The conflict experienced by a minority professional group in a collaborative workplace: Professional identity of nurses working in a nursery centre

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The conflict experienced by a minority professional group in a collaborative

workplace: Professional identity of nurses working in a nursery centre

YAMAMOTO Chika

1

1_{Faculty of Early Childhood Education, Tokoha University, Shizuoka, Japan}

This analysis consists of the interview of 3 nurses who had been working in a public childcare centre as a solitary occupation. Case A had 24 years of experience as a medical nurse in a childcare centre ; she decided to resign before the retirement age. Case B had only 7 years experience in a childcare centre, but she had been working after the retirement age as a temporary employee. Case C, who had been working for 9 years, was a rare case, because she was selected as the director of the childcare centre. Through the comparison of 3 narratives, I extracted 8 common categories and classified them depending on what the contents of each category were relevant to, and for whom. The results showed that of the 3 participants, Case A spoke the most about relating to being a childcare worker. Furthermore, the career continuation flowchart suggested that Case A and C had adjusted to the childcare culture, but there was the turning point between A and C, which was whether nurses could be promoted to the post of director in that workplace. I concluded that if a solitary worker from a particular occupation adjusts and gets close to mainstream culture, it could lead to conflict with respect to professional identity; thus, adjustment to mainstream occupation is not always beneficial to continued working.

INTRODUCTION

According to a setting standard, the employees at Japanese nursery centres consist of childcare workers, cooks, and medical nurses. In particular, certiﬁcated nurses tend to position themselves in nursery centres, which is related to the increase in entrance applicants of infant centres. In 2009, the Amending Acts ofﬁcially required the placement of medical nurses in nursery centres with more than 10 babies (Ministry of Health, Labour and Welfare, 2009). As the labour cost of a nurse is more than that of a childcare worker, this modification might lead to disapproval for extending the capacity for infants aged under 2 years in each centre. The Ministry of Health, Labour and Welfare (2016) reported that 86.8% of the waiting list of childcare centres consists of infants aged under 2 years. There remain critical issues for centres with inadequate capacity ; however, the placement rate of nurses working in childcare centres increased from 21.1% (Kimura, et al. 2006) to 53.2% (Tsuda & Kimura, 2016).

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A medical nurse is allocated about 5 or 6 centres; as a result, the nurse is the only medical professional in the workplace. Similar to the dearth of childcare workers, the short supply of medical nurses who work in nursery centres is a crucial issue. Most of the research studies on the vocational identity of nurses were based on nurses working in hospitals, and students and teachers of nursing schools (Sekine & Okuyama, 2006). From the viewpoint of solitary placement, Ishida and Sonoda (2016) investigated school nurses in primary, junior-high, and high schools. They focused not on the relation to other mainstream occupations such as teachers, but on the strength of the traits in nurses, and concluded that the issue of solitary placement is not one of manpower shortage, but the absence of an adviser of the same profession in the workplace.

This research study focused on the career development of medical nurses working in nursery centres through their relation to childcare work or childcare workers. The purpose of this study is to consider the change in the minority group identities in a workplace where various professional groups collaborate, through interviews with 3 nurses who have worked in nursery centres.

METHOD

Participants and Procedure

Initially, 2 informants (A and B) who had worked in the same city participated in our unstructured interviews. The question examples were as follows.

・The vocational career, with life events, of informant after graduation of training facilities.

・The differences of medical nurse’s role or duties between working in hospital and in nursery centre.

・Work style and life style in the past and the future.

Concerning informant A, we have had prior acquaintance; this person was 58 years old and decided to resign from work 2 years before the retirement age in disgust after being evaluated unfairly, which included not being considered for promotion to a managerial position. Informant B, who was introduced by Informant A, was 61 years old and working as a reappointment worker in a nursery centre. After the first research study, I found a case in another city in which a medical nurse was promoted as the director of the centre despite not being a childcare worker. We interviewed the director, aged 55 years, as informant C.

Before the interviews, we educated the informants about informed consent, the rights of the informants, and the handling of data, and obtained letters of consent. The interviews were recorded with an IC recorder. Verbal records were made after the interviews. Both A and B were interviewed in the laboratory, while C was interviewed in a room at the centre, in the presence of only the interviewer and interviewee. Each interview lasted around 1 to 2 hours.

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Analysis

The verbal records of each informant’s responses were segmented by 4 university students through the process of agreement formation; afterwards, I analysed this information in order to sum up their career history (Figure 1), and extracted the categories common to the 3 participants’ narratives (Table 1). In this process, the students divided the verbal records into 332,157,408 data segments, which were analysed to sum up the participants’ career history (Figure 1).

RESULTS

Through segmentation and classification analysis of interview data, we found 8 categories common to the 3 narratives. I quoted the applicable descriptions, positive or negative classiﬁcations, and the target in the contents (Table 1).

As shown in Table 1, the responses of informant A featured ‘for childcare workers’ and negative expressions. In particular, she could not feel any sense of self-efﬁcacy in her job (‘After all, although having a nurse is convenient, it is not highly necessary’), while responses of B featured ‘for themselves’ and negative expressions. She maintained a distance from her childcare work (‘I do not have a close bond with the children and parents’).

In contrary, the responses of C showed a good balance of targets and many positive expressions. Though she thought her greater assets were her negotiation skills with the upper management and adequate medical judgement when an accident occurred, she acknowledged her inexperience with childcare, and sought help from the childcare workers: (‘I’m sorry that I am not a childcare worker though I am the director, but I try to negotiate and deal with clerical tasks’).

Next, we made the ﬂowchart of the 3 informants from the start of working in a nursery centre to their current working conditions, from the viewpoint of their proximity to childcare workers (Figure 2). The main conclusions were

1) The turning point between A and C is whether medical nurses can be promoted to the director of a nursery centre.

2) While A showed a higher affinity toward nursery workers in the middle of her career, in contrast, B maintained a lower afﬁnity throughout. As a result, B could continue to work even after retirement age.

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Pa rtic ip an t Fr om t ra in in g c ou rs e to m un ic ip al e m pl oye es 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 A Assi st an t n ur se w or ki ng in a pr ivat e ho spi tal and at tendi ng nu rs in g s cho ol . A fter gr ad ua tio n, t he r eg ist er ed nu rs e fin ds a j ob as a mu ni ci pal emp lo ye e (2 3 ye ar s o ld ) Re si gna tion Re ti rem ent B Assi st an t n ur se w or ki ng in ano ther to w n' s m un ic ip al ho spi tal ; cha ng es j ob t o w or k as a m un ic ip al ho spi tal nu rs e (2 4 ye ar s o ld) Re ti rem ent C Ju ni or c ol leg e gr ad ua tio n: reg ist er ed nu rs e w or ki ng in 2 ho spi tal s fin ds a j ob as a mu ni ci pal emp lo ye e (2 7 ye ar s o ld ) Re ti rem ent Th ei r car ee rs as m un icipa l em plo yee s Wo rkin g a s a Med ical O ffice r in ch ar ge of va cci na tio n in sch oo l. Wo rkin g a s a m un icipa l h osp ita l n ur se; m ain ly su rg er y. M un ic ip al h ome for t he ag ed Reap po i ntm en t ; M ed ic al Nur se in Ch ild Nur se ry Med ical N ur se in C hild N ur ser y NO W Med ical N ur se in Ch ild N urs ery NO W Sh e w ant to re turn t o a n ursi ng job. NO W ) L J X U H 7 K H L U F D U H H U V D I W H U E H L Q J D G R S W H G D V P X Q L F L S D O H P S O R \ H H V Non-re gul ar em pl oy ee a s a Nurse _Teache r i n sc ho ol Wo rkin g a s a Med ical O ffice r in ch ar ge of p hysica l ex am in at io n. Med ical N ur se in C hild N urs ery D irec to r of C hi ld Nur se ry Sh e w an ted to ho ld th e D ire ct or of C hi ld Nur se ry po si tion

Figure 1 Their careers after being adopted as municipal employees

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DISCUSSION

Why did case A decide to resign?

Results show that the identities and decisions of nurses were based on their relationship with childcare workers who played a cardinal role in nursery centres. Usually we think about how the adjustment to other occupations facilitates adaptation in the workplace. In actuality, informant A and C did not wear the white coat, worked in the staff room, and understood the professional characteristics of nursery nurses. Kimura, et al. (2006) reported that over 40% of parents could not recognize the existence of nurses in childcare centres, and 87.5% of nurses evaluated themselves as not working enough in healthcare practice. This result shows, in terms of adjustments to childcare workers who are in a mainstream occupation in the centre, the nurses could adapt themselves to the workplace. Because they were successful in identifying themselves nurses not in hospitals but in nursery centres, a distinctive difference was not observed by the parents through external appearance. Case A and C did not wear white coats, but wore sportswear, and worked in the staff room. On the other hand, workers who attended to a non-mainstream occupation in the workplace could not fulfil their professional duties. Furthermore, a serious conflict could occur if their promotion to the managerial class is not accepted by the personnel affairs policy of the city. If non-mainstream workers think ‘I’m not being rewarded’, they try to adjust how the non-mainstream works, as A mentioned.

These results would be in contradiction with the usual discourse, in which the adjustment to the workplace is necessary to continue working. In fact, at the childcare centre, Case B maintained the role of a medical nurse almost exactly as the role in a hospital, and did not the adjust to the childcare culture; however, she had kept working after retirement age. Ishida and Sonoda (2016) suggested that the higher the self-education ability (the efforts for self-improvement), the more effective one was in reducing the feeling of difﬁculties on the job. Case A attended many off-the-job trainings, and explored new information about infants’ health, eagerly. These efforts might have reduced the feeling of difficulties, but they did not prevent her resignation. Rather than the adjustment to mainstream occupation helping solitary placement workers to continue working, it instead leads to possibilities of crisis that deprives them of their professional identities and self-efﬁcacy.

The importance of the openness to promote

Figure 2 showed that the branch point between A and C is whether medical nurses can be promoted to the director. The motivation of leadership in females is underestimated, because it is always described in comparison to males (Gervais, 2016). In this research study, on the promotion to managerial position and leadership motivation, it differed from the general research studies of career development. Childcare centres are female-centred workplace; in the absence of special circumstances in the city or town (e.g. the absence of a childcare worker suitable for a management

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role), as a custom in most public centres, only childcare workers can be promoted to managerial status. For now, it is possible to say that Case C would be rare.

However, we found there were many cases in which childcare workers confronted crises related to ‘Avoiding promotion’ and ‘Unqualified for managerial skill’ during the stage of transition to manager (Sakai & Yamamoto, 2015). It seems that the crisis is derived from 3 reasons. First, the certification systems of childcare workers lack the ‘management’ aspect. Second, there are great differences between childcare and management : ‘I like children, it is the reason for my selected occupation. But if I would become a director, I am going to work not with children, but parents and colleagues’. Finally, this would be the most related to the results : as nursing certification is rarer than certified childcare workers, sometimes nurses show a higher ability to plan and to develop skills; and, they receive a higher salary and social status. In other words, if a childcare worker received the managerial position, there would be a more talented person than her in the workplace, who would be her subordinate. This possibility leads nurses to complain and leads childcare workers to feel uncomfortable in that position.

The promotion system has limitations for nurses who adjust to the childcare culture; it brings about a serious conflict that leads some to resign, as mentioned. This conflict suggests that the areas of improvement are the following :

1) Take ‘diversity in the workplace’ seriously.

A transparent promotion system, in which managerial positions are open to everyone, and a fair evaluation procedure for promotion should be implemented in the workplace.

2) Recognise the signiﬁcant contribution of nurses in nursery centres.

The high level of expertise that nurses bring to childcare involves not only dealing with accidents, but also contributing to the care of a child. This means that it is important for nurses in nursery centres to have an inclination toward childcare education.

As stated above, the issues of solitary nurses in childcare centres need to be analysed from the viewpoint of their relation to childcare workers and their view of the system about occupational customs in the workplace. The issues I presented here should be inspected through a quantitative investigation in the future.

References

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Sakai,K. & Yamamoto,C. 2015 Careers and Resignation of Nursery School Teachers : Viewpoints of Former Directors of Public Nursery School. The Japanese Journal of Psychological Science, 36(2),44-55. Sekine,T & Okuyama,T. 2006 A Literature Analysis Study on Identity of Nurses in Japan. The

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