The phoenix process: a substantive theory about allegations of unprofessional conduct

This paper is a report of a grounded theory study of how nurses deal with an allegation of unprofessional conduct.

Limited research has been conducted into the experiences of nurses reported to a nurse regulatory authority for an allegation of unprofessional conduct. Previous research reveals that having an allegation of unprofessional conduct made against a nurse and being reported for it can have devastating and prolonged psychosocial and professional consequences. This lack of previous research was the impetus for this study.

Grounded theory methods including the constant comparative method were used to analyse data from in-depth interviews with 21 Australian Registered Nurses who were reported to a nurse regulatory authority for an allegation of unprofessional conduct. Data were collected between March 2004 and September 2005.

A substantive theory, the phoenix process, was generated. This describes a transformation of the personal and professional self which the nurse both 'engages in' and 'goes through'. This transformation is formed through complex deconstructive and reconstructive processes of the personal and professional self. This transformation of the individual is influenced by the degree of deconstruction initially experienced and the interplay with the influencing factors of vulnerability, resilience and support.

A new understanding of unprofessional conduct is needed, together with continued support of a systems approach to error management and support for nurses who err rather than punishing them.