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Correa-Betancour M, Chiarella M, Short SD. Intraprofessional cultural competence in nursing regulation: A critical content analysis of standards and codes in the United Kingdom, New Zealand and Australia. Nurs Inq 2024:e12652. [PMID: 39016218 DOI: 10.1111/nin.12652] [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: 03/06/2024] [Revised: 06/12/2024] [Accepted: 06/17/2024] [Indexed: 07/18/2024]
Abstract
There is a global shortage of nurses, leading many countries to recruit internationally qualified nurses (IQNs) to fill the gap. However, IQNs encounter challenges in integrating into their new professional environment, particularly in their interactions with locally qualified nurses (LQNs). Intraprofessional cultural competence (IPCC), defined as 'a set of congruent behaviours and attitudes that enable professionals to work respectfully and effectively in cross-cultural situations', may be a strategy to address these challenges. Content analysis was used to examine nursing regulatory documents (Standards for Practice [Standards] and Codes of Conduct [Codes]) from the United Kingdom, New Zealand and Australia. Data were extracted and organised based on four key themes relevant to IPCC. The analysis revealed a focus on 'Mutual collaboration and professional relationships' in six regulatory documents, with explicit commitments to preventing racism and discrimination in the Australian and NZ Codes. However, issues such as racism, discrimination, bullying and harassment faced by IQNs are not comprehensively addressed, as the documents mainly prioritize culturally appropriate patient interactions over relationships between colleagues. Using regulatory documents to address IPCC may influence positive change such as improving communication, and preventing racism, bullying, discrimination and harassment within nursing.
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Affiliation(s)
- Marcela Correa-Betancour
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Nursing Department, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Mary Chiarella
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Stephanie D Short
- Sydney School of Health Sciences, Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Rajpoot A, Merriman C, Rafferty AM, Henshall C. Transitioning experiences of internationally educated nurses in host countries: A narrative systematic review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2024; 6:100195. [PMID: 38832236 PMCID: PMC11145537 DOI: 10.1016/j.ijnsa.2024.100195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/24/2024] [Accepted: 03/26/2024] [Indexed: 06/05/2024] Open
Abstract
Background The shortage of nurses worldwide is a well-known issue that has changed the health and social workforce picture. Increased recruitment and migration of internationally educated nurses in the health and social care workforce pose many risks to successful integration into the healthcare system. Understanding the barriers and enablers affecting their integration in their host countries is imperative. Objective To critically and systematically review the current literature to explore the transitioning experiences of internationally educated nurses to understand the enabling influences affecting their workforce integration into their host countries. Design A narrative systematic literature review was conducted. This study was registered in the International Prospective Register of Systematic Reviews (Registered Number: CRD42023401090). The study results were reported as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Methods A comprehensive literature search using the search engines CINAHL, MEDLINE, PsycINFO, Academic Search, and PubMed was conducted. Only peer-reviewed papers written in the English language were included. Primary research studies published between 2019 and 2023, which explored the lived experiences of internationally educated nurses, were considered for review. Results Seventeen studies (16 qualitative and one quantitative) were included in the review. Three main themes were developed: (1) push and pull factors that mediated internationally educated nurses' migration experiences, (2) one-way integration logic, and (3) expectations versus reality. Conclusions There is a need for a comprehensive and collaborative organisational approach to enhance the integration experiences of internationally educated nurses into their host countries. This can also ensure their contribution is recognised and will help them fulfil the responsibilities of their role and become influential team members within their organisations. This comprehensive and collaborative approach is also required to tackle discrimination, racism, communication and language barriers. Addressing these challenges can improve internationally educated nurses' job satisfaction and, thereby, improve retention. Tweetable abstract A new systematic review study explores barriers and enablers for optimising internationally educated nurses' experiences of working in their host country @cathy_Henshall @clairmerriman9 @annemarieraffer.
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Affiliation(s)
- Aasia Rajpoot
- Oxford Brookes University, Jack Straw's Ln, Marston, Oxford OX3 0FL, UK
| | - Clair Merriman
- Nursing, Midwifery, and AHP Clinical Research Oxford Institute of Applied Health Research (OxInAHR), Oxford Brookes University, UK
| | - Anne-Marie Rafferty
- Nursing, Midwifery, and AHP Clinical Research Oxford Institute of Applied Health Research (OxInAHR), Oxford Brookes University, UK
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, James Clerk Maxwell Building, 57, Waterloo Rd, London SE1 8WA, UK
| | - Catherine Henshall
- Nursing Oxford Institute of Applied Health Research (OxInAHR), Oxford Brookes University, UK
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Merriman C, Freeth D. SIN-BARRSS - Developing a mnemonic to support nurses' participation in interprofessional ward rounds in intensive care: An appreciative inquiry for quality improvement. Intensive Crit Care Nurs 2024; 81:103609. [PMID: 38155052 DOI: 10.1016/j.iccn.2023.103609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 12/06/2023] [Accepted: 12/15/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVES To develop and pilot a mnemonic to increase the willingness and ability of bedside nurses to contribute to patient reviews in the daily interprofessional ward round. RESEARCH METHODOLOGY/DESIGN Appreciative inquiry quality improvement study, using ethnographic observations and appreciative inquiry discussions, augmented by quantitative data collection of basic facts. SETTING Large (44 beds) critical care unit in the United Kingdom. MAIN OUTCOME MEASURES Interprofessional development and acceptance of mnemonic; successful preparation for pilot; use and usability of mnemonic; improvements in bedside nurses' contributions to ward round discussions (frequency and focus). RESULT/FINDINGS Interprofessional development of a usable and useful mnemonic was successful, pilot implementation showed promising levels of take up and acceptance. Compared to before the quality improvement project bedside nurses were more willing and able to participate in ward round discussions, did so more often, and used the mnemonic script with insight and flexibility. CONCLUSIONS The implementation of a mnemonic supported bedside nurses' contributions to the ward round. This could provide a framework for introducing similar programmes to other intensive care units. Appreciative inquiry methodology could be replicated in other settings to aid the improvement of interprofessional ward rounds, or to address other quality improvement priorities. IMPLICATIONS FOR CLINICAL PRACTICE A mnemonic can provide a structure which supports bedside nurses' contributions in ways that make good use of bedside nurses' professional expertise and most up to date knowledge of patients' clinical state. Furthermore, a well-designed mnemonic can be used flexibly and provides an outline script that supports less experienced and less confident nurses to make well-focused and well received contributions to rapid interprofessional discussions. In turn, this can increase these nurses' confidence and capability. More experienced and confident nurses, and ward round leaders, can use the same mnemonic flexibly as an aide memoir that guards against missing information and insights that could affect the quality and safety of patient care.
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Affiliation(s)
- Clair Merriman
- London and Queen Mary University of London, Oxford Brookes University, United Kingdom.
| | - Della Freeth
- London and Queen Mary University of London, The Science Council, United Kingdom
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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.
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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
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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.
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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
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Al-Sheikh Hassan M. Commentary on Joseph et al.'s (2022) "Transition Experiences of Indian Nurses Into Australian Mental Health System". J Transcult Nurs 2023; 34:6-7. [PMID: 36214070 PMCID: PMC9749558 DOI: 10.1177/10436596221128778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- Mohammed Al-Sheikh Hassan
- Faculty of Health and Life Sciences, De Montfort University, Leicester, UK,University Hospitals of Leicester NHS Trust, UK,Mohammed Al-Sheikh Hassan, Faculty of Health and Life Sciences, De Montfort University, Gateway House, Leicester LE1 9BH, UK.
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Joseph B, Jacob S, Lam L, Rahman MA. Factors influencing the transition and retention of mental health nurses during the initial years of practice: Scoping review. J Nurs Manag 2022; 30:4274-4284. [PMID: 36336824 PMCID: PMC10100461 DOI: 10.1111/jonm.13882] [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: 05/25/2022] [Revised: 10/03/2022] [Accepted: 10/27/2022] [Indexed: 11/09/2022]
Abstract
AIM This review aims to identify the factors influencing the transition and retention of mental health nurses during the initial years of practice, recognize gaps in the literature and propose evidence-based strategies. BACKGROUND Mental health is a challenging specialty; recruitment, transition and retention of mental health nurses are known issues of concern. EVALUATION The present study undertakes a scoping review to identify factors influencing the transition and retention of mental health nurses during the initial years of practice and the gaps in that research domain. A literature search was conducted using electronic databases. To gain an understanding of the topic of interest, the review of the literature extended from 2000 to 2022. KEY ISSUES Existing evidence focuses on specific perspectives of transition. There is limited literature on factors influencing transition and retention among mental health nurses. Findings suggested that personal and professional factors could influence the transition and retention of mental health nurses during the initial years of practice. The main themes identified were personal attributes and professional factors with a number of subthemes. CONCLUSION The scoping review identified only a few studies, which showed personal and professional factors related to the transition and retention of mental health nurses at the early stages of their career. IMPLICATIONS FOR NURSING MANAGEMENT Potential benefits of effective transition and support with the understanding of factors influencing transition and retention of early career mental health nurses will enhance staff morale, sustainability of the workforce and better patient outcomes. Additionally, a few recommendations for nurse managers and leaders to improve transitional experiences and retention of early career nurses are highlighted.
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Affiliation(s)
- Bindu Joseph
- Institute of Health and Wellbeing, Federation University, Berwick, Victoria, Australia
| | - Sini Jacob
- School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Louisa Lam
- Graduate Studies, Institute of Health and Wellbeing, Federation University, Berwick, Victoria, Australia
| | - Muhammad Aziz Rahman
- Institute of Health and Wellbeing, Federation University, Berwick, Victoria, Australia
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