In recent years, health care organizations have drastically changed. A more diffuse network of organizations provides patient care, and many of these organizations have moved to a managed care model that primarily relies on team-based communication structures. With such changes, the roles of health care professionals have changed as well and it has become increasingly difficult to negotiate one's role and identity in relation to colleagues, patients, families, and other stakeholders. Additionally, with the changing demographics of the United States population, other personal identities (such as race, gender, and class) are affecting the ways that care is provided and identities are negotiated in health care organizations. This dissertation examines these issues, with particular focus on understanding the multiple professional and personal identities that health care professionals inhabit and how they are continually negotiated through communication.

In order to understand the complexities of health care professionals' identities and their configurations, this study builds on the concept of the crystallized self, the idea that identity is multidimensional and continually negotiated through communication. Specifically, this study asks how health care professionals conceive of their multiple identities and their interrelationships. In addition, using feminist standpoint theory as a lens, this study seeks to understand how an individual's social location within a culture shapes their experience, particularly as one's experience is shaped by the intersection of professional and personal identities.

This dissertation utilizes a two-phase, mixed methods approach to understanding the identity negotiation processes of health care professionals. The first phase of the study involved qualitative interviews with 50 health care professionals in the western United States. These interviews provided some initial insights into the crystallized self by identifying various identities that health care professionals manage and ways that they engage in identity negotiation processes. Three primary themes emerged from the interview data. First, identities were regionalized primarily into the work and home areas, while community and educational spaces were secondary regions for identity negotiation. Second, health care professionals experienced a major tension when working out the degree of overlap or separation between the work and home regions. For most, the goal was to have separation between the two regions, but the ability to achieve this desired outcome was highly related to one's access to resources that would facilitate this goal. Third, race, gender, and class were found to be influential personal identities that affected identity negotiation processes in important ways.

Using the qualitative findings as a touchstone, the second phase of the study conducted a quantitative survey with 206 health care professionals throughout the United States. Using latent class analysis, the data highlighted three potential standpoints of health care professionals with regard to identity negotiation: one standpoint focused on managing work and home life, a second prioritized integrity over all other responsibilities, and a third was primarily family-oriented. In addition, the data showed that health care professionals suffered when their personal sense of self did not align with the identity they portrayed at work. As a result of this identity gap, feelings of organizational assimilation and job satisfaction decreased.

In summary, this study examines identity negotiation processes for health care professionals. Findings demonstrate that while these professionals continually negotiate multiple identities, they do so with clear ramifications for their organizational experiences. The conclusion of this dissertation discusses the implications of these findings in relation to identity negotiation, the crystallized self, and work-life balance.