Changes in nursing identities: supporting a successful transition.

This article examines the role of nurse managers in delivering the NHS modernization agenda by supporting the development of new and innovative nursing roles as proposed in recent health care policy. A study by Ewens (1998) indicates that nurses will respond positively to new short-term developments because of the ability to re-conceptualize work roles before actually undertaking them, but that long-term success will depend upon whether the workplace provides the scope and flexibility for integration of new identities into the self-concept. It is argued that when nurses find a gap between what they believe their role could be and what in reality it is allowed to be they separate their self-concept from their work role. In this situation the nurse experiences frustration and disappointment and the work role becomes 'untenable', resulting in them either leaving or retreating back into traditional professional identities. A discussion is provided on the role of nurse managers in the prevention of this negative response by supporting innovative work environments that can accommodate the new roles envisaged in the current policy. The paper concludes with consideration of the current direction of nursing and questions whether this move towards the nurse as 'assistant physician' will, in the longer term, be a good thing for patients.