Foreign educated nurses’ work experiences and patient safety—A systematic review of qualitative studies

Abstract

AimThe aim of this systematic review was to identify the evidence contributed by qualitative research studies of foreign educated nurses’ work experiences in a new country and to link the results to patient safety competencies.DesignA systematic literature review of qualitative studies.MethodsElectronic searches in the Ovid MEDLINE, Embase, PsycINFO, Cochrane Library and Cinahl databases and additional manual searches in five scientific journals. A content analysis of 17 qualitative articles was conducted.ResultsThe analysis revealed one main theme: “Being an outsider at work” and two themes: “Cultural dissonance and Unfamiliar nursing practice. Two sub‐themes emerged from the first theme; Loneliness and discrimination” and “Communication barriers”. The second theme was based on the following two sub‐themes: “Handling work‐related stress” and “Role uncertainty and difficulties in decision‐making”. A better prepared and longer orientation period with continual clinical supervision including systematic reflection on practice experiences is needed to support foreign educated nurses in the transition period and strengthen their Patient Safety Competencies. Nurse Managers have an important role in ensuring the inclusion of foreign educated nurses and providing desirable working conditions.

Power distance and migrant nurses: The liminality of acculturation

“…Kim () also argues for a move away from assumptions of homogeneity in ‘Asian’ communication analyses, and a departure from an uncritical, one‐sided Eurocentric standpoint that privileges Westernised communication styles and theories. In a systematic review, Viken et al () contend that IQNs need an extended orientation period with supported opportunities for guided reflection on practice to ensure patient safety. However, we concur with arguments that both host and IQN nurses need these opportunities to reflect together, to foster learning through openness and experimentation, in order for teams to function coherently (Brunton & Cook, ; Cook & Brunton, ).…”

“…Successful transition involves reciprocity, rather than being the unilateral responsibility of IQNs (Brunton & Cook, ; Philip, Woodward‐Kron, Manias, & Noronha, ). Studies demonstrate that supportive leadership is a significant factor in transition and that leaders benefit from professional development to facilitate this process (Brunton & Cook, ; Khalili et al, ; Ramji & Etowa, ; Timilsina Bhandari, Xiao, & Belan, ; Viken, Solum, & Lyberg, ). The first author, who is an internationally qualified nurse, and currently a nurse educator, aimed to inform the role of educators and preceptors further by exploring challenges that a sample of Filipino and Indian culturally and linguistically diverse (CALD) nurses encountered when transitioning to the New Zealand nursing practice context.…”

“…Adjustment to different dynamics in power relations and power distance is also reported across numerous studies. However, these accounts are explored with brevity (see, e.g., Philip et al, ; Xu, ; Viken et al, ) and there is a dearth of literature that focuses in depth on culturally and linguistically diverse (CALD) nurses’ acculturation process in these areas. The rich data in the current study highlight familiar themes evident in the extant literature.…”

A courageous journey: Experiences of migrant Philippine nurses in Norway

“…Systematic reviews show that considerable research has been conducted on Philippine nurses who have migrated to Canada, Australia, the United States, the UK and New Zealand (Jenkins & Huntington, 2015;Pung & Goh, 2017;Viken, Solum, & Lyberg, 2018). Three qualitative studies indicate that the reasons motivating Philippine nurses' migration to Canada were opportunities for an improved economic situation, employment as a registered nurse (RN), improved social status, unemployment in the Philippines and family pressure to migrate (Hawkins & Rodney, 2015;Ronquillo, Boschma, Wong, & Quiney, 2011;Salami, Nelson, Hawthorne, Muntaner, & McGillis Hall, 2014).…”

Implementation of palliative care educational intervention in long-term care: a qualitative multi-perspective investigation

“…However, as evidenced in the results, mentoring by the hospice nurses improved both communication and confidence on the part of LTCF RN's in dealing with families. Clinical supervision accompanied by reflection on practice can support the practice of overseas-trained RN's (Viken et al 2018). Results also suggest the expansion of SHARE to include more interaction between the hospice nurse, LTCF's and GP's.…”