Understanding the processes involved in retaining nurses in the Emergency Department is essential for future hiring and retention; turnover rates are currently at approximately 16% in the emergency department. Using Grounded Theory Methods (Glaser & Strauss, 1967) and the conceptual framework of symbolic interaction, the process of becoming and remaining as an ED nurse was explored.

Data were collected through semi-structured, open ended interviews until data saturation occurred. The seven participants' ages ranged from 29-56 with ED nursing experience ranging from 1-17 years and nursing experience from 2-18 years. Five phases emerged from data analysis using constant comparative analysis of 183 pages of transcripts, through coding phrases, categorizing, and conceptualizing them. These phases, each with sub-categories, explained a process identified as Seeking Status. The five phases were: joining the troops, working in the trenches, passing muster, earning stripes, and looking ahead. Passing Muster emerged as the core category, the one that best explained the process and connected the other conceptual categories in this process.

The theory, Seeking Status, was compared to and contrasted with theories from nursing, sociology and anthropology such as socialization, rites of passage, adaptation, role identity, and reality shock. The theory overlapped with some of the theories explored; however it was unique in the finding regarding the significance of a two-tiered hierarchy of roles in the ED.

Implications for recruitment strategies, longer orientations and the need for preceptors for new nurses were described. Senior nurses, on the other hand, would benefit from increasing knowledge and skills regarding leadership and management strategies in their role.