Travelogue, dialogue: An arts exploration of psychiatric nursing identity formation

By Debra Dusome
April 2019
Print Version

What you need to know

This research identified significant psychiatric nursing characteristics and socializing influences of students, graduates, and nursing leaders. Identity formation influences included life experience with mental illness in self and/or loved ones, clinical practice, relationships with patients, and mentoring relationships in the workforce.

Why this research is important

The identity formation or the professional socialization of psychiatric nurses is an ambiguous and multi-dimensional process that is not well articulated in the literature (Cutcliffe & Goward, 2000). The purpose of this exploratory study was to gather information from students, recent graduates, and leaders about their process of professional identity formation. Information discovered from this study will help inform psychiatric nursing curriculum, stakeholder investment in transitioning new graduates into the workplace, and will permit the sharing of identity formation stories of psychiatric leaders, graduates and students.

How the research was conducted

This study was a grounded theory exploratory study, which allows the knowledge to be discovered through the voice of participants. This methodology is used when little is known about the subject. Two research methods were used, collage and narrative. Participants created two collages prior to attending a 4–6 hour workshop. The first collage titled, ‘This is Me’ was a self-representation piece designed to capture personality characteristics of the participants. The second collage titled, ‘The Ideal Psychiatric Nurse’ created the stimulus for the Dialoguing with Images process (McNiff, 1992).

Each ’Ideal Psychiatric Nurse’ collage had a dialogue associated with it. Each dialogue was comprised of five layers of responses. The participants: (1) provided a one to two word response to each collage as a whole, (2) posed questions to specific images on the collage or to the collage as a whole, (3) responded from the images’ perspective to the questions asked, (4) answered the question, “What message does this collage tell me about the ideal psychiatric nurse or psychiatric nursing?, and (5) shared the personal meanings of their collage and image selections.

Participants submitted a narrative about their most significant learning experience related to their identity formation. Data and themes generated from these three sources were utilized to triangulate the data and to establish rigor in the findings. Using three different sources of data that reveal similar findings provide stronger evidence for what is found in the study.

What the researcher found

Experience in clinical practice with patients and other mental health practitioners had the most significant impact on students, graduates, and nurse leaders. Students felt that the theory and skills learned in school were the foundation upon which they could begin to build their psychiatric nursing identity. Graduates transitioning into practice were impacted by team relationships, the atmosphere of the workplace, and the organizational culture. Leaders were influenced by numerous clinical and life experiences over time which assisted them in formulating a cohesive sense of themselves as psychiatric nurses. Leaders and graduates both reported challenges they experienced as they transitioned into the workforce.

Eighteen categories evolved from the Dialoguing with Images process. The five categories with the highest responses included, (1) person-centered/ relationship-based care (249), (2) self-awareness and self-care (243), (3) listening/therapeutic communication (225), (4) knowledge and competence (223), and (5) spiritual/existential issues (214). Categories with over 200 responses showed a high concordance of meanings. When all participants talked about relationships and person-centered care, they indicated this theme was central to their practice and to their identities as psychiatric nurses.

How this research can be used

Based on these research findings, educators should focus on clinical experiences of students in their programs and skills to assist students in their transition to the workforce. Employers need to focus on how they could use mentors to assist in the transition of new graduates. Psychiatric nursing leaders and ‘culture bearers’ of the profession may need to consider how they will make space for new psychiatric nurses coming into the field.


Athabasca University Graduate Student Disciplinary Research Fund ($1.000.00).
Western Region Canadian Association of Schools of Nursing Graduate Student Award ($4,000.00).

About the Researcher

Debra Dusome

Debra Dusome, RN, MA, Ex.AT

Debra Dusome is an Assistant Professor in the Faculty of Health Studies at Brandon University. She is located at the Winnipeg Campus.


  • art-based research
  • Dialoguing with Images
  • identity formation
  • professional identity
  • RPNs

Editor: Christiane Ramsey

Research at Brandon University follows comprehensive policies designed to safeguard ethics, to ensure academic integrity, to protect human and animal welfare and to prevent conflicts of interest.