| Summary: | In spite of national and international policy encouraging assistant nurses to become Registered Nurses (RNs), the work role transition they experience has attracted little attention from researchers. The present study addressed this gap, adopting a mixed methods, cross-sectional, sequential approach. Qualitative approaches were needed to develop core understandings of work role transitions and quantitative approaches for statistical measures to outline changes over time and influences on transitions. The dominant approach was qualitative, sequencing the qualitative to follow the quantitative data collection. The components were analysed separately up to the point of interface and the core qualitative component provided the mechanism for reporting the results. Three cohorts of student nurses at two universities, from academic years 1, 2 and 3, and with prior Health Care Assistant (HCA) experience, were surveyed then interviewed at the beginning and end of their academic years. It was found that students, clinicians and policy makers assume and expect that prior HCA experience facilitates students’ pathway to RN. Findings indicate that the former role and workplace experience do not automatically facilitate change and transition. A model of transition is presented from assistant worker to professional qualification. Students disconnected from their former work role, re-visioning old values and perceptions and finding that the student/RN role required different ways of thinking and working. They moved from a skills task focus to a whole-task approach. Students experienced role change shock as they found that prior experience did not automatically equip them for their placements and could constrain as much as facilitate their transitions. They entered a betwixt and between stage of uncertainty and discomfort while learning to act out the student role to the satisfaction of audiences of practitioners, educationalists and patients. Students changed and developed, clinically, professionally, academically and personally, becoming a “reconstituted” person before inclusion in the profession. The combination of transitions and dramaturgical, theoretical and analytical approaches explains the pattern and experiences of transition. The journey of transition cannot be reversed because, once educated to be a nurse, the traits deemed desirable by the profession are made to “stick” and exert their influence long after initial education. The support worker becomes professionally qualified – the transition from HCA to student and neophyte RN is completed.
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