Transition to a Health Visitor Role: A Constructivist Grounded Theory

Abstract

There has been a scarcity of studies which explore transition to the health visitor (HV) role. This is in stark contrast to research into the transition from student nurse to a newly qualified nurse (NQN) role, which is known to be a difficult and challenging time, impacting upon overall retention in the nursing role. As a nurse lecturer, I have witnessed very similar difficulties and challenges as aspirant HVs undergo the transition to the HV role. However, this transition differs fundamentally to that of a student nurse to NQN, due to the prerequisite for a registered nurse/midwife status before entry into training for the HV role. The student HV is therefore moving from a role in which they are already established, often highly skilled and autonomous practitioners, into to a new professional role. Using a constructivist grounded theory approach, this longitudinal study has explored this transition to the HV role, providing in-depth understanding of the experiences of the participants. It incorporated focus group and interview methods over a series of data collection points, throughout the transition. The aim to develop a substantive theory of the transition to the HV role. The transition is multifaceted and is influenced by a range of factors including changes to role identity and community of practice, alongside individual resilience, and the support provided by the wider HV team. The three core categories of Role Identity, Way of Working and Living the Journey are encompassed within the developed conceptual model, which also provides a framework to support this complex transition process. The transition from qualified nurse/midwife to HV is a multidirectional process and is fraught with challenges. Hence, the greater understanding of the transition provided by this study, will help both inform and support future HV students, the wider HV team, practice assessors/supervisors, employers and education providers. Recommendations include wide dissemination of the findings and conceptual model to allow exploration of the complexities of the transition with student and aspirant HVs, practice colleagues, educators and other stakeholders. Thus, enhancing the support for those undergoing this transition. There should also be greater recognition and valuing of individuals and diversity in the workforce and a focus on building resilient tendencies and wellbeing. Future research should include further exploration of managing multiple role identities, heightened definition of the HV role and the impact of difficult areas of practice (e.g., safeguarding). Other methods of entry into the HV role, rather than from a pre-existing registered nurse or midwife status, are recommended as this could alleviate some of the specific challenges faced within this important transition. There should also be further research to test this substantive theory in other role transitions, where there is a move from one professional role to another.