Military healthcare professionals’ experience of transitioning into civilian employment: A heuristic inquiry

3.1.1 Reaching a tipping point about deciding to leave the forces

My goal was not to leave the forces but, eventually, the opportunities for further professional development reduced and the option of leaving became more apparent. This is not to say that I was angry or upset; I accepted the situation for what it was and tried to be pragmatic. However, I also felt that I needed to protect my skill set as a nurse specialist as I realised it had value beyond my military career. This was probably when I realised that what was important to me and what was important to the military were beginning to part company. My commitment to the service began to weaken, and my identity as an independent person with a skill set of value to a wider labour market became more obvious to me. The reality is that most military personnel are obliged to seek a midlife career change, and my career would have come to an end anyway.

3.1.2 Uncertainty when leaving the forces and starting a civilian job

A lengthy notice period (8-months) made job seeking difficult and, I feel, weakened my position when negotiating the terms of a new job. This is because I had to focus on agreeing to the notice period and ask for flexibility by any potential new employer. This placed me in a weaker position when negotiating other conditions, such as pay. Indeed, one potential employer explained that the notice period was the reason they disregarded me at the point of application. However, it afforded financial advantages too, as it meant I moved beyond my pension point and was entitled to an immediate pension. I did not blame the military for this process but observed how challenging it felt at the time. Then, when it happened, the reality of my career-ending struck me.

Eventually, I was in a position to start my new job. I had moved my family, relocated geographically, and given up my navy pay. There was no way back now, and I felt the uncertainty of a new role, I was anxious but remained keen to make it work. I did not know what to expect from the first day but I hoped that I had made the right choice for my family and myself and now needed to see it through.

3.1.3 Managing insecurity within the civilian workplace

Over time I realised that I may compare unfavourably when competing with both more established employees and new employees from more traditional healthcare settings. I had committed my family to a significant geographical move, which resulted in a loss of connections and relationships. This made the threat feel worse to me, as I felt exposed and I found the uncertainty difficult to bear. I felt more vulnerable than during most of my career in the armed forces. In the forces, vulnerability is not about deploying to combat zones, as you prepare for that. Nor was it about the dynamics of the workplace, as you learn to operate within the system and how to exert agency. When I injured myself early in my career, failed a very physical course, and thought my military career was at risk if I did not recover from my injury, that was when I had previously felt this vulnerable. Only, on that occasion, I had no family and no children. Whereas this time, in a different part of the UK, in a rented house, with a family dependent upon my income, I think it weighed more heavily.

3.1.4 Building new working relationships

Building new friendships in new places has always felt difficult for me. I lived in a lot of different locations as a child, both in the UK and abroad. This meant countless schools where I felt odd, awkward, different, and was bullied at times. This has led to me feeling self-conscious and anxious when forming relationships. However, I recognised the value in work relationships, was conscious of the need to develop them, and was concerned about ‘getting it wrong’. Every military training course or deployment and most challenging work situations that I have experienced have always relied upon teamwork. Despite my anxiety, I am a good team player. However, I am always faced with an internal conflict between my anxiety and desire to escape or avoid social or group situations versus my experience of the value of working with others. Over the years, I have learnt to make a better first impression and to try to maintain work relationships. In my personal life, I am more typical of somebody with social anxiety, have a very narrow circle of friends, and depend upon my wife for friendship as well as love.

I decided that collaborating on work projects was a way to achieve new and positive working relationships. I sought out opportunities to work with others and aimed not to isolate myself. Seeking to isolate myself would have been an easy option and my default setting in new social situations. Despite my anxiety, I am also a good and proven team player, collaborating on work projects was a way to manage my social anxiety and to allow me to play to my strengths. However, when combined with job uncertainty, it would have been easy to take on too high a workload and to volunteer for too many projects.

3.1.5 Seeking stability in the face of non-work life stressors

As a new veteran, I opted for cheaper rented accommodation than whilst in the military. This was because I was uncertain about my net monthly wage once pensions and tax had been removed. I knew that I would be earning less money than my military wage and wanted a financial safety net. This resulted in an immediate and obvious environmental impact upon my family.

The impact of additional life stressors affected me at a time when I did not know how to access civilian healthcare services for either physical or psychological health problems. Within the military, I was very confident about how to access healthcare to meet my needs. While I had not reached the point of needing psychological support, I consider that my mental health could easily have worsened. Accessing help did not feel straightforward when I first became a veteran.

I experienced several life stressors that included financial insecurity, geographical moves, and health problems. These seemed greater than at most times during my military career. I am uncertain if this is because of leaving or a coincidence because my family and I are now older and are likely to have more needs. On reflection, I think it may have been a combination of both, which exacerbated the distress experienced during this period of adjustment. This felt like walking a tightrope, one missed step and I could easily have spiralled into increased distress and then not functioned effectively at work at the exact time when I needed to be demonstrating my value as an employee.

3.1.6 Experiencing a change in identity

My military role involved liaison with different parts of the armed forces and civilian healthcare services. Each of these groups would hold a different world view and, to liaise effectively, I would have to adapt my approach to account for this. Adopting an entrenched or rigid approach to my military work had never been useful, and I took this learning into leaving the forces. The main difference with leaving the military for a new career was that previously I sought to accommodate the social norms of other groups from the position of knowing who I was. On this occasion, I had relinquished my strong foundation as a credible expert in military mental health nursing.

My interpretation was that the man on the train was reminding himself (and others) of the position of strength from which he derived. Without it, he was another man in his 50 s sat on a train, but with it, he and others knew where he came from. I remember when I got promoted in the forces to a rank that represented credibility within my role. It involved the right to wear a slightly different uniform – peaked cap, long sleeve shirt, tie and different rank slides. To me, this uniform represented credibility because rank was associated with skill and experience in my military role. It helped others to understand my skill and experience, and without it, I felt more vulnerable.

The reality was very different, and my military experiences, or point of reference, seemed to contribute very little compared to my peers’ NHS experiences. My expected strong platform upon which to launch a civilian career seemed weaker than I first thought, and I compared myself unfavourably to my civilian peers. I had to shift my perspective and adjust my new identity to reflect this change of status. This was driven by a motivation to overcome the challenges that I faced and to make my new situation work. I had left the forces a credible expert and joined my new organisation as a novice on probation. Seeing things from this new perspective of novice helped me to develop a flexible strategy that focused upon learning new skills while building upon existing ones. When adopting this strategy, I began to feel more confident and could begin to understand why they had employed me, which was not for what I was but instead for what I might become within their organisation.

3.2.1 Reaching a tipping point about deciding to leave the forces

The main subthemes relating to reaching a tipping point for deciding to leave the forces were about opportunities and values. Weighing up military and civilian opportunities was a prominent subtheme that led to a tipping point for choosing to leave.

The concept of it being ‘my time to go’ resonated with most types of service leavers and represented a moving apart of previously shared values between the organisation and the employee. This shift seemed most pronounced for those who left whilst experiencing a glass ceiling, and they typically reported a period of conflict and significant unhappiness in the workplace.

Participants were also able to make comparisons with other people who had already left and to make a prediction about what to expect. For example, Participant G went on to explain that they found it helpful to know that people who had left did not regret doing so, and that their portfolio of skills and experience were comparable to veteran peers. Knowing that their skills were marketable, combined with discontent, seemed to lead to a tipping point for leaving. This period of conflict and unhappiness was shared with those who left more suddenly than planned due to health issues. This group perceived that their contract with the military had been broken and reported feeling undervalued, let down, and a subsequent period of loss. By comparison, those leaving at the end of their career reported a more gradual process of change that included a need to accept a shift in opportunities within the forces, age-related physical limitations, and a growing tiredness or apathy with military life.

3.2.2 Uncertainty when leaving the forces and starting a civilian job

The subthemes about uncertainty when leaving the forces were an emotional reaction to leaving, preparation for leaving, and transferable skills. The emotional reaction tended to be anxiety, which was commonly experienced at the point of leaving. It would seem that a degree of anxiety was both a typical and a normal part of experiencing the uncertainty about leaving a stable job for the unknown of civilian employment.

For other people, this anxiety persisted, and this did not seem to be dependent upon the reason for leaving the forces or at what stage in a person’s career they chose to leave. Instead, it was driven by an extended period of uncertainty about future civilian employment once they had left and were no longer receiving military pay. The reasons for uncertainty when starting a civilian job were varied but included the process of emigrating, redundancy, job offers falling through, human resources errors, and zero-hours contracts.

Preparedness for leaving was something that many of the participants reported was helped by the sorts of experiences and training opportunities that they had exposure to whilst in the forces. In common with all military personnel, there were opportunities available to participants for additional resettlement training. The perceived usefulness of the resettlement training was variable. However, all participants felt that time needed to be better protected for resettlement and the process of transition. For those who considered that they possessed transferable skills or experience, this reduced uncertainty, led to a speedier process of securing appropriate employment, and less reliance upon the resettlement training opportunities.

Others had started their career within a role that would lead to less transferable skills and may have hoped to resolve that while serving. Where they were unsuccessful in gaining transferable skills, due to military commitments, this led to greater dependence upon the resettlement process. This meant that securing civilian employment became about making use of networking skills, while also trying to invest wisely in resettlement and post-military training. The hope was that the resettlement training would lead to greater civilian job stability, however training courses could be costly and did not always lead to employment.

3.2.3 Managing insecurity within the civilian workplace

Some participants reported perceived insecurity in their civilian workplaces. Subthemes were the emotional reaction it caused, credibility, and skills. The types of insecurity or unexpected events reported were the threat of a job falling through, problems with administrative processes, no permanent work, and redundancy. Whatever the unexpected event, a dominant feature was the impact upon how the participant felt in the situation, more specifically, their emotional reaction to negative workplace events. On occasion, this was exacerbated by other life experiences or their previous military role. For some people, this period of insecurity seemed to pass within a few months, whereas other people had to tolerate job insecurity for an extended period. Insecurity about civilian work included extended periods away from home, unsatisfying work roles, long hours, and non-permanent contracts that impacted upon mental wellbeing.

Participants described how they planned for stressful events and problem solved how to manage them and to improve their situation. This included planning for predicted periods of insecurity, contingency planning for different eventualities, and identifying a goal to work towards when faced with adversity. Two factors that impacted upon those plans were perceived credibility in their role and possessing transferable skills.

3.2.4 Building new working relationships

Building new working relationships was fundamental to participants’ experience of civilian employment, with soft skills and valuing military or shared experiences reported as the main subthemes. Some reported that they sought out employment that had similarities to military life with an expectation of a shared understanding. While there may have been some similarities, ultimately the civilian employment was in a different organisational structure that seemed less cohesive at times.

One participant suggested that useful characteristics from the military were self-discipline, motivation, and getting things done without prompting (Participant A). Whilst another suggested that qualifications will only get a person so far, as other skills are important to climb the corporate ladder (Participant B). Sometimes the application of soft skills was reported as challenging. Nevertheless, more generally, the application of soft skills was perceived as a strength derived from military life.

Soft skills were perceived as an important tool within the workplace. Interpersonal skills were valued at times of uncertainty to build working relationships, to gain permanent employment, or to create promotional opportunities. Most viewed this as very much a long game and, given that all participants had served a minimum of 12 years in the military, this may have been consistent with their previous work experience.

3.2.5 Seeking stability in the face of non-work life stressors

One other participant shared my experience of a non-work-related negative life event when leaving the forces and transitioning into civilian employment. This life event was a relationship breakdown and they observed that a geographical move and lack of immediate social network meant it was harder to meet new people. Another participant recognised that their civilian employment was impacting upon their ability to enjoy family life, which was because they had made choices that involved working away from home. They recognised this was like being separated from family due to a deployment and realised it was now optional rather than a mandatory part of life. By comparison, most participants reported that civilian employment had resulted in a more stable social and family setting.

3.2.6 Experiencing a change in identity

Participants reported that their military values shaped their civilian identity and that they identified with the term veteran. In general, military experience was not always as highly prized by their civilian employers as they had expected it to be. More rarely, previous military experience or status added value to new employment or shaped how the employer might perceive the veteran within the workplace. On occasion, this led to the employer holding unrealistic expectations about how the veteran would perform their role.

Some veterans orientated themselves towards specific civilian roles such as nursing, the ambulance service, or working in an offshore medic on oil rigs. However, although these roles attracted veterans, their previous military experience did not always translate or lead to job offers. In fact, a common message was that employers were not too interested in operational tours, medals, and specific military experiences. Despite this lack of interest in previous military experience, most participants were in employment. A minority of veterans reported job roles that seemed to lead to a concentration of employees who were also veterans, suggesting that military camaraderie and values remained important.

Despite the perceived lack of value by civilian employers in participants’ previous military experience, most felt like their previous military role would always shape their identity.

Although participants sought out roles where they hoped that there would be some similarities to their previous military values and that this would continue to form part of their identity. Sometimes the reality was not exactly as expected, values incongruent, or the civilian workplace was too focused upon financial pressures as opposed to the people within the organisation and the quality of the service that they were delivering. On other occasions, the transition into a civilian identity included benefitting from what were perceived as transferable values.

3.3.1 The tipping point

While it is true that I was frightened of leaving the forces, it is equally true that I was scared to stay. There was increasing tension between my values and employment needs compared to the expectations of the military. This felt like a gradual shift in my identity from a sailor who was also a nurse to becoming a nurse who happened to be working in the navy. This tension slowly led to a tipping point where the opportunities as a civilian began to outweigh those in the forces. Most of the people that I talked to shared this experience. On reflection, many of us worked towards this eventuality by developing civilian work skills, professional training, and outside interests that bore fruit in the latter stages of our careers. This served as a cushion during the transition process, and when it did not happen for whatever reason, for example, ill health or lack of opportunity, then the shock of leaving seemed more severe and the adjustment took longer.

I have learnt that, during a military career, it is important to target professional development that includes transferable skills and civilian qualifications. One advantage to serving as a healthcare professional was the scope to exploit opportunities for civilian training, as some of the civilian professional roles were not dependent upon previous military experience, and it felt like it was the skill that was transferable and of value in the civilian labour market more than the person. However, there is a risk that a growing realisation of the value of civilian skills or qualifications might increase the tension or conflict near the time of leaving. For example, I and others began to feel that the value of our skill set had transcended whatever rank or role was being performed in the forces and the military structure. For some, this was evident in the monetary value placed upon our skills and the demand for our services in part-time civilian employment that was more favourable than our military grade. This led to a tipping point, where leaving seemed to be an opportunity to flourish, but staying felt increasingly like a dead end.

3.3.2 Adjustment

With the decision made to leave, there came a period of adjustment. This was a triple whammy of uncertainty about the process of leaving and the starting of new employment, insecurity in the workplace, and a loss of identity. Most people reported a period of adjustment that included increased anxiety or low mood. Some people had been able to develop and perform their future civilian role while still serving and before giving their notice, which may have cushioned them a little from some of the stress of leaving. However, for others, leaving meant a period of deciding how best to make use of resettlement funding for further training and job hunting. There were mixed views about this resettlement process with some finding the workshops, courses, and job fairs useful and others making little use of them. I fell into the latter category and could not work out how to make use of the available funding and courses.

Having spent time during their military careers drafted to different geographical locations with or without their families, most people left the forces for greater stability and security for the future. All participants had invested many years in the forces and had flourished. Leaving was a time of uncertainty that involved navigating bureaucratic processes, a long notice period, and securing civilian employment. This was particularly challenging when it coincided with civilian job insecurity that came in many forms from not fitting in with the team norms, the agreed job no longer being available, problems with emigration, zero-hours contracts, and the threat of redundancy. This was managed by problem-solving strategies to improve the situation that included improving CVs through targeted training and job experience, securing different employment, and trying hard to fit in and to progress within the organisation despite the job insecurity.

3.3.3 Progression

You never sit still in the forces as you are always at risk of being drafted, practising skills, training or working towards promotion; but you never sit still. Everybody learns how to navigate the opportunities this presents and feels the frustration when it does not work out the way we hoped it would, for example, being turned down for a promotion, a wrong draft or rejected for a desirable training opportunity. Everybody learns how to navigate that system, to play to their strengths and to progress. The key is to make yourself invaluable, to become credible, to be dependable, and to fit in.

The importance of this was best represented by one of the early leavers and one person whose career ended suddenly. The former was ambitious and keen to gain a senior role. However, soon after leaving, he was made redundant and learnt the importance of building credibility and networking in the civilian workplace to defend himself against future job losses and to create opportunities. The latter was on a zero-hours contract and trying to gain full-time employment in his chosen field. Again, to develop a full-time role meant being liked and well regarded. Soft skills were paramount in both cases to develop positive work relationships. To achieve this, they both sacrificed work-life balance and played the long game for their careers through self-sacrifice and relationship building in the short to mid-term. When faced with adversity and uncertainty at work, I defaulted to the same strategy which was to sacrifice work-life balance for the team, help as much as possible, and try to build a reputation as somebody who could be depended upon to deliver the task at hand. This resonates with my training experiences in the military; whether it was basic training, leadership training or deployment training, the principal was always the same. The principle was to act in the best interests of the team because a resilient team benefits all the team players.

Everybody felt that they had developed a set of military values that had helped shape their identity and were useful. More specifically, values such as punctuality, smart dress, and working hard were deemed important and associated with being ex-military. Clearly, these attributes are not exclusive to veterans, yet many reported being able to identify other military personnel and being drawn to them, on occasion, either in work or socially. I now see the strengths of my civilian colleagues and my military peers, whilst noticing that these are not mutually exclusive. I have let myself become more distant from my military past and others in this study have chosen to do the same but to greater or lesser degrees. As I focus upon my current work role, performed by me as a civilian healthcare professional who once worked in the military, I realise that being a veteran remains part of all of us and contributes to who we are in a civilian workplace. However, it does not need to exclusively define my civilian work identity, as we all get to shape our future selves, the jobs we do, the way we act, and what we say. This feels forward focused, as opposed to dwelling on the past, and it feels like progression.