1
|
Ung DSK, Goh YS, Poon RYS, Lin YP, Seah B, Lopez V, Mikkonen K, Yong KK, Liaw SY. Global migration and factors influencing retention of Asian internationally educated nurses: a systematic review. HUMAN RESOURCES FOR HEALTH 2024; 22:17. [PMID: 38429767 PMCID: PMC10905872 DOI: 10.1186/s12960-024-00900-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 02/14/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Given nurses' increasing international mobility, Asian internationally educated nurses (IENs) represent a critical human resource highly sought after within the global healthcare workforce. Developed countries have grown excessively reliant on them, leading to heightened competition among these countries. Hence, this review aims to uncover factors underlying the retention of Asian IENs in host countries to facilitate the development of more effective staff retention strategies. METHODS A mixed-methods systematic review was conducted using the Joanna Briggs Institute methodology for mixed-method systematic review. A search was undertaken across the following electronic databases for studies published in English during 2013-2022: CINAHL, Embase, PubMed, Scopus, Web of Science and PsycINFO. Two of the researchers critically appraised included articles independently using the Joanna Briggs Critical Appraisal Tools and Mixed Methods Appraisal Tool (version 2018). A data-based convergent integrated approach was adopted for data synthesis. RESULTS Of the 27 included articles (19 qualitative and eight quantitative), five each were conducted in Asia (Japan, Taiwan, Singapore and Malaysia), Australia and Europe (Italy, Norway and the United Kingdom); four each in the United States and the Middle East (Saudi Arabia and Kuwait); two in Canada; and one each in New Zealand and South Africa. Five themes emerged from the data synthesis: (1) desire for better career prospects, (2) occupational downward mobility, (3) inequality in career advancement, (4) acculturation and (5) support system. CONCLUSION This systematic review investigated the factors influencing AMN retention and identified several promising retention strategies: granting them permanent residency, ensuring transparency in credentialing assessment, providing equal opportunities for career advancement, instituting induction programmes for newly employed Asian IENs, enabling families to be with them and building workplace social support. Retention strategies that embrace the Asian IENs' perspectives and experiences are envisioned to ensure a sustainable nursing workforce.
Collapse
Affiliation(s)
- Danny Shin Kai Ung
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yong Shian Goh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
| | | | | | - Betsy Seah
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Violeta Lopez
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton, Australia
| | - Kristina Mikkonen
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Keng Kwang Yong
- National Healthcare Group, Ministry of Health, Singapore, Singapore
| | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| |
Collapse
|
2
|
Zulfiqar SH, Ryan N, Berkery E, Odonnell C, Purtil H, O’Malley B. Talent management of international nurses in healthcare settings: A systematic review. PLoS One 2023; 18:e0293828. [PMID: 37930991 PMCID: PMC10627454 DOI: 10.1371/journal.pone.0293828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/20/2023] [Indexed: 11/08/2023] Open
Abstract
AIM To identify and systematically review current scholarship on talent management of international nurses in healthcare organizations. BACKGROUND As nurse shortages persistently pose challenges for healthcare organizations globally, one of the primary strategies employed to address these shortages is employment of international nurses. To date little has been done to systematically review and collate contemporary research on talent management of this strategically important cohort. Talent management is a holistic construct that can support healthcare organizations to attract, develop, motivate, and retain talented employees to drive organizational performance. This systematic review isolates, appraises and collates available evidence on talent management practices for international nurses. STUDY DESIGN Systematic literature review. DATA SOURCES Searches of PubMed, EBSCO and Scopus were made covering literature from 2012-2022. REVIEW METHODS This study followed Cochrane protocol for Systematic Reviews and key search terms were developed in consultation with University of Limerick library. As a key aim of the review was to provide evidence for the development of effective talent management practices, only peer-reviewed academic papers and empirical studies were included. Initial articles screening was conducted by two reviewers and full articles review was conducted by the entire research team. Findings were combined in a data extraction template for further analysis. RESULTS This review includes 62 articles thematically analysed under the headings recruitment and selection, retention and turnover, career progression, professional development, discrimination and racism, culture and communication. CONCLUSION No articles were found that directly address talent management for international nurses. Although there are studies that address aspects of talent management independently, more research is required on talent management as a holistic process for international nurses to inform evidence-based practice. IMPACT This research emphasizes the importance of talent management for retention of international nurses in healthcare settings. It provides a knowledge base for healthcare organisations to enhance employee retention and ensure quality care for patients, as well as setting the foundation for future studies in this area.
Collapse
Affiliation(s)
- Sidra Hareem Zulfiqar
- Department of Work and Employment Studies, Kemmy Business School, University of Limerick, Limerick, Ireland
| | - Nuala Ryan
- Department of Management and Marketing, Kemmy Business School, University of Limerick, Limerick, Ireland
| | - Elaine Berkery
- Department of Management and Marketing, Kemmy Business School, University of Limerick, Limerick, Ireland
| | - Claire Odonnell
- Department of Nursing Studies and Midwifery, School of Medicine, University of Limerick, Limerick, Ireland
| | - Helen Purtil
- Department of Mathematics and Statistics, Science and Engineering, University of Limerick, Limerick, Ireland
| | | |
Collapse
|
3
|
Zhong Y, McKenna L, Copnell B, Zhao W, Moss C. Professional Adaptation Experiences of Chinese Migrant Nurses in Australia: A Qualitative Study. West J Nurs Res 2023; 45:626-633. [PMID: 37021833 PMCID: PMC10278380 DOI: 10.1177/01939459231167711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Chinese-educated nurses are increasingly important to the international labor market. This study aimed to examine how Chinese migrant nurses adapt and evolve professionally while pursuing nursing careers in Australia, using a qualitative descriptive approach. A total of 17 Chinese-educated nurses were recruited by purposive and snowball sampling in Australia during 2017. Data were collected by individual semi-structured interviews and analyzed using thematic analysis. Three central themes and eight subthemes were generated. Perceived differences in nursing involved: work options and flexibility, professional autonomy and independence, and freedom of expressing professional opinions. Elements comprising challenges to adaptation included communication barriers, nursing workload and responsibilities, and collegial relationships. Participants' professional transition journeys were accompanied by two key areas of self-evolution: Embracing the authentic self and embracing individual differences. Our findings have important implications for migrant-host nursing workforce integration in Australia and internationally.
Collapse
Affiliation(s)
- Yaping Zhong
- School of Nursing and Midwifery, Monash University, Victoria, Australia
- Peter MacCallum Cancer Centre, Victoria, Australia
| | - Lisa McKenna
- School of Nursing and Midwifery, La Trobe University, Victoria, Australia
| | - Beverley Copnell
- School of Nursing and Midwifery, La Trobe University, Victoria, Australia
| | - Wenjuan Zhao
- Department of Nursing Administration, Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Cheryle Moss
- School of Nursing and Midwifery, Monash University, Victoria, Australia
- School of Nursing and Midwifery, La Trobe University, Victoria, Australia
| |
Collapse
|
4
|
Toyin-Thomas P, Ikhurionan P, Omoyibo EE, Iwegim C, Ukueku AO, Okpere J, Nnawuihe UC, Atat J, Otakhoigbogie U, Orikpete EV, Erhiawarie F, Gbejewoh EO, Odogu U, Akhirevbulu ICG, Kwarshak YK, Wariri O. Drivers of health workers' migration, intention to migrate and non-migration from low/middle-income countries, 1970-2022: a systematic review. BMJ Glob Health 2023; 8:bmjgh-2023-012338. [PMID: 37156560 PMCID: PMC10174016 DOI: 10.1136/bmjgh-2023-012338] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 04/25/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND The migration of healthcare workers (HWs) from low/middle-income countries (LMICs) is a pressing global health issue with implications for population-level health outcomes. We aimed to synthesise the drivers of HWs' out-migration, intention to migrate and non-migration from LMICs. METHODS We searched Ovid MEDLINE, EMBASE, CINAHL, Global Health and Web of Science, as well as the reference lists of retrieved articles. We included studies (quantitative, qualitative or mixed-methods) on HWs' migration or intention to migrate, published in either English or French between 1 January 1970 and 31 August 2022. The retrieved titles were deduplicated in EndNote before being exported to Rayyan for independent screening by three reviewers. RESULTS We screened 21 593 unique records and included 107 studies. Of the included studies, 82 were single-country studies focusing on 26 countries, while the remaining 25 included data from multiple LMICs. Most of the articles focused on either doctors 64.5% (69 of 107) and/or nurses 54.2% (58 of 107). The UK (44.9% (48 of 107)) and the USA (42% (45 of 107)) were the top destination countries. The LMICs with the highest number of studies were South Africa (15.9% (17 of 107)), India (12.1% (13 of 107)) and the Philippines (6.5% (7 of 107)). The major drivers of migration were macro-level and meso-level factors. Remuneration (83.2%) and security problems (58.9%) were the key macro-level factors driving HWs' migration/intention to migrate. In comparison, career prospects (81.3%), good working environment (63.6%) and job satisfaction (57.9%) were the major meso-level drivers. These key drivers have remained relatively constant over the last five decades and did not differ among HWs who have migrated and those with intention to migrate or across geographical regions. CONCLUSION Growing evidence suggests that the key drivers of HWs' migration or intention to migrate are similar across geographical regions in LMICs. Opportunities exist to build collaborations to develop and implement strategies to halt this pressing global health problem.
Collapse
Affiliation(s)
- Patience Toyin-Thomas
- Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
- The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire, USA
| | - Paul Ikhurionan
- Department of Child Health, University of Benin Teaching Hospital, Benin City, Nigeria
| | - Efe E Omoyibo
- Department of Paediatrics, Federal Medical Centre, Asaba, Nigeria
| | - Chinelo Iwegim
- Fraser Health Authority, Surrey, British Columbia, Canada
| | - Avwebo O Ukueku
- Department of Obstetrics and Gynaecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
| | - Jermaine Okpere
- Department of Clinical Research, Alpha Research Clinic, Edmonton, Alberta, Canada
| | - Ukachi C Nnawuihe
- Department of Clinical Services, Intercountry Centre for Oral Health for Africa, Jos, Nigeria
| | - Josephine Atat
- Department of Restorative Dentistry, University of Benin Teaching Hospital, Benin City, Nigeria
| | - Uwaila Otakhoigbogie
- Department of Oral Pathology and Oral Medicine, University of Nigeria, Enugu, Nigeria
| | | | - Franca Erhiawarie
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | | | - Uyoyo Odogu
- Department of Preventive Dentistry, Lagos University Teaching Hospital, Lagos, Nigeria
| | | | | | - Oghenebrume Wariri
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, Gambia
- Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
5
|
Joseph B, Olasoji M, Moss C, Cross W. Transition Experiences of Indian Nurses Into Australian Mental Health System. J Transcult Nurs 2022; 33:41-48. [PMID: 34160305 DOI: 10.1177/10436596211026373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION In the past decade, there has been an influx of migrant nurses from India to Australia. Migrant professionals have specific transition needs associated with working in Mental Health (MH). This study aimed to explore the transition experience of overseas trained nurses from India working in Australian MH settings. METHOD Hermeneutic phenomenology was the methodological approach used in the study. The participants (N = 16) were overseas trained nurses from India. Data were collected through in-depth interview and analysed using thematic analysis. RESULTS The findings resulted in the identification of the following themes: (1) Living in dual culture, (2) Loneliness, (3) Discrimination, and (4) Feeling incomplete. DISCUSSION It is evident that the transition to work in MH in Australia was a journey of mixed experiences. While certain findings of this study are comparable with experiences of migrant nurses in other settings, it provides insight into those that are working in MH.
Collapse
Affiliation(s)
- Bindu Joseph
- Federation University Australia, Mt. Helen, Victoria, Australia
| | | | - Cheryl Moss
- Monash University, Clayton, Victoria, Australia
| | - Wendy Cross
- Federation University Australia, Mt. Helen, Victoria, Australia
| |
Collapse
|
6
|
Stokes F, Iskander R. Human Rights and Bioethical Considerations of Global Nurse Migration. JOURNAL OF BIOETHICAL INQUIRY 2021; 18:429-439. [PMID: 34224100 PMCID: PMC8256228 DOI: 10.1007/s11673-021-10110-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 12/16/2020] [Indexed: 05/22/2023]
Abstract
There is a global shortage of nurses that affects healthcare delivery, which will be exacerbated with the increasing demand for healthcare professionals by the aging population. The growing shortage requires an ethical exploration on the issue of nurse migration. In this article, we discuss how migration respects the autonomy of nurses, increases cultural diversity, and leads to improved patient satisfaction and health outcomes. We also discuss the potential for negative impacts on public health infrastructures, lack of respect for cultural diversity, and ethical concerns related to autonomy and justice, including coercion and discrimination. This analysis is written from a rights-based ethics approach by referring to rights held by nurses and patient populations. Nurse migration highlights conflicts between nurses and between nurses and healthcare systems. Increased awareness of ethical challenges surrounding nurse migration must be addressed to enhance the well-being of nurses and patient populations.
Collapse
Affiliation(s)
- Felicia Stokes
- American Nurses Association, 8515 Georgia Avenue, Silver Spring, MD 20910 USA
| | - Renata Iskander
- McGill University, 845 Sherbrooke Street West, Montreal, QC H3A 0G4 Canada
| |
Collapse
|
7
|
Covell CL, Adhikari A, Salami B. Surviving the employment gap: a cross-sectional survey of internationally educated nurses. Int Nurs Rev 2021; 69:167-174. [PMID: 33687068 DOI: 10.1111/inr.12668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/17/2020] [Accepted: 02/04/2021] [Indexed: 11/29/2022]
Abstract
AIM To examine the extent to which the type of financial assistance (personal resources, social programmes and earnings) and source country influence the length of time for internationally educated nurses to secure employment as regulated nurses in Canada. BACKGROUND Internationally educated nurses must professionally recertify in order to work as regulated nurses in Canada. For many, it can be a lengthy, cumbersome and costly process that delays employment, while others recertify and secure employment quickly. Financial assistance in the form of personal resources, or from social programmes or earnings from working could contribute to the length of time to recertify. When internationally educated nurses cannot readily recertify, they turn to survival jobs where they can remain and never practice their profession in Canada or leave the country to work in jurisdictions where it easier to obtain professional credentials. METHODS Data were collected via cross-sectional survey of internationally educated nurses (n = 1186) who were immigrants, permanent residents and employed as regulated nurses. Multiple linear regression was employed to examine the influence of the type of financial assistance (personal resources, social programmes and earnings) and source country on time to regulated nurse employment. RESULTS Regression model explained 9.3% of variance in time to regulated nurse employment. Three predictors were statistically significant: source country, social programmes and earnings. Personal resources was not a significant predictor. CONCLUSION Financial assistance helps internationally educated nurses survive the regulated nurse employment gap. The type of financial assistance and source country influences the length of time to regulated nurse employment. IMPLICATION FOR NURSING AND SOCIAL POLICY Provides initial evidence to support the development of policies, and educational and social programmes to assist internationally educated nurses with financially surviving the gap in regulated nurse employment.
Collapse
Affiliation(s)
| | - Anu Adhikari
- South East Home Care, Alberta Health Services, Edmonton, Alberta, Canada
| | - Bukola Salami
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
8
|
Caruso R, Rocco G, Shaffer FA, Stievano A. Current Data of Foreign-Educated Nurses in Italy and the Recognition of Their Professional Qualifications. Nurs Adm Q 2019; 43:26-31. [PMID: 30516704 DOI: 10.1097/naq.0000000000000325] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Up-to-date data on foreign-educated nurses (FENs) in Italy and the recognition of their professional qualifications are pivotal to boost international discussion, and to improve the engagement and involvement of multistakeholders in the nursing profession. Currently, FENs in Italy represent roughly 6% of the total number of registered nurses. FENs are predominantly females between 35 and 54 years old. This article discusses FENs' paths to achieve their professional qualification to practice in Italy. It also offers insights for regulators and stakeholders, such as the need to enlarge the scope of practice for nurses.
Collapse
Affiliation(s)
- Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy (Dr Caruso); Centre of Excellence for Nursing Scholarship, OPI Rome, Italy (Drs Rocco and Stievano); CGFNS International, Inc, Philadelphia, Pennsylvania (Dr Shaffer); and Nursing and Health Policy, International Council of Nurses, Geneva, Switzerland (Dr Stievano)
| | | | | | | |
Collapse
|