to analyse the data.

Data sources: CINAHL, PsycINFO and PubMed were utilised to search literature published between 2018 and 2023.

Results: A total of 18 articles were included. Five themes were identified: (1) internal influences; (2) external influences; (3) externalisation of role; (4) early versus seasoned career experiences and (5) barriers to professional identity formation.

Conclusion: This review found evidence of multiple influencing factors, predominantly external, shaping acute care nurse professional identity. Research on the long-term impacts on practice, management, policy and education remains limited.

Implications: Enablers to forming professional identity foster empowerment, confidence, belonging and job satisfaction. Barriers to formation lead to hesitation, performance impediments, stress and exhaustion. Development of nurse professional identity may be instrumental in tackling acute care workforce challenges.

Impact: Review findings on professional identity formation can guide initiatives for enhancing healthy work environments and workforce retention. This exploration has international contemporary relevance for the nursing profession with suggestions for future research.

Impact statement: Existing literature underscores the significance of professional identity in nursing, yet the mechanisms underlying its integration and maintenance in the contemporary acute care workforce remain unclear. In the context of overwhelming workloads that adversely affect nurse mental health and retention, coupled with the escalating nursing shortage as we emerge from the pandemic, this examination of professional identity formation holds contemporary relevance for the evolving acute care landscape, offering implications for future research. The insights gleaned from this review may guide organisational leaders in developing new strategies addressing acute care nurse management, policy, education and retention.

Reporting method: Reporting adheres to the EQUATOR network, ENTREQ guidelines.

Patient or public contribution: None.