The professional identity of dual-qualified nurse-paramedics: A descriptive phenomenological study

Despite the presence of dual-qualified nurse-paramedics within the Australian health system, little is known about their professional identity. Given the predominantly profession-specific nature of health governance in Australia, it is important to understand how dual-qualified nurse-paramedics experience and construct their professional identity. A strong professional identity has been associated with improved outcomes for health workers, patients and health systems. Failure to recognise and meet the needs of this group may place their well-being at risk and compromise patient and system outcomes. The aim of this research was to explore the professional identity of dual-qualified nurse-paramedics. A Husserlian descriptive phenomenological approach was adopted, with data analysed using Colaizzi's method. Thirteen dual-qualified nurse-paramedics employed by jurisdictional ambulance services and/or emergency departments across Australia participated in online interviews. Participants reported feeling confused about their professional identity. Describing a constant ‘tug of war’ between being a nurse and a paramedic, they attributed this tension to governance structures that enforce strict professional boundaries. Interprofessional rivalry and a perceived lack of understanding of each other's professional roles further contributed to their identity confusion. Participants frequently described pressure to conform to the fixed expectations of one profession or the other, despite valuing both. Professional identity formation for individuals navigating both nursing and paramedicine is challenging. The siloed nature of existing governance structures, while not deliberately exclusionary, contributes to feelings of exclusion and a fragmented sense of identity. These dynamics filter down into organisations and workplace culture, creating a sustained lack of acknowledgement that leaves dual-qualified nurse-paramedics feeling invisible, disheartened and exhausted. In the context of contemporary health system challenges, this situation warrants careful consideration by health leaders and decision-makers.