Choosing nursing as a career: a narrative analysis of millennial nurses' career choice of virtue

F e a t u r e

Choosing nursing as a career:a narrative analysis of millennialnurses’ career choice of virtue

Sheri Lynn Price,a,b Linda McGillis Hall,b Jan E Angusb and Elizabeth Peterb

aDalhousie University, Halifax, NS, Canada, bUniversity of Toronto, Toronto, ON, Canada

Accepted for publication 11 February 2013

DOI: 10.1111/nin.12027

PRICE SL, MCGILLIS HALL L, ANGUS JE and PETER E. Nursing Inquiry 2013; 20: 305–316

Choosing nursing as a career: a narrative analysis of millennial nurses’ career choice of virtue

The growth and sustainability of the nursing profession depends on the ability to recruit and retain the upcoming generation

of professionals. Understanding the career choice experiences and professional expectations of Millennial nurses (born 1980

or after) is a critical component of recruitment and retention strategies. This study utilized Polkinghorne’s interpretive, narra-

tive approach to understand how Millennial nurses explain, account for and make sense of their choice of nursing as a career.

The positioning of nursing as a virtuous choice was both temporally and contextually influenced. The decision to enter the pro-

fession was initially emplotted around a traditional understanding of nursing as a virtuous profession: altruistic, noble, caring

and compassionate. The centricity of virtues depicts one-dimensional understanding of the nursing profession that alone could

prove dissatisfying to a generation of professionals who have many career choices available to them. The narratives reveal how

participants’ perceptions and expectations remain influenced by a stereotypical understanding of nursing, an image that

remains prevalent in society and which holds implications for the future recruitment, socialization and retention strategies for

upcoming and future generations of nurses.

Key words: career choice, Millennial generation, narrative inquiry, nurse imagery, nursing recruitment.

Nursing recruitment is a recognized national and interna-

tional priority. Health workforce and human resource plan-

ning is a priority for health systems internationally, and a

significant focus has been addressing the nursing shortage

(World Health Organization 2006). Nurses are the largest

group of healthcare providers, and the needs of people, pop-

ulations and the health system as a whole require the avail-

ability of a sustainable nursing workforce. The growth and

sustainability of the nursing profession depends in large part

on the ability to recruit and retain the upcoming Millennial

generation (born between 1980 and 2000) to the profession

(CNA 2009). However, we do not have an in-depth under-

standing of the career choice experiences of this upcoming

generational cohort. Understanding how these future nurses

come to choose nursing as a career option is of critical

importance to the profession, with implications for both

recruitment and retention. The following paper presents

one theme of a narrative inquiry into Millennial nurses’

career choice experiences.

BACKGROUND

Career choice has been studied since the early 20th century,

predominantly within the disciplines of organizational and

vocational psychology (Strong 1927; Roe 1956; Holland 1959).

Within this body of literature, there is recognition of a myriad

of influences on career choice across the life span, in particu-

lar during childhood and adolescence (Ginzberg et al. 1951;

Super 1980; Lent, Brown and Hackett 1994). Several

prominent career choice theories recognize a myriad of earlyCorrespondence: Dr. Sheri Lynn Price, Assistant Professor, School of Nursing, Dal-

housie University, Halifax, NS, Canada. E-mail: <[email protected]>

Nursing Inquiry 2013; 20(4): 305–316

© 2013 John Wiley & Sons Ltd

influences on occupational choice such as gender role orien-

tation, personality, educational experiences and parental

and peer interactions (Gottfredson 1981; Eccles 2011). Hav-

ing the opportunity to learn about the attributes of a particu-

lar profession early in life not only has been linked to career

choice, but has also been associated with professional sociali-

zation, career transition and job satisfaction (Davis 1968,

1975; Dorcy 1992; Schoon and Polek 2011).

Career choice research within the discipline of nursing

has often sought to explore influences on the decision to

enter the nursing profession and has found several factors

that guide career choice, including gender (Boughn 2001;

Muldoon and Reilly 2003; Whitehead, Mason and Ellis

2007); culture (Gregg and Magilvy 2001; Lai, Peng and

Chang 2006; Martin and Kipling 2006); experiential knowl-

edge (Kohler and Edwards 1990; Beck 2000; Porter, Edwards

and Granger 2009); self-concept (Andersson 1993; Dombeck

2003; Larsen, McGill and Palmer 2003); and an altruistic

desire to help others (Law and Arthur 2003; Mackintosh

2006; McLaughlin, Moutray and Moore 2010). The career

choice literature also identifies that traditional views of

nurses and nursing as caring and nurturing remain preva-

lent and continue to influence the decision to enter the pro-

fession (Boughn and Lentini 1999; MacIntosh 2003).

Historically, career choice in nursing was associated with a

‘vocational calling’ to perform a virtuous role (Gordon and

Nelson 2005). As Gordon and Nelson (2005) assert, the prev-

alence of a virtue script in the imaging of nurses, which cen-

ters on characteristics of kindness, compassion and caring,

can trivialize the complexity and scientific knowledge base of

nursing practice.

Although the nursing literature provides some insight

into career decision-making, most of the career choice

research has used quantitative methods and surveys to iden-

tify specific influences on the decision to become a nurse.

Despite a wealth of research and theorizing, there currently

exists a lack of contextual understanding of the way in which

individuals process multiple career choice influences, come

to choose nursing, and how they make sense of their deci-

sions (McIlveen and Patton 2006; Price 2009a). Furthermore,

there is a gap in our understanding of how the Millennial

cohort of nurses choose nursing as a career, a group theo-

rized to have distinct socialization experiences and career

expectations than preceding generations (Boychuk-Duch-

scher and Cowin 2004). The characteristics of generational

cohorts have been categorized and described within several

well-cited texts (Strauss and Howe 1991; Zemke, Raines and

Filipczak 2000). One reason for the recent focus on genera-

tional issues in the workforce arises from the fact that there

are currently four generations of workers co-existing within

the workplace, each with distinct characteristics (Lancaster

and Stillman 2002). A growing body of generational litera-

ture and research has shown significant differences between

the Millennial generation and preceding generational

cohorts (Veterans, Baby boomers and Generation X) in rela-

tion to career aspirations and expectations (Hill 2002; Eisner

2005; Hartung, Porfeli and Vondracek 2005). The Millenni-

als are the most recent generational cohort to enter the work-

place. In addition to being characterized as the most

technologically savvy of the generational groups, they are also

noted to have high expectations of themselves and others;

work well in cohesive, collaborative and collegial environ-

ments; and look for feedback and recognition for their

achievements (Boychuk-Duchscher and Cowin 2004).

Understanding the career choice decision-making of the

Millennial generation of nurses is of significant concern

given recent research that suggests growing attrition rates of

new nursing graduates (Beecroft, Dorey and Wenten 2008).

Recent statistics suggest that 30–60% of new nursing gradu-

ates may leave the profession within the first 2 years of pro-

fessional practice (Bowles and Candela 2005; Beecroft et al.

2008). These statistics are even more disconcerting given

that the nursing shortage is projected to rise over the next

decade (CNA 2009). One explanation in the literature for

this attrition is that new graduates, as part of a younger gen-

erational cohort, may have significantly different childhood

experiences and expectations of occupations/workplaces

than previous generations (Zemke et al. 2000; Hu, Herrick

and Hodgin 2004) and often experience incongruence

between the environment in which they were raised and edu-

cated and the professional setting into which they are indoc-

trinated (McNeese-Smith and Crook 2003). Recent research

in nursing has identified that the Millennial generation are

also significantly less satisfied with their jobs than older gen-

erational cohorts and have the largest proportion of nurses

experiencing burnout (Cho, Laschinger and Wong 2006;

Laschinger, Finegan and Wilk 2009). Addressing the loss

and job dissatisfaction of new graduates from the profession

will be essential to addressing the current and growing short-

age of nurses (O’Brien-Pallas, Tomblin-Murphy and Shami-

an 2008). A more in-depth understanding of the career

choice and professional socialization experiences of this gen-

eration of nurses is needed.

OBJECTIVES

The purpose of this narrative inquiry was to further under-

stand the experience of choosing nursing as a career among

individuals of the Millennial generation. The specific

research questions were:

SL Price et al.

© 2013 John Wiley & Sons Ltd306

1. How do participants explain, account for and make

sense of their choice of nursing as a career?

2. How do participants narrate personal, social and organi-

zational influences within their career choice narratives?

3. How do these narratives reflect an understanding, or

create images, of nursing as a career and as a profession?

DESIGN

This research employed an interpretive, narrative inquiry

using Polkinghorne’s (1995, 1997) theory of narrative con-

figuration and emplotment, influenced by the philosophical

writings of Ricoeur (1984, 1985, 1991a, 1991b, 1997). Narra-

tive, as theorized by Ricoeur and Polkinghorne, is not a mere

retelling or description of another’s story, but a dynamic pro-

cess of interpretation that alters and contributes to the

meaning of the story. Polkinghorne’s theory of narrative

emplotment recognizes that life is not merely a storied text

but is something that requires interpretation. Hermeneutic

methods such as this are particularly well suited to studying

self-narratives and self-identity (McAdams 1993; Polking-

horne 1997; Singer 2004). Within this approach, narratives

are viewed as a primary means by which humans give mean-

ing to their lived experiences. Narrative meaning draws

together human actions and events, and meaning is created

by recognizing the contributions of these actions and events

to a specific outcome and then configures these parts into a

unified, meaningful and coherent whole. Understanding

career choice using narrative theory requires attending to

the process of emplotment, how individual events are linked

together, with particular attention to context, language and

temporality. Temporality is an essential component of narra-

tive theory and denotes that an event is more than a tempo-

ral occurrence, but instead reveals the significance that

certain events have for one another (Polkinghorne 1997).

SETTING

The setting for this study was a large university school of nurs-

ing located in Eastern Canada. Participants were recruited

from those accepted for admission to the Bachelor of Sci-

ence in Nursing (BScN) program. Enrollment in the pro-

gram for the calendar year of 2009–2010 was 185 students.

PARTICIPANTS

The target population included individuals from the Millen-

nial generation for whom nursing was their preferred career

choice. Inclusion criteria included: Females or males, born

in 1980 or later, who were entering their first year of study in

nursing.

Twelve Millennial women, for whom nursing was their

preferred career choice, participated in the study. This sam-

ple size is in keeping with the interpretive and narrative nat-

ure of the methodology, the wealth of data for each

participant and the analytical method (Morse 2000). This

study employed Polkinghorne’s (1995) paradigmatic analyti-

cal method that enables a larger sample to be considered

(n = 12–18), versus case study (3–6), and results in a move-

ment from individual stories to common themes to produce

general concepts. All 12 participants were born in 1980 or

after. Six of the participants were new high school graduates

(18 years old). The remaining six participants were applying

following either partial or complete post-secondary educa-

tion. Ten of the participants were born in Canada, and all 12

had completed junior high and high school in Canada. All

participants had been employed either full-time or part-time

prior to entry in nursing school. Five participants were enter-

ing nursing following several years of full-time employment

in other fields. Nine participants had volunteer or employ-

ment experience within the healthcare arena and four

worked as personal care aides within nursing homes.

METHODS

Data collection methods consisted of two face-to-face inter-

views, participant journals and investigator field notes. Fol-

lowing ethical approval and informed consent, the

participants were interviewed by using a semi-structured

interview guide. Participants were interviewed by the lead

investigator, who was not teaching within the nursing pro-

gram. Along with assurances of privacy and confidentiality,

participants were assured that their participation in the study

would not negatively affect their status as a student. All inter-

views were audio-recorded and transcribed verbatim by a

professional transcriptionist. At the conclusion of the initial

interview, participants were provided with a small journal to

chronicle emerging thoughts and any additional informa-

tion they wished to share. The journals and second inter-

views are critical in narrative approaches where reflection on

events and actions throughout one’s lifetime often requires

pause and consideration (Polkinghorne 1988, 2005). Jour-

nals entries and preliminary analysis of the first interview

were used to elicit further discussion in the second interview.

The second interview took place 4–6 weeks following the ini-

tial meeting. Interpretation is enhanced through contextual

understanding, and investigator field notes were essential to

understand the texts in the context of the interview (Pol-

kinghorne 1983; Lindseth and Norberg 2004).

Millennial career choice narratives

© 2013 John Wiley & Sons Ltd 307

Data analysis

All data were analyzed using Polkinghorne’s (1995) theory

of narrative configuration and emplotment using the ana-

lytic procedure described by Beiter (2007). The analytical

process moved from sensing the interview as a whole to the

recognition, development and refinement of narrative struc-

ture, including plots, subplots, characters, settings and time.

The process of narrative analysis must not only seek to bring

the parts of the story together into a coherent whole but

must also ensure that the complexity of the participants’ sto-

ries is not lost in the process (Emden 1998). Frequent

returns to the full-text transcripts and the employment of a

narrative mapping technique (Lapum et al. 2010) ensured

ongoing connection to the wholeness of the participant’s

stories. The final stages of the analysis included examination

within and across narratives for thematic characterizations

and the identification of similarities and exceptions. The

notion of a ‘theme’ within the context of this narrative

inquiry does not necessarily represent something that is sta-

ted repeatedly but instead reflects an understanding or sig-

nificance.

Rigor

The subjective nature of narrative inquiry does not negate

the need for researchers to address the validity of the col-

lected evidence and the interpretation of the data. Polking-

horne (2007) identifies that validity threats arise in narrative

research when the storied description of experience does

not reflect the meaning as experienced by the participants.

Four sources of disjunction between participants’ experi-

enced meaning and the resulting narrative include limits of

language to capture complexity of experience, limitations of

reflection and recall, reluctance to fully share experiences

due to social desirability and the intersubjective nature of

the narrative structure. The use of face-to-face, repeat inter-

views, journaling and field notes were strategies used to

enhance the credibility and trustworthiness of the results.

FINDINGS

The following discussion presents the theme: ‘Emplotting

Career Choice Around the Virtues of Nursing’. Within each

narrative, career choice was represented as a course of dis-

covery and understanding more than a static moment in

time or definitive event. The narratives are organized not

only around specific events but in how the participants’ sto-

ries are told: what is foregrounded, what is backgrounded

and what is reconfigured over time. The narratives are an

evolution and unfolding of career choice both over time and

in relation to time. In other words, the way the participants

told their story tells a story.

The participants initially emplotted their career choice

around a traditional and stereotypical understanding of

nursing as a virtuous profession. The participants’ character-

ization of nurses, role models, points of inspiration and the

process of choosing nursing were narratively grounded in

the perceived virtues of the nursing profession, such as altru-

ism, caring and compassion. Our use of the term ‘virtue’ in

this study relies on a commonplace understanding of virtue

as a moral disposition, such as altruism in the case of nurses.

We recognize, however, that a more theoretically robust

sense of virtue, using the work of Aristotle for instance, could

embrace practical wisdom, along with moral and intellectual

wisdom (Begley 2006). Such a definition would make possi-

ble a congruence among scientific, practical and moral wis-

dom.

It is important to note that the virtuous scripting of the

choice of nursing is only one plot of the participants’ stories.

The narrative scripts evolved from positioning nursing as vir-

tuous toward understanding the meaning of career choice

in relation to one’s position in the social world where consid-

eration of status, autonomy, respect and quality of life were

also emphasized. The second major plotline of the findings

was related to the societal positioning and social scripting of

career choice. However, this paper focuses exclusively on the

virtue script/plotline, which was foregrounded in the narra-

tives. The findings are presented within the following subthe-

mes: Making a Difference, Characterizing Self as Nurse,

Imaging Nursing as the Ideal Career and Constructing

Choice as a Calling. Pseudonyms are used to identify the par-

ticipants’ stories.

Making a difference

In making sense of their career choice, all of the participants

started by locating their story within the context of making a

difference. Their stories were framed by their understanding

of nursing as a virtuous profession: honorable and noble.

The stories were narrated in a way that emphasized a caring

and helping orientation to the choice of nursing. Within the

narratives, the desire to make a difference in people’s lives

and ‘help others’ was forefront in the participants’ stories of

how they came to choose nursing. The narratives positioned

career choice as an altruistic decision and portrayed nursing

as a ‘helping’ career. As Judy shared:

It’s probably years … years wanting to help people. It wasalways that ‘wanting to help’…Working as a medic- It mademe feel so good to be able to make a difference with some-

SL Price et al.


one. These moments gave me such joy to see how much dif-ference you can make in someone’s life.

Several participants described a lifelong desire to help oth-

ers. Although the stories identify several sources of external

inspiration, the narratives also position the choice of nursing

as an intrinsic need to make a difference in the lives of oth-

ers. Beth’s mother’s decision to become a nurse during her

teenage years was a source of inspiration for choosing nurs-

ing, yet she initially stated that her career choice followed a

lifelong desire. As Beth shared:

Just like being able to like help people. I don’t know, I’vealways just wanted to do that … even when I was little … Soit wasn’t like I was picking something now. It’s somethingthat I wanted my whole life.

Although the narratives also demonstrate the role of prag-

matics in career choice, the participants initially framed their

decision within a helping orientation. Nursing was emplot-

ted as a helping, caring and people-oriented profession, and

the choice of nursing as a career was positioned as a mean-

ingful and altruistic act. As Allison shared, her connection to

people and desire to help were central to her choice of nurs-

ing:

I want a job where I work with people. … So you have totake certain aspects of your personality to like help peoplein different situations. I am pretty good at reading people soI know how to act around them… I feel like in nursing, youhave like the medical part of it but then there is also thecompassion aspect to it.

Allison’s desire to make a difference and help others was

derived in part from her experience as an immigrant from

another country, where there was an emphasis on contribut-

ing to the larger community. Tina, who was motivated by her

family’s service as missionaries, also framed her choice of

nursing as virtuous, as a way to make a meaningful contribu-

tion and ‘tangible difference’. As Tina shared:

I wanted a job that is rewarding, that I can see direct results.Direct results where you make a difference. Like either youstop pain… Like you can see something, even if it’s notdirect but it’s within a week… I think thinking of those andknowing that I wanted to be in a role where I am in a posi-tion to – I am using this phrase a lot – help others.

It was evident from the participants’ stories that there was

a tendency to narrate and create meaning for their career

choice that fit with their perceptions of nursing as a helping

career. Within the narratives, nursing was often positioned as

superior to other careers, especially in terms of the helping

potential of one choice over another. Several participants

identified as part of a generation who had a social conscience

and were socialized to help others in need. They also

described being uninspired by non-health-related work experi-

ences which influenced them to choose a career that made

them feel as though they were making ‘more of a difference’.

Characterizing self as nurse

Storytelling provides an opportunity for individuals to

describe who they are (Polkinghorne 1997; Singer 2004).

The location of self, and concept of self-identity, is central to

narrative structure and is organized along a temporal whole

(Polkinghorne 1997). Within the narratives, the participants’

experience of self is organized temporally in that the ‘whole

of who they are’ arises from their past, present and future

roles. The participants commenced their storytelling with a

description of self that emphasized personal virtues and vali-

dated why they chose nursing and why they were a ‘good’ fit

for the profession. The participants’ characterization of self

as a nurse aligned closely with their perceptions and descrip-

tions of nursing as virtuous. The narratives recreated tradi-

tional images of nursing and nurses, often with an emphasis

on personal virtues, attributes and interpersonal skills such

as caring, compassionate and attentive. As Ava shared:

I am a really big people person in general. I mean nomatterwhat I did, it had to be with people. I find I am very empa-thetic in a way almost. Even if I am watching when peopleget hurt or when they are sad, I really like to be around peo-ple and help comfort them. Because I feel like that is soimportant. And then I also really like science and howbehind all of that, there is really complicated stuff that youhave to learn and know.

Central to the virtuous plotline is an emphasis on interper-

sonal skills and attributes over other defining personality

traits and characteristics. In making sense of her decision to

choose nursing, Allison wrote in her journal:

What makes me a good nurse is I’m a huge people person;I’m a fabulous listener and good with advice; I have thesocial and compassion aspect; I am assertive; organized; aca-demically inclined; determined; hard worker; can read peo-ple and their emotions; emotionally very strong; experiencevolunteering.

Allison’s journal entry is an example of the participants’

tendency to make sense of the choice of nursing and define

one’s self in a way that fits with a traditional image of a nurse.

Allison’s story also characterized her as intelligent, ambi-

tious, adventurous and confident. She seeks a career that has

prestige, respect and power: power to make a difference on

a global level. Millennials are known to be goal orientated

and high achievers yet when speaking of their roles in nurs-

ing, the participants often spoke in general, non-specific

terms that downplayed their previous academic achievements.



As noted above, when Allison made sense of her choice of

nursing and identified attributes befitting a nurse, she

focused on being a ‘people person’, emphasizing interper-

sonal skills over other defining characteristics (ambitious,

leader, decision-maker).

Inherent within narrative inquiry is attention to contexts.

The capacity to recollect and narrate experience is intrinsi-

cally linked to social class, race and gender (Polkinghorne

1995), which are also well-recognized influences on career

choice (Gottfredson 1981; Boughn 2001). The participants’

descriptions of nursing and nurses’ roles were constituted in

terms of gender discourses as evidenced by the emphasis on

traditional feminine characteristics: motherly, caring, kind,

compassionate, soft, comforting, patient and reassuring. Sev-

eral participants rejected the notion that nursing was a

female profession and acknowledged that, unlike previous

generations, gender was no longer an obstacle in consider-

ing career options today. However, the traditional, gendered

view of nursing as a female occupation was evidenced within

several narratives as the participants’ decision to become a

nurse was positioned as somewhat predictable and fitting,

given their ‘motherly’ tendencies. As Jane shared:

A lot of my friends weren’t surprised when I picked nursingjust because they all like… They are always like teasing meand saying, ‘Oh, you are like such a mom. You are alwaystelling me don’t do that, you are going to hurt yourself,’and stuff like that. So my friends weren’t really like shockedwhen I chose that, I guess.

Personal virtues such as kindness, thoughtfulness and caring

were central to the participants’ self-identity as a nurse. The

description of self was emplotted in a way that positions the

choice of nursing as a logical and expected career path. As

Beth explained, her friends validated her choice of nursing

by stating that it fit with her tendency to take care of every-

one:

I’ve always been like the one who takes care of everyone elseanyway… So they were just like, ‘Well, now you are going tobe paid to take care of people.’ People always joke around,and like I’m the mother of the group … So it’s just like itsuits you to like want to take care of people.

The participants’ stories create images of nurses as

‘motherly’, women who possess traditionally female attri-

butes such as loving, nurturing and compassionate. The par-

ticipants’ self-identification as a nurse is narratively scripted

around virtues: the perceived personal characteristics of a

nurse valued in society. Personal attributes are often emplot-

ted as the genesis of career choice. However, despite refer-

ence to a range of personality traits within the narratives, the

choice of nursing was positioned in relation to virtuous attri-

butes such as kind, empathetic and caring. The participants

make connections between academic performance and gen-

eral career choice; however, the narratives place emphasis

on interpersonal attributes in relation to nursing. As narra-

tive theory maintains, self-identity does not equate to any

one social role and the narratives provide an understanding

that the participants were not defined solely by any one per-

sonality trait or interest (Polkinghorne 1988). The descrip-

tion of self is considered temporal in that it displays ‘the rich

and complex unfolding of life process over time’ (Polking-

horne 1988, 29). The participants’ identification of self

evolved over time from the confines of a stereotypical view of

nurses to a point where they shared aspects of their self that

existed outside of being a nurse. Narrative theory acknowl-

edges that the storyteller often shifts their description of self

to fit within the context of the story being told. Through nar-

rative configuration, self-identity is understood as a process

that evolves over time (Polkinghorne 1997).

Imaging nursing as the ideal career

With roots in linguistics, narrative as a theoretical approach

requires attention to language. The participants’ choice of

words within their stories painted a picture of nursing and

nurses that initially emphasized their career choice in a posi-

tive light. The participant’s perceptions of nursing are

embedded throughout the plotlines of their narratives and

provide distinct insight into how nursing is portrayed in soci-

ety, reflecting both traditional and contemporary images.

Nursing was narrated by participants as an ‘all-in-one’ career.

The narratives provide an image that nursing was a career

that ‘had it all’: noble, rewarding, secure and diverse. As

Tina shares:

… knowing that it is good pay and it’s job security as well.…But the pay, I think that is a huge deciding factor for usright now … it feels like we are just living pay cheque to paycheque. We are trying to save to get a house but it’s chal-lenging … I guess in the back of my mind is that we wouldlike to eventually move back [home] And there’s not muchthere. So I mean in a rural community, nursing would be acareer that I could fall back on easily. That I could do in anyenvironment or any location.

Several participants emphasized that nursing was a career

that provided guaranteed work at the end along with job

and financial security. As evidenced in all of the participants’

narratives, nursing was perceived as one of the few reliable

career choices that ensured stable employment and this was

often linked to the participants’ home/family life. Even for

participants who did not yet have spouses or children, nurs-

ing was often described as a career that enabled a family-cen

tered lifestyle. As Kate, who worked with nurses in her role at

a health clinic, describes:

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A lot of [nurses] had families, which I thought was reallyappealing. It is a career that you have the opportunity tohave both those things – a career and a family. And it worksreally well. You can go part-time, you can go casual, you cango full-time, you can work nights, you can work weekends…There’s a lot of flexibility in it, I think … And that is sort ofappealing because I’ve always wanted to have a family.

The participants’ emphasis on finding a flexible and family-

friendly career was often informed by personal experiences

within their own families, especially in relation to parental

employment. Several of the participants described being

encouraged by their Baby Boomer parents, who are often

characterized as workaholics (Strauss and Howe 1991), to

choose a career that would both enable a life outside of work

and allow them to ‘be all they could be’. Nursing was nar-

rated as a career that offered diversity and enabled both per-

sonal and professional fulfillment especially given the wide

array of roles and settings. As Beth shared:

I wouldn’t want to sit in a cubicle and do the same thingevery day. But like with nursing, you could like work in achildren’s hospital and work with children, or you can go toa manor and work with old people, or you can move upNorth and work there, or you can work on a helicopter forlike the transports. Like there’s so much you can do and somuch … You can always learn new things … It’s excitingthat you can change.

The narratives provided insight into the fact that the par-

ticipants did not want to be ‘bored’ with their career choice:

they wanted evolution and continued growth. The partici-

pants described being open to change within their careers, a

generational characteristic often associated with the Millen-

nial generation (Boychuk-Duchscher and Cowin 2004).

Nursing was portrayed as a career that could provide lifelong

professional diversity within the same career. Most of the par-

ticipants spoke of being able to advance their careers within

the profession and also anticipated having several different

careers all within nursing. Career change could be conceived

within the choice of nursing given the diversity in roles and

settings. As Ava shared:

Nursing is a career path that allows you to go in almost anydirection you choose … it makes me so excited to know I’mgoing in to a field that gives me so many choices. If I’m look-ing for a career for the rest of my life, then I don’t want toget bored. Nursing is going to be so exciting and differenteveryday … I like that I can go on and get my Masters and Ican specialize in something like intensive care or neonatal.And then there is the nurse practitioner aspect … I just likeall of that… and you could teach if you wanted to.

The participants often rejected the idea of doing one

thing for the rest of their life, and nursing was portrayed

as a choice that could provide several careers within one.

The participants had formed an image of nursing as a

career with endless job options, including the opportunity

for travel. Nursing was narrated as a career in which you

could see the world while making a living. As Lauren

described:

Being able to work in different areas. Like they said you caneither work in hospitals or you can work in homes. You cando research. There are just so many things that you can do.And then my friend was like, ‘They need nurses down atJacksonville, Florida’. She’s like, ‘We are going there afterwe graduate’ … I’ve never really travelled. I’ve never goneoutside the country … so I think it would be new and excit-ing.

Plotlines centering on the choice of nursing for prag-

matic reasons, financial and job security, were informed

from the coverage of the nursing shortage in the news

over the last few years. All of the participants referenced

the nursing shortage within their stories, using language

and descriptions they had heard reported in the news.

The narrative scripts often emulated what was presented in

the media. As Ava asserted ‘I also love that with the short-

age, I will be able to work anywhere. I can travel if I would

like to or stay here’.

Challenges associated with a career in nursing were often

backgrounded in the narratives. The participants balanced

perceived challenges with the rewards of knowing they would

be helping others in their time of great need. Jane, who had

a first-hand understanding of the frustrations and challenges

of nursing through her grandparents’ illness experiences,

focused her narrative more on the rewards of the profession.

As she shared, ‘It’s a very difficult job and you need to be

well prepared. It’s not always fun but that’s what makes it

rewarding’. The narratives were not void of perceived chal-

lenges inherent in nursing; however, the positive aspects of

the profession were emphasized. The participants engaged

in encouraging self-talk when they reflected on perceived

challenges in nursing. As Verna shared:

I think nursing is a beautiful career choice that will be veryrewarding and motivating … Unfortunately, from what Ihave heard, sometimes nurses are underappreciated andthat can easily lead to frustration. However, I think if youstand with your head held up high and keep pushing all thesame, in the end you will be happy with yourself and that isreward enough.

In the above quote, nursing is described as a beautiful,

rewarding and motivating career followed with an acknowl-

edgement that nurses are underappreciated. Several of the

participants acknowledged burnout as a concern among

nurses, yet stated that they believed they could overcome it

by focusing on the positive contribution nurses make. Kate

described her view of nursing as idealistic yet she believed

this was attainable. As she shares:



I’ve heard it said that new people in any occupation are soidealistic and have these optimistic ideas of what it’s goingto be like and I know I’m definitely one of those peoplewho really believe that they’re going to make a difference.I really think that giving 100% is what you should do andwill really make you love what you do. And I hope I can staythat way. I don’t want to become one of the jaded ones andever think it is ok to give less than my best.

A common subplot among the narratives was that partici-

pants believed they could overcome the challenges that

other nurses experienced: most notably burnout and cyni-

cism. As Ava shared, after witnessing less than ideal care by a

nurse, ‘I couldn’t believe a nurse could be so mean … but

that really inspired me to become an awesome nurse’. The

participants told a story that accentuated the positive virtues

of nursing and also served as validation for their choice.

Constructing choice as a calling

Within their stories, the participants narrate the decision to

become a nurse as both a calling and a choice. The former

reflects an attempt to make sense of their career choice as

destiny. Further reflective of a virtue plot within the narra-

tives is that the participants often reference the choice of

nursing as something they were ‘meant to do’, or ‘supposed

to do’. Inherent in this phrasing is an understanding of

career choice as a vocational calling. Although the narratives

clearly portray the participants’ career choice as an informed

decision, the participants often reference this event as some-

thing destined to happen. As Verna shared:

Every step that I took, I think got me to this point… I thinkmaybe my subconscious knew that at some point … I knowit sounds a bit crazy but that at some point, I was going toend up in nursing. And maybe all those choices that I madebefore were to lead me up to this choice. Which I think isthe right one.

Narrative theory attends to understanding how the past,

present and future are interconnected and how individuals

make sense of these interconnections (Ricoeur 1991a). Life

experiences are organized along a temporal dimension and

interpretations of experience are considered temporal in

that the past influences the meaning of present. Each of the

participants demonstrated a need to make sense of past life

choices within the context of choosing nursing. Delayed

career choice, or a non-linear path to nursing, was often

framed positively and depicted as a process of ‘finding their

way’ with acknowledgement that everything happens for a

reason. Tina shared her belief that faith guided her choice:

I think that I believe that everything happens for a reason,and that God has a plan for everybody … it makes me knowthat the gifts and talents that I have, I am not being selfish

with them but I feel like we all need to share those. Andtogether, it makes our society and community a better placewhen we can put everything together and use each other’sstrengths. So I feel that is sort of what I am supposed to do… that comes from my faith.

Only two of the participants specifically referenced religion

when making sense of their choice of nursing, yet several

participants stated that they were guided by their faith. These

participants positioned their choice of nursing in terms of

religious servitude: being called to serve or help others. The

narratives conjured images of nurses as angels caring for oth-

ers, an image prevalent in nursing’s history (Gordon and

Nelson 2005). As Allison shared, she believed she had an

obligation to serve others:

I would never say that I am religious in the sense of like fun-damentally religious because it’s not really me. I just reallylike focus on love and compassion, like all those things thatpeople should focus on… like in the Bible, it says about thatif you are full of love in your life, and I feel that I am a veryloving person, and that you will help like the poor.

At the same time career choice was characterized as a call-

ing, a duty or pre-destined path, the narratives also portray

that the participants actively navigated and negotiated

their own decisions. This contradiction may represent the

participants’ process of making sense of their career

choice within the context of perceiving nursing as a virtu-

ous profession.

DISCUSSION AND IMPLICATIONS

The participants’ storytelling commenced by emplotting

their career choice within a tale of nursing as virtuous. Tim-

ing is an essential component of narrative configuration and

the participants’ storytelling initially took place upon accep-

tance into nursing school, a period of time when they had to

‘sell themselves’ as potential nurses and still sought valida-

tion of their choice. The prevalence of virtue scripts and vir-

tuous imaging within nursing conveys only one aspect of the

profession. Although the participants also identified the

need for critical thinking and expertise within nursing, the

narratives emphasized virtuous attributes such as caring,

kindness and compassion. The desire to care for others is a

salient theme in the career choice literature, and the con-

cept of caring is central to nursing practice (Price 2009b).

The problem with an emphasis solely on virtues is that it can

deemphasize the knowledge, skill and expertise required

within nursing practice: something that may prove dissatisfy-

ing for future generations of nurses (Dombeck 2003; Gor-

don and Nelson 2005). The image of nurses as virtuous

caregivers can be helpful in recruiting individuals to nursing.

However, it may prove problematic if it is the only image that

SL Price et al.


is used, especially for a generational cohort who have many

rewarding career options presented and available to them.

Although this narrative approach was well suited to

guide this research inquiry, the findings are not necessarily

transferable to all individuals entering nursing school or all

members of the Millennial generation. However, this

research does provide an in-depth, contextualized under-

standing of career choice among this sample of Millennial

nurses, and the findings hold implications for nursing

recruitment, socialization and retention. Career choice

research identifies that informal learning about occupa-

tional choices starts in early childhood, yet most formal

career learning and recruitment initiatives only start in the

last year of high school or during university (Hartung et al.

2005). Professional nursing organizations, especially those

involved with recruitment, need to be involved in the crea-

tion of positive images and messages about nurses: images

that emphasize both knowledge and skill, directed toward all

age groups, from kindergarten to high school (Drenkard,

Swartwout and Hill 2002). Innovative strategies for the

recruitment of future tech-savvy generations are needed.

Websites and other social media platforms can provide inter-

active options to receive a variety of information about nurs-

ing such as educational preparation, professional

development, job opportunities and the diversity of nursing

roles (Kasoff 2006; Greenbank 2009). The use of other quali-

tative methods, such as discourse analysis, may be useful in

future research to more fully explore the contextual role of

society and media in career choice.

The literature highlights that generational differences

in regard to childhood experiences may result in distinct

expectations of occupations and workplaces (Zemke et al.

2000; Hu et al. 2004). For example, recent research dem-

onstrates that young people today are parented differently

and as a result may not be as exposed to work environ-

ments and part-time student employment opportunities in

the same way as previous generations (Hartung et al. 2005;

Ungar 2007). Real-life exposure to nurses and nursing

practice is an important strategy in coming to know nurs-

ing and forming a professional identity (Bardick et al.

2005). Opportunities are needed for students to ‘meet’

real nurses either through social media or in-person to fur-

ther explore nursing as a career option and access addi-

tional information (Neilson and McNally 2010). Career

fairs during junior high and high school can provide stu-

dents with a reliable source of career information, provid-

ing both formal and informal learning for students with

an interest in nursing and health-care. Given the current

nursing shortage and workload demands on nurses in clin-

ical practice, organizing work placements and shadowing

opportunities may present a challenge. However, one inno-

vative strategy for providing learning opportunities to stu-

dents interested in nursing may be the use of summer

camps (Buss, Crockett and Redden 2003) designed for stu-

dents interested in exploring a career in nursing or health

professions more broadly. Given the current trend in orga-

nizational environments toward fewer work placements

and practical learning experiences, summer camps and

social media platforms may offer novel strategies to

enhance career choice decision-making for the next gener-

ation of emerging professionals (Meijers 2002).

CONCLUSION

The health needs of people, populations and healthcare

delivery systems require the availability of an effective, pro-

ductive and sustainable health workforce, and nurses are the

largest group of healthcare providers. Given the critical nurs-

ing shortage globally, strategies to enhance the recruitment,

socialization and retention of nurses are essential. The find-

ings from this study highlight the importance of updated

and realistic imaging of nurses. In order to both attract new

recruits and prepare them for the growing complexity of

health-care, future imaging and messaging must reinforce

that nursing is a profession ‘grounded in science, technol-

ogy, and knowledge’ (Gordon and Nelson 2005, 62). In addi-

tion, there is a need for individuals to make an informed

choice based on the current realities and future opportuni-

ties within nursing and health-care. Assisting career choice

and engaging future nurses early in their career decision-

making process can enhance not only recruitment but also

retention within the profession. These findings also provide

an understanding of the Millennial generation’s career

choice experiences and contribute to the growing body of

generational literature. Understanding career development

of the emerging generation of professionals can provide

insight into how to enhance professional satisfaction and ful-

fillment for the Millennial cohort, both within and outside

of nursing.

ACKNOWLEDGEMENTS

This research has been funded by the Canadian Institutes of

Health Research, the Canadian Nurses Foundation and the

NovaScotiaHealthResearchFoundation.

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Documents

Choosing nursing as a career: a narrative analysis of millennial nurses' career choice of virtue