Rapport au travail, mobilité professionnelle et parcours de vie : le cas de jeunes infirmières et infirmières auxiliaires d'un centre de santé et de services sociaux

This doctoral thesis in applied social sciences first set out to address a very concrete problem, namely turnover among nurses and nursing assistants in the health and social services system. Along the way, however, it became apparent that there was a need to broaden our investigation to include the issue of young nurses’ relationship with work so as to grasp the broader social dynamics behind some work-related decisions, including the nurses’ decision to leave their jobs. This thesis therefore pursued two main goals. First, it sought to identify all the processes that lead young nurses to decide to leave their jobs. Second, it aimed to better understand how young nurses’ relationship with work evolves over the course of their lives.  The theoretical perspective chosen was based on two complementary approaches, that is, the life course perspective and various streams of sociology of the individual which all place great importance on the social context and structural constraints as well as the autonomy of actors and their capacity to take action to influence their life course. These approaches proved to be particularly fruitful for our study because they made it possible to consider the complex relationships between the more general social context, the particular contexts involved in individuals’ lives, and their employment behaviours. Thus, the relationship with work was conceptualized as a process that evolves over time and through which different aspects of individuals’ lives and of the lives of their loved ones combine to guide their professional trajectories. Viewed from this perspective, the decision to leave one’s job involves a process that is constructed over a relatively long period of time and involves several dimensions of one’s life. The perspective adopted in this thesis addresses some gaps in this field since few studies have examined – from the point of view of the actors themselves – the various processes that shape individuals’ relationship with work over time and lead to the decision to leave their jobs.   To meet the goals of this research, a qualitative study was conducted. Individual life-narrative interviews were carried out to investigate – from their own point of view – how the participants’ relationship with work evolved and the processes that led them to leave their jobs. A case study was undertaken in a health and social services centre in the province of Quebec which had a particularly high turnover rate. It involved nurses and nursing assistants, a professional group affected by a high rate of turnover. In-depth interviews lasting from 2½ to 3 hours were conducted with 42 nurses and nursing assistants.  The study results were presented in three scientific articles. The first, Pour une compréhension dynamique du rapport au travail: la valeur heuristique de la perspective des parcours de vie (For a dynamic understanding of the relationship with work: the heuristic value of the life course perspective) aims to bring out the usefulness of the analytical principles associated with the life course perspective for the study of the relationship with work. This article shows that individuals’ relationship with work involves a complex process wherein their aspirations, concrete working conditions and the events that occur in their personal and family lives are dynamically and interdependently linked and shape their relationship with work throughout their lives. This article reflects on a question posed by researchers, that is, how best to grasp the factors involved in young people’s relationship with work?   The second article, Rencontre entre l’idéaltype de travailleur et l’idéal de travail: le cas de jeunes infirmières en début de vie professionnelle (Encounter between the ideal type of worker and the ideal of work: the case of young nurses at the start of their working lives) explores how nurses’ expectations regarding work came up against the concrete realities of their work at a specific time in their professional trajectory, that is, their initial integration into the job and their first years on the job. The article shows that three dimensions of the nurses’ relationship with work were affected by the new managerial practices prevailing in the health and social services system: 1) the desired role of work in their lives 2) the ability to self-actualize through work, and 3) the meaning given to work. This article makes an important contribution to the understanding of the relationship with work of young professionals practising a helping profession in Quebec’s health and social services system.  The third article, Comprendre le roulement comme un processus lié au cycle de la vie: le cas des infirmières (Understanding turnover as a lifecycle process : the case of nurses), more specifically examines turnover among nurses. It presents four turnover trajectories with distinct characteristics related to the mismatch between the nurses’ expectations regarding work and the realities of their work, the interaction between work and life outside of work and the way the nurses’ decision to leave their jobs developed over time. The results show that the nurses’ decision to leave their jobs involved a process that developed over a shorter or longer period of time, involved various dimensions of their lives, and was intimately tied to the quest for self-actualization through work and in other spheres of their lives. This article proposes a way to grasp turnover that differs from the dominant models, which approach this issue from an essentially individualizing and psychologizing perspective.  The contribution of this thesis to the advancement of knowledge mainly resides in its innovative way of examining the relationship with work and employee turnover, that is, by applying the life course perspective and sociology of the individual to these issues. Our approach aimed to grasp the social processes and many other aspects that need to be taken into consideration when examining young nurses’ relationship with work and their decision to leave their jobs. It highlights the importance of considering the broader social context affecting all people in modern societies who must construct their identity over the course of their lives.

Keyphrases: Rapport au travail, Parcours de vie, Jeunes, Nurses and nursing assistants, Young workers, Relationship with work, Life course perspective, Employee turnover