Workplace Integration: Key Considerations for Internationally Educated Nurses and Employers

Abstract

Integration of internationally educated nurses (IENs) in the workplace over the long term, has not been a clear focus in nursing. The role of the employer organization in facilitating workplace integration for IENs has also not been emphasized in research. The overall aim of this paper is to highlight findings from an instrumental qualitative case study research informed by critical social theory, which examined workplace integration of IENs. The study explored what is meant by 'integration' and how the employer organizational context affects workplace integration of IENs. A purposeful sample of twenty-eight participants was involved. The participants included: stakeholders from various vantage points within the case organization as well as IENs from diverse backgrounds who were beyond the process of transitioning into the Canadian workplace-they had worked in Canada for an average of eleven years. Four methods of data collection were used: semi-structured interviews; socio-demographic survey; review of documents; and focus group discussions (FGDs). Thematic analysis methods guided the within subcase analysis first, followed by an across subcase analysis. FGDs were used as a platform for member-checking to establish the credibility of study findings. The resulting definition and conceptual framework point to workplace integration of IENs as a two-way process requiring efforts on the part of the IENs as well as the employer organization. This paper elaborates on selected themes of how beyond transition, workplace integration entails IENs progressing on their leadership journey, while persevering to overcome challenges. Organizational factors such as workforce diversity, leadership commitment to equity and engagement with the broader community serve as critical enablers and the importance of workplaces striving to avoid common pitfalls in addressing the priority of IEN integration are also discussed. This paper concludes with implications and key considerations for workplace integration of IENs.

Unpacking “two-way” workplace integration of internationally educated nurses

“…Workplace integration of IENs as a two-way process and outcome is new to nursing. [13,24] However, within the social sciences, notions of two-way integration of immigrants and refugees into their host communities have been part of the discourse for some time now. Definitions in immigrant and refugee studies describe integration as a mutual, twoway process between the new home or host society and the newcomers.…”

“…[6] However, the longer-term focus is necessary to understand IENs' ongoing satisfaction, progress and retention within the workplace and nursing profession. [12,13] This research's emphasis on the organizational context explores workplace integration as a 'two-way' process in nursing and generates insights for how employers can effectively facilitate workplace integration of IENs.…”

Power distance and migrant nurses: The liminality of acculturation

“…Acculturation is impeded if IQNs experience limited career advancement and lack of recognition of prior abilities that they associate with discrimination and racism. Ramji and Etowa () note that social closure, the exclusionary practices of majority groups that limit IQNs’ professional advancement, leads to a persistent sense of being ‘other’ and therefore disrupts workplace integration. Acculturation at best involves reciprocity.…”

“…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.…”

Social Processes Affecting the Workforce Integration of First-Generation Immigrant Health Care Professionals in Aging Citizens in the Netherlands

“…Their overseas diplomas from the Global South, their knowledge and skills were often not recognized in the Global North. They were more seen as professionals who had deficiencies and needed retraining, than people who could add value (Ramji & Etowa, 2018). Besides, first-generation immigrant nurses were expected to expend significant effort in adapting into the new health care institutions, while little was demanded from established nurses (Muller, Beckers, & Pijpers, 2017).…”