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

Abstract

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.

What made Lebanese emigrant nurses leave and what would bring them back? A cross-sectional survey

“…Hence, nurses in the region may not be attaining what they are seeking when migrating to the Gulf, or may be facing barriers to integration. A recent study reports that internationally educated nurses in the US faced several barriers to their integration such as language, communication, stigma due to educational preparation, legal issues, and differences in culture and practice ( Ghazal et al, 2019 ). The literature has also cited movement of nurses from other countries such as India to the Middle East, to gain experience, prepare for foreign nursing exams, and save money, before they migrate to the US or UK ( Percot, 2006a ).…”

Nurses’ experiences of a recertification process involving a series of examinations to obtain a nursing license in a new country

“…Eriksson et al, 2018;Moyce et al, 2016;Wheeler et al, 2014). Even though language tests assess basic language competency, they do not address the communication needs of a nurse (Ghazal et al, 2019), which might explain the language difficulties described in the present study and several others (Chun Tie et al, 2019;Eriksson et al, 2018;Lum et al, 2016;Nortvedt et al, 2020;Stubbs, 2017;Viken et al, 2018). Some IENs in our study expressed the need for additional courses, both in language and in preparation for the examinations.…”

The Ethical Recruitment of Internationally Educated Nurses

“…16 Evidence for this is found in cultural clashes, interpersonal conflicts, communication problems, prejudiced attitudes, and discrimination towards immigrant nurses. 17,18 Learning from each other in multicultural teams and positive intergroup interaction in promoting intercultural understanding are enablers contributing to immigrant nurses' adaptation and workforce integration. 19 Nurse leaders globally and professional organizations such as the Philippine Nurses Association of America in collaboration with the American Nurses Association together with the National Coalition of Ethnic Minority Nurse Association (NCEMNA) have a key role in supporting the migration journey of internationally educated nurses through policies that follow the Codes from the Alliance and the World Health Organization.…”