Role transition in primary care settings.

BACKGROUND: This paper reports on research that explored how nurses who are engaged in advanced practice adapt and adjust to their roles in primary and community health settings. Successive government policy has highlighted how the changing roles of nurses, who are engaged in advanced practice, are crucial to delivering high-quality patient care. The paper offers a framework for role transition which is potentially generalisable to doctors, physiotherapists and other healthcare professionals. The aim of the study was to enable an understanding of role transition, from a study of nurses going through changes to their roles or moving to new roles. The intended purpose of the study was to explore what was going on within role transition, and considers by what process(es) role transition evolves or is experienced.
METHOD: Eleven nurses' actions, expectations, and experiences of role transition were explored, within three district nurse centres and two community NHS trusts. Data were collected from participant and non-participant observation, content analysis of job descriptions and from individual and group interviews, including semi-structured schedules and focus group techniques. Data were comparatively analysed to conceptualise and saturate core themes, which were discussed and developed with participants and healthcare managers.
RESULTS: A theory of role transition is proposed through a model representing the 'who', 'what', 'where' and 'how' of role transition, through four concepts of centring identity(ies); focusing role(s); enacting role(s); and shaping role(s). Identity was regarded by the participants as being the role, the person, and as part of a group. Current and anticipated role foci directed enactment of role within given contexts and resources, while shaping of role involved a balance of role loss and role expansion.
CONCLUSIONS: This article presents a theory of role transition for primary care professionals.