Experiences of Nigerian Internationally Educated Nurses Transitioning to United States Health Care Settings

Iheduru-Anderson, Kechinyere; Wahi, Monika M.

doi:10.1177/1043659618766225

Cited by 30 publications

(42 citation statements)

References 25 publications

(38 reference statements)

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“…Much of the literature concerning foreign-educated nurses in the United States has focused on demographics, licensure, and transition to practice (Iheduru- Anderson & Wahi, 2018;Jose, 2011;Xu, Gutierrez, & Kim, 2008;Xu & He, 2012;Xu & Kwak, 2007). Few studies have explored these nurses' career trajectories in the United States.…”

Section: Present Studymentioning

confidence: 99%

“…Despite various positive action initiatives and position statements by various nursing organizations, such as the National League for Nursing (NLN), the American Association of Colleges of Nursing (AACN), and the American Nurses Association (ANA) that echo the need to commit to improving diversity, equity, and inclusion in nursing practice and academia, Black nurses in general remain grossly underrepresented among senior leadership in nursing practice and academia (Phillips & Malone, 2014;Schmieding, 2000;Sullivan, 2004). Many experience discrimination in recruitment and promotion processes (Beard & Julion, 2016;Iheduru-Anderson & Wahi, 2018;Porter & Barbee, 2004;Wingfield, 2009). To achieve full diversity, inclusion, and equity, there must be concerted efforts to understand factors contributing to inequities in promotional opportunities in nursing.…”

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confidence: 99%

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Accent bias: A barrier to Black African‐born nurses seeking managerial and faculty positions in the United States

Iheduru-Anderson

2020

Nursing Inquiry

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A large number of internationally educated nurses are recruited each year from developing low-income countries to alleviate the nursing shortage experienced by US healthcare organizations (Kingma, 2007; Li, Nie, & Li, 2014). Many of these nurses speak with a non-native accent. As students, they may be considered English as a second language students or English language learners. According to the Pew Research Center, there were 4.2 million Black immigrants living in the United States in 2016, making up 10% of all Black people in the United States (Anderson & Lopez, 2018). Growth in the foreign-born Black population is fueled by African migration, with Africans comprising 39% of the overall foreign-born Black population (Anderson & Lopez, 2018). According to the Migration Policy Institute report, sub-Saharan African immigrants have higher levels of educational attainment compared to other immigrants and the native U.S. population (Echeverria-Estrada & Batalova, 2019), and a large share of them work in the healthcare sector (Anderson & Connor, 2018; New American Economy, 2018). The exact number of Black African-born nurses (BABNs) in the United States is not known. However, it can be reasonably assumed that they contribute to the 19.5% of nurses, who identify as ethnic minorities, and the 243,032 Black nurses, who comprise 6.2% of registered nurses in the United States (Smiley et al., 2018). The racial and ethnic identities of nurses who hold managerial and executive positions are not recorded in official nursing workforce data. Nurse migration is motivated by the search for professional development, better quality of life, personal safety (Tregunno, Peters, Campbell, & Gordon, 2009), and even the desire to experience new cultures. However, increased earning potential, career, and learning opportunities continue to be the most frequently reported incentives for nurse migration, especially by nurses from less-developed countries (Kingma, 2007). 1.2 | Discrimination Studies show that African-born students and nurses face numerous challenges during their transition to the United States

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Section: Present Studymentioning

confidence: 99%

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confidence: 99%

Accent bias: A barrier to Black African‐born nurses seeking managerial and faculty positions in the United States

Iheduru-Anderson

2020

Nursing Inquiry

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“…They often felt they had to work harder than their white counterparts to earn the same recognition 24 . Nurses in 17 study reported being bullied and treated as less knowledgeable due to minority status and their foreign accent. Many of the nurses left their place of employment due to experiences of discrimination, lack of support, and feelings of exclusion.…”

Section: Review Of Literaturementioning

confidence: 84%

“…Ethnic minority nurses experienced discrimination, marginalization, and unequal career advancement opportunities 17,23‐26 . They often felt they had to work harder than their white counterparts to earn the same recognition 24 .…”

Section: Review Of Literaturementioning

confidence: 99%

Barriers to career advancement in the nursing profession: Perceptions of Black nurses in the United States

Iheduru-Anderson

2020

Nurs Forum

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Background There is a paucity of Black and minority ethnic group nurse leaders and faculty in the nursing profession, even though the overall number of nurses within this demographic has increased. This study aimed to examine Black nurses' perceptions of the barriers to career advancement in nursing profession in the United States. Procedure Participants included 30 Black nurses aged 25 to 65 from health care settings across five US states recruited through purposive sampling. The study used a focused ethnographic design with semi‐structured interviews to elicit responses about participants perceptions and experiences of seeking leadership and faculty positions. Results Thematic analysis revealed seven main themes: maintaining white comfort, distrust, no one like me, paving the way, worthy of representation, leadership role not expected of Black nurses, and an advanced degree does not equal advanced opportunities. Conclusion The findings suggest that Black nurses face significant challenges in entering leadership or faculty positions. They face racial discrimination and lack access to mentorship and support which discourages sufficiently qualified and experienced nurses from applying for high‐level positions. Ensuring all nurses are afforded equal opportunity for career advancement is essential for the nursing profession's continued growth.

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“…Of the 18 studies included in this review, 11 were qualitative (Connor, 2016;Dicicco-Bloom, 2004;Ho, 2015;Iheduru-Anderson & Wahi, 2018;Jose, 2011;Lin, 2014;Sherman & Eggenberger, 2008;Wheeler, Foster, & Hepburn, 2013;Wheeler, Foster, & Hepburn, 2014;Wolcott, Llamado, & Mace, 2013;Yi & Jezewski, 2000), six were cross-sectional (Beechinor & Fitzpatrick, 2008;Ea, Griffin, L'Eplattenier, & Fitzpatrick, 2008;Geun, Redman, & McCullagh, 2016;Jose, Griffin, Click, & Fitzpatrick, 2008;Ma, Quinn Griffin, Capitulo, & Fitzpatrick, 2010;Pittman, Davis, Shaffer, Herrera, & Bennett, 2014), and one was a case study (Liou & Cheng, 2011). The cross-sectional studies varied, measuring levels of acculturation (Ea et al, 2008), demands of immigration in the TTP experiences of IENs (Beechinor & Fitzpatrick, 2008;Jose et al, 2008;Ma et al, 2010), expected and perceived organizational experiences and turnover (Geun et al, 2016), and perceived discrimination (Pittman et al, 2014).…”

Section: Study Characteristicsmentioning

confidence: 99%

Transition-to-U.S. Practice Experiences of Internationally Educated Nurses: An Integrative Review

Ghazal

Djukic

et al. 2019

West J Nurs Res

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Internationally educated nurses (IENs) are an important part of the U.S. nursing workforce. Optimizing their transition-to-practice (TTP) experiences in the United States is crucial for ensuring high-quality patient and IENs’ outcomes. The purpose of this integrative review is to analyze and synthesize the current evidence surrounding IEN TTP experiences in the United States from 2000 to 2018 to inform improvements in TTP. Eighteen studies were included. TTP was defined through IENs’ description of facilitators and barriers of the transition process and presented in seven themes. Two themes were facilitators: support from family and nursing colleagues, and perceptions of self-efficacy. The remaining five themes were barriers: (a) the stigma associated with educational preparation, (b) communication and language, (c) differences in culture, (d) differences in nursing practice, and (e) legal issues. Findings are important for improving TTP programs. Further research focusing on the outcomes of transition programs is needed to inform policymaking surrounding IEN recruitment and retention.

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Experiences of Nigerian Internationally Educated Nurses Transitioning to United States Health Care Settings

Abstract: NIENs face personal and organizational barriers to adaptation, especially fear, anger and disappointment. Future research should seek to develop a model for optimal adaptation that focuses on improving both personal and organizational facilitators and decreasing barriers.

Cited by 30 publications

References 25 publications

Accent bias: A barrier to Black African‐born nurses seeking managerial and faculty positions in the United States

Accent bias: A barrier to Black African‐born nurses seeking managerial and faculty positions in the United States

Barriers to career advancement in the nursing profession: Perceptions of Black nurses in the United States

Transition-to-U.S. Practice Experiences of Internationally Educated Nurses: An Integrative Review

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