Reworking professional nursing identity.

In spite of professional socialization through nursing education programs, new graduates experience stress as they become working professionals. This grounded theory study explores experienced nurses' perceptions of how they became professional. The central problem for nurses was dissonance between expectations and experiences; they addressed this through an iterative, three-stage process of reworking professional identity. The stages of this process are assuming adequacy, realizing practice, and developing a reputation. Iterations of this process occur as new discrepancies are noticed, enhanced awareness dawns, practice changes, learning is undertaken, or experienced nurses become relative novices in another work area. Nurses move through stages more quickly and at different levels with each iteration. Three contextual factors influence the process: expectation; perception of the status accorded by others to nursing; and supportiveness by acceptance, assistance, and advocacy from others in the workplace. These findings expand knowledge about professional socialization and how nurses themselves understand developing professional identity.