title: The professional development and career advancement of Technical Diploma Nurse graduates in Egypt
Creators: name: Gorman, Linda
Publisher: name: University of Glasgow
Year: 2020

description: Background: Global strategic agendas for strengthening the nursing workforce have emphasised the need for nurses to participate in professional development and career advancement to ensure the high-standing of the profession. However, key challenges within lower-middle-income countries, such as Egypt, have prevented nurses from fully engaging in professional updating activities and progressing successfully in their careers. While attention has been paid to perceptions of professional development and career advancement of nurses within the international literature, an Egyptian perspective, and specifically that of Technical Diploma- level nurses within the country has not been represented.

Purpose: The aim of this research was to explore and describe the perceptions of the professional development and career advancement of Technical Diploma Nurse graduates from a private non-profit Technical Institute of Nursing in Egypt. Moreover, the study aimed to gain an understanding of Technical Diploma Nurse graduates’ aspirations and motivations for their development, as well as the opportunities and challenges they face, and the factors influencing their decision-making around their professional development and careers.

Methods: This study used a qualitative descriptive exploratory design guided by an interpretive stance, and in-depth semi-structured interviews to extend the knowledge on this topic. Data collection involved two phases. Phase 1 involved interviewing 18 Technical Diploma Nurse graduates from the identified Technical Institute of Nursing who were employed at the Institute’s key stakeholder hospital. The perceptions of nurse educators (n=2) from the Technical Institute of Nursing, and healthcare managers (n=3) from the stakeholder hospital, were also explored using in-depth semi-structured interviews for Phase 2. Interviews were transcribed verbatim and data were subjected to Braun and Clarke’s (2006) thematic analysis using an inductive approach. The interpretation and discussion of findings was facilitated by the study’s conceptual framework. This was based on the social and cultural influences on, and its relationship to, the motivations and aspirations of Technical Diploma Nurses’ professional development and career advancement to which Ryan and Deci’s (2000a) Self-determination Theory of Human Motivation was an integral feature.

Findings: Three themes were prominent in perceptions of the participants: 1) mechanisms for learning and development; 2) sources of support, and 3) moving up the career ladder. The theme ‘mechanisms for learning and development’ consisted of two sub-themes: ‘wanting a higher degree’ and ‘participating in work-related learning’; whilst the theme ‘sources of support’ had the sub-themes of ‘family and marriage’ and ‘organisational support’.

Discussion and Conclusion: The study’s conceptual framework, rooted in Ryan and Deci’s (2000a) Self-determination Theory of Human Motivation, helped to explain the phenomena described around extrinsic and intrinsic tendencies of Technical Diploma Nurses’ motivation towards their professional development and career aspirations in this context. The key findings suggest social and cultural factors were important contextual determinants of professional development and career motivation. Social contexts supportive of the basic psychological needs for autonomy, competence and relatedness were identified which impacted positively on motivation and facilitated behaviours that were more autonomous and self-determined. Organisational factors, as well as social support from senior colleagues and peers were influential in stimulating learning and the careers of Technical Diploma Nurse graduates. Domestic support and influence of family, as well as marriage and children also played a significant role in decision- making regarding Technical Diploma Nurses’ development. Nevertheless, Technical Diploma Nurses faced significant challenges which limited opportunities for professional growth and explained why controlled extrinsic motivation and aspirations tended to be prioritised by the graduates interviewed in this study. Outwith the context of the stakeholder hospital, existing educational and healthcare structures in Egypt appeared to thwart satisfaction of innate psychological needs, shifting Technical Diploma Nurses towards extrinsic rewards, focusing on income, promotion and prestige. Economic conditions within the country, as well as the poor societal image of the nurse were also identified as important extrinsic drivers. When presented with limited prospects for development, graduates sought possibilities outside of Egypt to fulfil their professional development and career aspirations. Nevertheless, often these extrinsic drivers represented how Technical Diploma Nurses could ultimately achieve more important intrinsic aspirations.

Significance: Technical Diploma Nurses constitute a significant part of the nursing workforce in Egypt and it is therefore important that they can fully actualise their professional development and career aspirations to effectively contribute to the healthcare system in Egypt. This study, from a private non-profit Technical Institute of Nursing employed at one hospital in Egypt, draws together the perceptions of key stakeholders and provides a more nuanced understanding of the social and cultural factors which influence Technical Diploma Nurse graduates’ motivations and aspirations for development. Although perspectives were gathered from only two institutions, the study’s key findings and implications could provide a baseline for suggestions on how Technical Diploma-level nurses could be best supported to achieve optimal growth within an Egyptian context. Recommendations for further research are highlighted along with some implications for practice and for policy.