City University of New York (CUNY) CUNY Academic Works All Dissertations, Theses, and Capstone Projects Dissertations, Theses, and Capstone Projects 2013 Becoming Someone Different: A Grounded Theory Study of How Nurses Integrate Pregnancy and Full Time Employment Paul Gregory Quinn The Graduate Center, City University of New York How does access to this work benefit ou?y Let us know! More information about this work at: https://academicworks.cuny.edu/gc_etds/1961 Discover additional works at: https://academicworks.cuny.edu This work is made publicly available by the City University of New York (CUNY). Contact: [email protected] Becoming Someone Different: Nurses, Pregnancy & Full Time Employment Becoming Someone Different: A Grounded Theory Study of How Nurses Integrate Pregnancy and Full Time Employment by Paul Gregory Quinn A dissertation submitted to the Graduate Faculty in Nursing in partial fulfillment of the requirements for the degree of Doctor of Philosophy, The City University of New York 2013 i Becoming Someone Different: Nurses, Pregnancy & Full Time Employment This manuscript has been read and accepted for the Graduate Faculty in Nursing in satisfaction of the dissertation requirement for the degree of Doctor of Philosophy. Barbara DiCicco-Bloom, Ph.D., RN Date Chair of Examining Committee Keville Frederickson, Ph.D., RN, FAAN Date Executive Officer Steven Baumann, Ph.D., RN Barbara Katz Rothman, Ph.D. Bernadette Curry, Ph.D., RN Supervisory Committee THE CITY UNIVERSITY OF NEW YORK ii Becoming Someone Different: Nurses, Pregnancy & Full Time Employment Abstract Becoming Someone Different: A Grounded Theory of How Nurses Integrate Pregnancy and Full Time Employment by Paul Gregory Quinn Advisor: Dr. Barbara DiCicco-Bloom In the United States, 40% of the contemporary nursing workforce is comprised of women of childbearing age, 65% of whom are employed full-time. Hence, the likelihood of pregnancy occurring for this population at some point in their employment is high. A holistic exploration of how nurses integrate pregnancy and full-time employment has been lacking. The purpose of this research was to explore how primiparous nurses managed pregnancy and full- time employment. Using a grounded theory approach, nurses who were pregnant and delivered their first baby, while employed full-time on 12-hour work shifts, provided a firsthand account of how they incorporated pregnancy with employment. Nurses, as social actors, experience many interactions in their workplace environment. The basic social process, becoming someone different, emerged to explain those interactions and allowed a substantive grounded theory to be developed. From that exploration, the researcher will present the basic social process, becoming someone different, and the four core categories that arose from the analysis: 1) looking different, feeling different – to explain how the physical and emotional changes of pregnancy result in nurses looking and feeling differently about themselves as nurses; iii Becoming Someone Different: Nurses, Pregnancy & Full Time Employment 2) expectations while expecting – where the nurse, with previous experiences and ideas about what is expected of her and what she expects from others, changes how she sees herself, based upon her interactions in the workplace with her peers and coworkers; 3) connecting differently – explains how the nurse, while pregnant, develops new relationships and interactions with the people in her environment, specifically her peers, coworkers and patients, and 4) transitioning labor – where, despite challenges from interactions within the workplace from coworkers or tasks, the participant nurses began to focus on their eventual maternity leave and working as long as possible up to the time of delivery in order to prolong that maternity leave. iv Becoming Someone Different: Nurses, Pregnancy & Full Time Employment Acknowledgments “Believe…” This has truly become my own personal “Miracle on 34th Street”. This work would not be possible if it had not been for the mentors that guided and supported me along the way. I owe a tremendous debt of gratitude to my dissertation committee: Dr. Barbara DiCicco-Bloom, Dr. Keville Frederickson, Dr. Steven Baumann, Dr. Barbara Katz-Rothman, and Dr. Bernadette Curry. Special thanks to the 20 nurses who shared their intimate experiences with me by participating in this study. I would be remiss if I did not acknowledge the people who helped me to get to where I am today. The faculty of St. Vincent’s Hospital School of Nursing provided me the foundation in nursing that I cherish and honor. Thank you, Mrs. Maureen Heitmann, Ms. Joan Caruana, Sr. Miriam Kevin Phillips, S.C., and the memory of Sr. Mary Robert Nagle, S.C. All of you believed in me, made me proud to be a nurse and made me strive to continue my education. Patientia, Fortitudo et Perseverantia forever. Thank you Dr. Carol Vicino and Dr. Amilcar Baretto for setting me on my journey toward doctoral education. I have come to realize that friends are the people that God didn’t give me as brothers or sisters. My heart will be forever grateful to my life-long friends: my “St. Vinny’s” classmates Linda Grimsland, Renee Kidger-Eguiguiuerens, Cathy Koch, Kathy Armstrong-Finnerty, Siobain Blumenberg-Wentworth, and Kim Burrows; Larry Lane, Jim McCoy, Alex Keomurjian, Dr. Michael Greco, Perry Nagle, Marvin Kasper, Lettie Conrad, Gregory Locoparra, and Tina Marie Neri-Badame. v Becoming Someone Different: Nurses, Pregnancy & Full Time Employment To the people I met along the way, especially my “White Plains Hospital family”. They were the people who stood by me and supported me on a daily basis, specifically Sheran Lyons, Francine Orefice, Leslie Nieves, Kristine Kohl-Cappo, my boss Leigh Anne McMahon, Cathy Waters, and my incredible Maternal-Child Health staff and managers. Many thanks to the “Boys of 163 Oak Walk” in the Fire Island Pines for memorable summers and for not letting take myself too seriously. My family, near and far, played an important role in my success on so many levels. Many thanks to the memory of my uncles, William Quinn and Joseph Guidice, Sr., who pushed me to be more than I ever thought I could be and believed in my potential. I remain grateful to my cousins for their support, especially Mary Hodnett, Donna Petrolia, Roxanne Guidice, Denise Quinn-Mojica, Mary Quinn, and Kelly Quinn-Greco. Along the way, I gained a new “family”: John, Mindy, Johnny, Katie, and Matt Gilsenan; Mike, Mary, Christine and Mike Jr. Lanni; Rich Gilsenan; and Mrs. Gladys Gilsenan who supported and encouraged me throughout these past four years. My brother, Vincent Guidice, left this earth too soon on May 22, 1996. His spirit lives within me and when I was ready to give up or turn and run the other way, his strength sustained me and pushed me forward. Finally, all of my gratitude and love belong to David Gilsenan. My best friend, my partner on this journey, the quiet one in my corner, the shoulder I cried on, the one who makes me laugh, and the one who keeps me reaching to be more, do more, and dream bigger. Thank You! “More than You Know…” vi Becoming Someone Different: Nurses, Pregnancy & Full Time Employment Dedication This work is dedicated to my mother, Eileen Guidice, RN. You have been my inspiration and mentor long before my career began. Your legacy to me will always be that taking care of the sick is an honor, and that becoming a nurse, and a midwife, was the most precious gift life would ever give me. If I can become half the nurse you are, my career will not have been in vain. The nurse I am, the work I do, the man I am and yet to become, are all because of you. vii Becoming Someone Different: Nurses, Pregnancy & Full Time Employment Table of Contents Page Number Abstract……………………………………………………iii Acknowledgments………………………………………….v Dedication………………………………………………...vii Chapter I: Introduction……………………………………..1 Purpose……………………………………………..2 Research Question……………………………….....2 Inclusion Criteria..………………………………….2 Background………………………………………....3 Significance………………………………………....5 Method…………………………………………….. 6 Implications for Nursing…………………………....8 Assumptions & Biases……………………………...9 Summary…………………………………………....9 Chapter II: Review of Literature…………………………...10 Chapter III: Methodology………………………………….41 Researcher Profile………………………………….42 Pilot Study………………………………………….44 Data Collection……………………………………..45 Finding Participants………………………………...46 Interview Process…………………………………...54 viii Becoming Someone Different: Nurses, Pregnancy & Full Time Employment Data Analysis……………………………………….56 Trustworthiness……………………………………..59 Reflexivity…………………………………………..61 Limitations………………………………………….63 Summary……………………………………………66 Chapter IV: Findings……………………………………….67 Workplace Setting………………………………….69 Looking Different, Feeling Different……………….72 Expectations when Expecting………………………80 Connecting Differently……………………………...85 Transitioning Labor...................................................95 Summary…………………………………………....99 Chapter V: Discussion, Implications for Nursing, & Future Research…100 Symbolic Interactionism……………………………101 Stages of Pregnancy………………………………...103 Early Stage: Looking Different, Feeling Different….104 Early Stage: Expectations when Expecting………....107 Later Stage: Connecting Differently.………………..110 Later Stage: Transitioning Labor…………………....112 Implications for Nursing…………………………….116 Future Research……………………………………...119 References…………………………………………………...129 ix Becoming Someone Different: Nurses, Pregnancy & Full Time Employment