A unique breed of nurses for the US market is emerging-the Physician-Nurses. They are foreign-educated physicians who have retrained as nurses. The purpose of this study was to generate a theory that can explain the development of their nursing identity. Specific aims were to discover barriers that participants perceived as problematic in their transition to nursing and catalysts that influenced how they addressed the central problematic issue they articulated. Grounded theory methodology guided by the philosophical foundations of symbolic interactionism was used. Twelve Physician-Nurses were interviewed. Transcribed interviews were imported to ATLAS.ti. Text data were analyzed by constant comparative method. Concept formation, development, modification and integration were accomplished through different levels of coding. Methods were employed to ensure trustworthiness of findings. Core categories were discovered and a central social psychological problem experiencing the burdens of a new beginning and a basic social psychological process combining the best of two worlds emerged. Further theorizing generated the substantive theory combining the best of two worlds and the beginnings of a formal theory. The substantive theory explained the three-dimensional central problem and the five-stage basic social psychological process. Dimensions of the central problem were (a) crossing cultures, (b) starting from zero, and (c) crossing professions. Stages of the basic process were (a) letting go of professional identity as physician, (b) experiencing growing pains, (c) seeing nursing as a saving grace, (d) gaining authority to practice as a nurse, and (e) engaging self to nursing and asserting "I am a nurse." The substantive theory is a springboard toward the development of a formal theory which may be able to further explicate the development of nursing identity in Physician-Nurses. This theory named, Theory of Transprofessionalism, was initially conceptualized as having five phases namely: (a) disengagement, (b) discouragement, (c) enlightenment, (d) encouragement, and (d) engagement. These stages correspond to the five stages of the substantive theory. The key concept nursing identity was operationalized by utilizing three statements published by the American Nurses Association that describe the professional registered nurse, the knowledge base for nursing practice, and the code of ethics for nurses.

Several factors inform health professionals decisions to migrate from developing to developed countries to practice their profession. This study explores the Push and Pull factors that informed African-trained physicians decisions to migrate to the province of Saskatchewan, how well they integrated into their new working environments upon arrival and how that might contribute to future migration and retention in Saskatchewan. Based on questionnaire surveys and face-to-face interviews, this study identified differences in the relative importance of precipitating factors for physicans from South, North and Other African nations. Although the majority of African-trained physicians for the study indicated that profession-related push factors were the precipitating factors for their migration, a smaller number did not cite these as important. Most respondents for the study integrated well into the health care system and have remained at their current location of practice because of the support they received from colleagues at their work places.

Several factors inform health professionals decisions to migrate from developing to developed countries to practice their profession. This study explores the Push and Pull factors that informed African-trained physicians decisions to migrate to the province of Saskatchewan, how well they integrated into their new working environments upon arrival and how that might contribute to future migration and retention in Saskatchewan. Based on questionnaire surveys and face-to-face interviews, this study identified differences in the relative importance of precipitating factors for physicans from South, North and Other African nations. Although the majority of African-trained physicians for the study indicated that profession-related push factors were the precipitating factors for their migration, a smaller number did not cite these as important. Most respondents for the study integrated well into the health care system and have remained at their current location of practice because of the support they received from colleagues at their work places.