“Fit for nursing?” A qualitative analysis of disabled registered general nurses’ and other health professionals’ views on health and illness in relation to nursing employment.

The employment of registered general nurses (RGNs) is underpinned by management’s
need for economic utility in that the cost of salaries must be reconciled with the need to
meet the demands inherent in service provision. Using grounded theory, interviews
captured the experience of physically disabled RGNs, who use the phrase ‘physically
disabled’ to describe themselves. Their collective experience was then compared with nondisabled
RGNs working in the clinical areas of general medical wards, general surgical
wards, and day case units, situated in three district general hospitals. Data collection was by
partial participant observation, and interviews. The data revealed that both nurseinterviewee
groups share an understanding of the meaning of health and illness. Both the
physically disabled and non-disabled RGNs manipulate working time to take unauthorised
breaks in order to ‘accommodate tiredness’ and ‘stamina lack’. ‘Accommodating need’ is
the identified basic social process (BSP) and ‘pacing’ is the identified core category. RGNs
distinguish between using a ‘public’ voice and a ‘private’ voice. In respect of a physically
disabled RGN ‘doing nursing’, the data uncovered stigma relating to a spoiled identity.
Theoretical sampling interviews with senior nurse managers, occupational health doctors,
and trade union officials (termed ‘elite groups’), reflected the data findings of both the
physically disabled, and non-disabled RGNs, in identifying the factors limiting the
employability of physically disabled RGNs. Moreover, data from the elite group interviews
revealed the importance of economic utility, in that management has to take account of
diminishing returns. This is the crux of the employment issue. ‘Maintaining organisational
pace’ is the generated grounded theory, and was confirmed by aligning data to the
established literature on Labour Process Theory (LPT) in a supplementary theoretical
sensitivity validation process.