Fit to practice : exploring the work experiences of registered nurses who are disabled during the course of their careers : a thesis presented in partial fulfilment of the requirements for the Masters of Philosophy in Social Policy at Massey University, Manawatu, New Zealand

Abstract

A potential for systemic discrimination against nurses with impairments has been identified within literature relating to the nursing profession. Workforce shortages combined with an ageing nursing population suggests that there will be an increase in the number of nurses with impairments and a need to recruit and retain these nurses. There is very little known about the experience of nurses who have acquired impairments during the course of their careers. The intention of this research is to explore the experience of nurses who have acquired impairments and the impact on their identity and their nursing practice. The study draws on a range of theoretical works including those from disability studies and employs a qualitative approach that is influenced by Somers’ (1994) narrative methodology. Inclusive to this methodology is an abductive strategy based on a constructivist view of social reality (Blaikie, 2000; 2007; 2010) which produces accounts of social life drawing on the concepts and meanings used by social actors and the activities in which they engage (Douglas, 1996). Seven nurses were interviewed and their narratives analysed to identify the social and cultural scripts which shape their experiences and the formation of identity within the nursing context. The research findings indicate the participant’s experience of negotiating a disabled identity takes place largely in isolation and is influenced by biomedical narratives of disability which provide the foundation of the continuity of a predominantly disabling nursing environment. The experience of impairment is viewed as problematic and as an individual responsibility whilst the practices of organisations which perpetuate disabling environments were largely unquestioned. Issues of disclosure and non-disclosure have created tension for most of the participants within workplace environments that operate on an assumption of non-disability. The participants contribute to the practice of the nursing profession in a variety of roles which they have sought out as a means of managing within the nursing context. This research challenges the perspective of an individual pathologised view of disability and promotes a perspective which embraces a rights based understanding. The research suggests that a willingness to promote equity of access and freedom from discrimination needs to be reflected in policy and standards of both the Nursing Council of New Zealand as nursing’s regulatory body and within employing organisations.