Regulation of nurses and other healthcare workers has only a “minimal” effect on their professional identity, with factors like education and uniform deemed more important, according to a report by the body that oversees the work of the Nursing and Midwifery Council.
The findings, published by the Professional Standards Authority, contradict recent comments in an official consultation on the forthcoming nursing associate role, which claimed regulation of the new position would enhance the credibility of those in the new post.
“Regulation does not have a heavy influence on professional identity, instead playing a peripheral role”
In its review of literature, the PSA noted the importance of professional identity – defined as the set of attributes, values, motives, and experiences through which people define themselves at work – and its potential benefit for patients and practitioners.
It pointed to previous research that found if a person was able to identify what was distinct about their profession then there was a chance they would value their role more, and that they would be more resilient to pressures and demands.
But the PSA found professional identity was largely shaped by a range of factors including education, mentors, the symbolism of uniform and external perceptions formed from the media and stereotypes. In contrast, regulation was considered a “peripheral” factor.
The role of training and mentors was particularly important in forming healthcare professionals’ sense of identity, said the PSA.
It also noted how identity was linked closely to resilience and to quality of care, as well as the perceived threat to identity when a complaint was made about a professional.
“An interesting facet of this paper has been how professional identity is affected by perceptions of the public”
Only in a crisis or out-of-the-ordinary situation, such as removal from the register, does regulation have an effect on personal identity, suggested the PSA.
“The information identified for this review suggests that there may be some, possibly minimal, role played by regulation in professional identity,” said the body in its report called Professional identities and regulation: a literature review.
“Regulation has been viewed by some commentators as a means of providing credibility to a profession, as monoprofessional regulators can be viewed as entrenching the distinctiveness of a profession, said the PSA report.
“Regulation can also be perceived to affect professional identity negatively, for example, when a professional is erased from a register, he or she is prohibited from acting out their professional identity,” it added. “Regulation though does not have a heavy influence on professional identity, instead playing a peripheral role to other factors.
‘Healthcare assistants do not need statutory regulation’
“An interesting facet of this paper has been to show how professional identity is affected by perceptions of the public and those outside of a profession,” it concluded.
Christine Braithwaite, director of standards and policy, at the PSA, said: “The review has shown that professional identity is a flexible construction, which is receptive to a range of factors. The review’s findings will hopefully be useful to regulators thinking about the role of regulation in supporting professionalism and protecting patients.”
The PSA’s report published this week follows a separate review that it recently carried out on whether nursing associates should be regulated or not.
It said it was unable to come to a decision at the time due to lack of information about the scope of the role and instead recommended associates be registered – rather than regulated – as an interim measure.
However, following much support among the profession’s senior nurses, last week health secretary Jeremy Hunt announced he had asked the NMC to regulate nursing associates.
It will decide at its next council meeting on 25 January whether to agree to the request, following a “full and thorough debate”, the NMC’s chief executive and registrar Jackie Smith told Nursing Times.