“It’s only the skin colour, otherwise we are all people”: the changing face of the Australian nurse

Abstract

The aim of this paper is to report on the experience of racial discrimination by black sub-Saharan overseas qualified nurses working in rural Australia. Background:The arrival of black African people as skilled professional migrants is relatively new in rural Australia. The presence of black sub-Saharan African nurses in Australian healthcare facilities is changing the face of the Australian nurse. Australia, like other developed countries, has been receiving migrant nurses from the African continent in a bid to reverse its critical nurse shortage. Literature has shown that globally, overseas qualified nurses of colour have encountered work challenges that have included racial discrimination. study design and methods: A qualitative hermeneutical phenomenological approach was used. Eighteen nurses were purposively selected using personal invite and a snowballing technique. Data collection involved individual face to face interviews and a focus group discussion. results:The exploration of experiences revealed issues of race and colour among colleagues and between patients and overseas qualified nurses. Overseas qualified nurses experienced incidents of discrimination based on race and skin colour from their colleagues and patients. They felt unwelcome, not trusted and undervalued. They adopted various coping strategies to adjust to being seen differently. Discussion:The literature suggests that overseas qualified nurses tend to be discriminated against in their destination countries. In this paper the migration experience of black sub-Saharan African overseas qualified nurses has shown the power of welcoming people to their new country, the existence of discrimination by race at their healthcare facilities as well as showing the importance of trust and teamwork at the workplace. The study has also shown the resilience of black sub-Saharan African overseas qualified nurses in their time of adversity. conclusion: There are pockets of racial discrimination that need to be checked within the Australian healthcare system. These undermine the confidence of overseas qualified nurses in their professional practice. implications for research, policy and practice:The results provided insight into the existence of racism within the workplace. Black African nurses need to feel safe in their workplace and need more support to facilitate their integration.

Transitioning experiences of internationally educated nurses in host countries: A narrative systematic review

“…The selected studies were published between 2019 and 2023. Thirteen studies focused on exploring internationally educated nurses' experiences, which included transition ( Pawlak, 2021 ; Joseph et al, 2022 ), integration ( Calenda et al, 2019 ; Kamau et al, 2022 ), temporary work permits ( Nourpanah, 2019 ), mobile nursing, ( Leone et al, 2020 ), early experiences, ( Dywili et al, 2021 ), experiences and perceptions of being migrants ( Rodriguez‐Arrastia et al, 2021 ), and sociocultural adaptation ( Zanjani et al, 2021 ). Three studies ( Brunton et al, 2019 ; Philip et al, 2019 ; Philip, Woodward‐Kron and Manias, 2019 ) focused on the communication of internationally educated nurses, and one study focused on perceptions of internationally educated nurses' job satisfaction ( Almansour et al, 2022 ).…”

“… No Author and year of publication Country Study setting Study design or methods Study focus Sampling type 1 Brunton et al, 2019 New Zealand and the United Arab Emirates Hospitals and Residential Care Facilities Exploratory qualitative Communication Convenient 2 Calenda et al, 2019 Finland Social and Health CareOrganisations, Hospitals and Private Elderly Care Home Qualitative: Content analysis Integration experience of internationally educated nurses Purposive 3 Nourpanah, 2019 . Canada Caring for an Ageing Population Qualitative: Ethnographic Experienced by Foreign Nurses on Temporary Work Permits Purposive 4 Philip, et al, 2019 a Australia Hospital, Aged Care, and Rehabilitation Exploratory qualitative Communication Purposive 5 Philip, et al, 2019 b Australia Hospital Qualitative: Observations and Discourse Communication Purposive 6 Leone et al, 2020 UK Organisational and Policy Levels and NHS Exploratory qualitative Experience of Mobile Nursing Workforce Snowball 7 Angus et al, 2021 New Zealand Aged Residential Care (ARC) Qualitative descriptive Experience of internationally qualified nurses Self-selected, Convenient 8 Dywili et al, 2021 Australia Rural New South Wales (NSW) Qualitative hermeneutical phenomenological Early experiences of internationally educated nurses Snowballing, Purposive 9 ...…”

“… Themes Sub-themes Concepts from studies Contributing studies Push and pull factors that mediate the experiences of migration of internationally educated nurses Personal & Professional push & pull factors Unemployment, pay rates, better jobs, better careers, upskilling processes, better standards of living, better family life, political factors, and job security Calenda et al, 2019 ; Leone et al, 2020 ; Dywili et al, 2021 ; Korzeniewska, et al, 2021 ; Pawlak, 2021 ; Rodriguez-Arrastia et al, 2021 ; Zanjani et al, 2021 ; Almansour et al, 2022 Socio-Economical Push & pull factors Unemployment, better pay rates, lack of career progression opportunities, the countries' socio-economic decline, established contacts, and support. Calenda et al, 2019 ; Leone et al, 2020 ; Dywili et al, 2021 ; Korzeniewska, et al, 2021 ; Pawlak, 2021 ; Rodriguez-Arrastia et al, 2021 ; Zanjani et al, 2021 ; Almansour et al, 2022 One-way integration logic Pre-departure support Inflexible regarding registration, requirements, pre-departure training, lack of information to help make informed decisions, and lack of Intra-organisational communication Calenda et al, 2019 ; Nourpanah, 2019 ; Leone et al, 2020 ; Joseph et al, 2022 Organisational support Induction programme, training, education, professional development, promotion/grades lack of Intra-organisational support, professional relationships, deskilling Brunton et al, 2019 ; Calenda et al, 2019 ; Nourpanah, 2019 . ; Philip, et al, 2019 a; Angus et al, 2021 ; Joseph et al, 2022 ; Korzeniewska, et al, 2021 ; Rodriguez-Arrastia et al, 2021 ; …”

Attending to our conceptualisations of race and racism in the pursuit of antiracism: A critical interpretative synthesis of the nursing literature

“…Social categorisations are not uncontested or incontestable, yet this is how they appear in the nursing literature. For example, Sellers et al (2016, p. 578) state that, ‘… patient race along with other information can help guide diagnostic and treatment decisions in some circumstances…’; this categorising view of race is echoed by Dywili et al (2021, p. 20), ‘…the absence of participants from other races deprived the study of their experiences’, as well as Beard and Julion (2016, p. 593), ‘… analysis of the data leads to the conclusion that race is indeed a factor that hinders the nursing profession from achieving its diversity goals’. This lack of nuance makes it possible for the reader to confuse a constructivist authorial perspective on race with a biological one.…”

An Insight into the Experiences of Black and Minority Ethnic Nurses within Healthcare: A Narrative Literature Review

“…However, the author claimed these feelings may occur due to transition issues, given migration to new countries with diversity in language and cultural practices can cause a sense of vulnerability for BME nurses. On the contrary, Dywili, O'Brien, and Anderson [39] emphasized that there are pockets of racial discrimination that need to be checked within the Australian healthcare system, condemning how racial discrimination undermines the confidence of overseas qualified nurses in their professional practice.…”