Cardiff Health Organisation and Policy Studies (CHOPS) Seminar

This event has ended.

'Lost in transition? Unravelling career advancement in emergent hybrid roles'

Professor Julie Davies, University College London, and Dr Karen Shawhan, University of Manchester

Transitions between jobs are common experiences with important consequences for people’s lives.

The impact of creating new types of hybrid roles in the public sector which span multiple professions are not well understood. In this three-year study using focus groups, we analysed the experiences of 36 trainee advanced clinical practitioners (ACPs) to examine the effects of public policies which are intended to address nursing and medical workforce shortages by creating new kinds of roles for non-medical prescribing clinicians.

We investigated change trajectories during the transitions of trainee ACPs. We found that several ACPs felt highly valued as intermediaries between different occupational groups and those towards the end of their careers who had wished to retire in palliative care settings felt liberated in their new roles. Some individuals, however, in acute settings tended to feel trapped as substitutes for junior doctors and misunderstood while ACPs in primary care felt most vulnerable in practising beyond their licence. We found that older and more experienced secondary care nurses had higher levels of confidence and satisfaction in hybrid roles than individuals who were less used to working in multi-disciplinary teams and hospital settings.

Our findings illustrate the phenomenon of permanent liminality as ACPs act as go-betweens and never fully transition from one traditional professional identity to another emergent hybrid identity. These findings point to dynamic relationships between public sector workforce policies, inter-occupational transitions, and career satisfaction. They raise important questions about creating enhanced roles to integrate professional services in a context of public sector pay restrictions and chronic essential workforce retention and recruitment challenges.