Call to action for advocacy of immigrant nurses during COVID-19 pandemic

The impact of bridging education programs on internationally educated nurses becoming registered nurses in high-income countries: A mixed-methods systematic review

AIM

To synthesize the current literature on the impact of bridging education programs for internationally educated nurses (IENs) from low- and middle-income countries (LMICs) seeking to become registered nurses (RNs) in high-income countries (HICs).

BACKGROUND

The issue of qualification pathways for IENs through bridging programs has garnered significant attention in contemporary discourse. The growing population of IENs in HICs has made it imperative to streamline the qualification process to facilitate their integration into the healthcare system.

METHODS

Utilizing a structured review method, we sourced data between January 2023 and April 2024 from the CINAHL, Scopus, and MEDLINE databases with no year limitations. Out of 817 studies, eight were included. The mixed-methods systematic review was carried out by two authors who adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. We employed a qualitative content analysis from a feminist standpoint to assess the impact of bridging programs on the transition of IENs to become RNs.

RESULTS

Eight studies were included (mixed methods = 1, quantitative = 3, qualitative = 4). Three themes revealed important key findings. Language proficiency emerged as a critical factor influencing success in bridging programs, with IENs needing to attain a certain level of proficiency in the local language required for licensure. Enhancing nursing competence highlighted skepticism and the need for tailored educational approaches. Transitioning into the workplace emphasized cultural challenges, highlighting the importance of targeted support for continuous integration.

CONCLUSION

Our findings revealed that despite previous higher education attainment in nursing and nursing experience in the home countries from LMICs, bridging programs aided IENs in transitioning and assimilating into the host country's healthcare employment sector.

IMPLICATION FOR NURSING POLICY AND PRACTICE

It is essential for policymakers in the education sector to integrate language instruction, cultural sensitivity training, and adapted educational approaches into bridging programs to enhance IENs' readiness for efficient healthcare delivery.

Effect of mode of healthcare delivery on job satisfaction and intention to quit among nurses in Canada during the COVID-19 pandemic

The COVID-19 pandemic resulted in a major shift in the delivery of healthcare services with the adoption of care modalities to address the diverse needs of patients. Besides, nurses, the largest profession in the healthcare sector, were imposed with challenges caused by the pandemic that influenced their intention to leave their profession. The aim of the study was to examine the influence of mode of healthcare delivery on nurses' intention to quit job due to lack of satisfaction during the pandemic in Canada. This cross-sectional study utilized data from the Health Care Workers' Experiences During the Pandemic (SHCWEP) survey, conducted by Statistics Canada, that targeted healthcare workers aged 18 and over who resided in the ten provinces of Canada during the COVID-19 pandemic. The main outcome of the study was nurses' intention to quit within two years due to lack of job satisfaction. The mode of healthcare delivery was categorized into; in-person, online, or blended. Multivariable logistic regression was performed to examine the association between mode of healthcare delivery and intention to quit job after adjusting for sociodemographic, job-, and health-related factors. Analysis for the present study was restricted to 3,430 nurses, weighted to represent 353,980 Canadian nurses. Intention to quit job, within the next two years, due to lack of satisfaction was reported by 16.4% of the nurses. Results showed that when compared to participants who provided in-person healthcare services, those who delivered online or blended healthcare services were at decreased odds of intention to quit their job due to lack of job satisfaction (OR = 0.47, 95% CI: 0.43-0.50 and OR = 0.64, 95% CI: 0.61-0.67, respectively). Findings from this study can inform interventions and policy reforms to address nurses' needs and provide organizational support to enhance their retention and improve patient care during times of crisis.

Linguistic racism towards internationally educated nurses in Finland: Critical reflective analysis

BACKGROUND

The shortage of nurses in Finland has prompted the recruitment of Internationally Educated Nurses (IENs) from developing countries mostly with fragile health systems. However, linguistic racism has emerged as a growing threat to the safety and well-being of IENs in the country.

AIM

To discuss the consequences of linguistic racism directed towards IENs and to propose solutions to address this issue.

METHOD

This discussion employed self-reflection as a means of engaging in critically reflective analysis.

DISCUSSION

The discussion highlighted the factors contributing to linguistic racism, including poor language proficiency, misrepresentation of the nursing profession due to skin color, and political tensions. The phenomenon of linguistic racism affects IENs' communication with patients and colleagues and has a detrimental impact on the mental health and overall health of IENs.

CONCLUSION

To address the issue of linguistic racism, this discussion proposed a comprehensive strategy that includes anti-racism training for healthcare personnel, the establishment of a conducive workplace culture that fosters diversity and inclusivity, and the provision of adequate assistance and support for IENs.

A Systematic review protocol on workplace equality and inclusion practices in the healthcare sector

INTRODUCTION

While equality and inclusion practices in healthcare have been advanced from a service user perspective, little is known about the application of workplace equality and inclusion practices in healthcare on upper-middle-income and high-income countries. In the developed world, the composition of the healthcare workforce is changing, with nationals and non-nationals working 'side-by-side' suggesting that healthcare organisations must have robust and meaningful workplace equality and inclusion practices. Healthcare organisations who welcome and value all their employees are more creative and productive, which can lead to better quality of care. Additionally, staff retention is maximised, and workforce integration will succeed. In view of this, this study aims to identify and synthesise current best evidence relating to workplace equality and inclusion practices in the healthcare sector in middle-income and high-income economies.

METHODS AND ANALYSIS

Using the Population, Intervention, Comparison and Outcome (PICO) framework, a search of the following databases will be made-MEDLINE, CINAHL, EMBASE, SCOPUS, PsycInfo, Business Source Complete and Google Scholar-using Boolean terms to identify peer-reviewed literatures concerning workplace equality and inclusion in healthcare from January 2010 to 2022. A thematic approach will be employed to appraise and analyse the extracted data with the view to assessing what is workplace equality and inclusion; why it is important to promote workplace equality and inclusion in healthcare; how can workplace equality and inclusion practices be measured in healthcare; and how can workplace equality and inclusion be advanced in health systems.

ETHICS AND DISSEMINATION

Ethical approval is not required. Both a protocol and a systematic review paper are to be published concerning workplace equality and inclusion practices in the healthcare sector.

Utilizing telehealth intervention to support patients with cardiovascular diseases in Jordan: A qualitative study

INTRODUCTION

Telemedicine is one of the new technological solutions used to facilitate treatment and intervention in patients with Cardiovascular Diseases (CVD). Nevertheless, the utilization of telehealth in Jordan is under-researched.

PURPOSE

To explore the perspectives and experiences of patients with cardiovascular disease (CVD) and healthcare providers on how telehealth can help manage critical and long-term CVD health problems.

METHOD

A qualitative, descriptive approach was employed, whereby individual interviews were conducted with 12 healthcare providers and 12 cardiac patients from Abdali and Prince Hamzah Hospitals in Jordan. The derived data were analyzed using thematic analysis, according to the method expounded by Braun and Clarke (2014).

RESULTS

The analysis of collected data revealed that telehealth deployment exhibited several advantages from the participants' perspectives, these can be divided into the following six themes: mitigating associated risks, qualified and friendly staff, streamlined work processes, effective and structured services, accessibility and privacy of patient information, affordable and convenient services.

CONCLUSION

The current study suggests that telehealth can be helpful and convenient in many aspects of the health care services for patients with CVD, mainly during the crucial times of the COVID pandemic. With this study, stakeholders and Jordanian managers can better understand the telehealth advantages. This will enable them to improve the quality of care in their health organizations in the future.

A Glance at the Barriers and Enablers of the Nursing Role in Pandemics: An Integrative Review

Objective: to analyze the enablers and barriers to nurses’ professional role fulfillment during pandemics and disasters. Materials and methods: this was an integrative review based on the SALSA analytical method, carried out in eight databases, namely: Medline, Proquest, CINAHL, Web of Science, BVS, SpringerLink, Scopus, and Pubmed. The descriptors used were the following: ‘nurse’s role’ AND ‘pandemic’ AND ‘patient’ AND ‘coronavirus infection’, in English, Spanish and Portuguese. Filters along with inclusion and exclusion criteria were applied to the 11,031 articles found, after which the final sample consisted of a total of 32 articles. Results: considering the objectives set and the results obtained, it is noted that all actions focused on three main instances, namely: a) training and updating for role performance; b) predictors, enablers, and barriers for exercising the role in the face of a pandemic; and c) evidence of the role in the face of pandemics. Conclusion: this study allowed understanding both the barriers and the enablers that allow the fulfillment of nurses’ professional role in the face of pandemics or catastrophes. It also clarified that emerging infectious diseases must be addressed in an immediate, collaborative, and multidisciplinary way. Nurses’ experience, leadership, and professional training are key attributes that these professionals possess to enable their role to be more proactive during an emergency situation.

Health care workers and migrant health: Pre- and post-COVID-19 considerations for reviewing and expanding the research agenda

The main purpose of this article is to review several ways in which health care workers could either impact migrant health or be directly impacted by migration and, based on this, suggest the expansion of the current research agenda on migration and health to address a range of topics that are currently either neglected, insufficiently researched, or researched from different perspectives. To ground this suggestion and emphasize the complexity and significance of migrant health research, we start by briefly reviewing several migration-related notions including the process of migration and its key facilitators and benefits; existing barriers to the provision of migrant health care; and the intricate links between health systems, health professionals, and migrant health. The three areas of research examined in this article address (i) the specific role of health workers in providing care to migrants and refugees and their capacity to do so, (ii) the health problems experienced by health workers who become migrants or refugees, and (iii) the precarious employment conditions experienced by both migrant and non-migrant health care workers. After summarizing the current available evidence on these topics, we discuss key information gaps and strategies to address them, while also incorporating several relevant COVID-19 pandemic considerations and research implications. Expanding the focus of research studies on migration and health could not only enhance the results of current strategies by supplying additional information to support their implementation but also spearhead the development of new solutions to the migrant health problem.

Clinical outcomes and risk factors for COVID-19 among migrant populations in high-income countries: A systematic review

BACKGROUND

Migrants in high-income countries may be at increased risk of COVID-19 due to their health and social circumstances, yet the extent to which they are affected and their predisposing risk factors are not clearly understood. We did a systematic review to assess clinical outcomes of COVID-19 in migrant populations, indirect health and social impacts, and to determine key risk factors.

METHODS

We did a systematic review following PRISMA guidelines (PROSPERO CRD42020222135). We searched multiple databases to 18/11/2020 for peer-reviewed and grey literature on migrants (foreign-born) and COVID-19 in 82 high-income countries. We used our international networks to source national datasets and grey literature. Data were extracted on primary outcomes (cases, hospitalisations, deaths) and we evaluated secondary outcomes on indirect health and social impacts and risk factors using narrative synthesis.

RESULTS

3016 data sources were screened with 158 from 15 countries included in the analysis (35 data sources for primary outcomes: cases [21], hospitalisations [4]; deaths [15]; 123 for secondary outcomes). We found that migrants are at increased risk of infection and are disproportionately represented among COVID-19 cases. Available datasets suggest a similarly disproportionate representation of migrants in reported COVID-19 deaths, as well as increased all-cause mortality in migrants in some countries in 2020. Undocumented migrants, migrant health and care workers, and migrants housed in camps have been especially affected. Migrants experience risk factors including high-risk occupations, overcrowded accommodation, and barriers to healthcare including inadequate information, language barriers, and reduced entitlement.

CONCLUSIONS

Migrants in high-income countries are at high risk of exposure to, and infection with, COVID-19. These data are of immediate relevance to national public health and policy responses to the pandemic. Robust data on testing uptake and clinical outcomes in migrants, and barriers and facilitators to COVID-19 vaccination, are urgently needed, alongside strengthening engagement with diverse migrant groups.