Organizational support in the recruitment and transition of overseas-qualified nurses: lessons learnt from a study tour

Black African international nurses' experiences of pastoral support: A scoping review

Purpose

Overseas nurses are not new to the United Kingdom (UK), and neither is the concept of pastoral care. The immense contributions of international nurses are so obvious that it would be commonly assumed that there will be a strong literature base on pastoral care for these nurses. However, the opposite is very much the case. Pastoral support is crucial to the successful adaptation and integration of nurses who are recruited outside the United Kingdom to work within the NHS. To offer comprehensive fit-for-purpose support, the perspective of the nurses is important.

Objective

This scoping review aims to identify what is known about pastoral support for internationally educated nurses in the UK.

Methods

A scoping review method was used to review literature on pastoral support.

Results

Existing literature provided evidence on current practices, the challenges, and outcome criteria for successful pastoral support. It also provided evidence on how early pastoral support can fortify the nurses or deskill them. Finally, it revealed significant disparities in the support received by overseas nurses.

Conclusion

While the nurses' experience of the previous adaptation programme has been explored, evidence on the current pastoral care practices is mostly found in policy guidelines, trainers' reports, and opinion pieces. Since the inception of the NMC test of competence in 2014, the voice of the recipients of pastoral care is yet to be heard. This scoping review suggests that there is a difference in understanding of pastoral care practices. Therefore, the perspectives of specific groups such as Black African nurses should be explored on this issue.

Examining Workplace Practices Used to Facilitate Successful Integration of Internationally Educated Nurses Into Acute Care Settings: A Scoping Review

BACKGROUND

Although the recruitment of internationally educated nurses (IENs) seems to be an effective strategy to sustain a diversified nursing workforce, challenges with transition to practice continue to be documented in the literature. Prelicensure bridging programs purport to facilitate practice readiness; however, IENs who complete these programs also experience difficulties. Little is known about tailored workplace-based bridging programs. This scoping review maps out our current understanding of IEN integration and education strategies implemented within acute care settings and identifies areas for further research.

METHOD

Arksey and O'Malley's (2005) five-step scoping review was used to explore current literature and highlight gaps based on the needs of IENs during transition into acute care.

RESULTS

Two themes were identified: the need for tailored clinical practice bridging programs within acute care settings and the impact of corporate involvement and social structures on IEN integration.

CONCLUSION

Inconsistencies in IEN integration practices point to the significance of implementing tailored, workplace-based bridging programs to ensure safe and full scope of practice. [J Contin Educ Nurs. 2024;55(4):195-201.].

Mapping nursing practices in rehabilitation units in Spain and the United Kingdom: A multiple case study

Because of the crisis in the health sector with few employment opportunities, many Spanish nurses are looking for professional development abroad. No studies have mapped nursing practices across Europe. The aim of this research was to provide a comprehensive approach to understand nursing practices and features of the context in Spain and the United Kingdom within the rehabilitation unit and to discuss those practices from a patient safety point of view. Multiple case study design with thematic analysis was applied in this study. The methods for data collection were in-depth interviews, nonparticipant observations, and document analysis. Results were classified into six categories: resources, techniques and nursing procedures, patients' personal care, health education, documentation task, and attitudes and communication skills. This study concludes that differences exist between nursing practices despite both countries having similar nursing competences. In addition, the UK unit has a positive safety culture, recognizes that mistakes happen, and applies more barriers to avoid them. The study provides valuable information to help the decision-making process for Spanish nurses considering working in the UK.

Internationally educated nurses in Canada: perceived benefits of bridging programme participation

AIM

To examine internationally educated nurses' perceptions of the extent to which participating in bridging programmes is beneficial for preparing to practise nursing in Canada.

BACKGROUND

Internationally educated nurses continue to migrate from low-income to high-income countries. Many experience challenges when attempting to practise their profession in the destination country. Canada and other top destination countries offer educational support, such as bridging programmes, to assist internationally educated nurses' with preparing to practise nursing in the destination country. The research evidence falls short in demonstrating the usefulness of bridging programmes.

METHODS

A subsample of 360 internationally educated nurse participants from a Canadian cross-sectional survey conducted in 2014. All were permanent residents, employed as regulated nurses and participants of bridging programmes. Multiple linear regression was employed to examine the influence of internationally educated nurses' human capital (academic preparation, language proficiency, professional experience) and the economic status of their source country on perceived benefits of bridging programme participation.

RESULTS

Regression model explained 11.5% of variance in perceived benefits of bridging programme participation. Two predictors were statistically significant: source country and professional experience.

CONCLUSION

Bridging programmes help internationally educated nurses address gaps in their cultural, practical and theoretical knowledge. Source country and amount of professionally experience influences the extent to which internationally educated nurses benefit from participating in bridging programmes in Canada.

IMPLICATIONS FOR NURSING POLICY

Provides emerging evidence for decision-makers globally when developing policies and supports to help internationally educated nurses integrate into the destination country's nursing workforce.

Supporting international medical graduates' transition to their host-country: realist synthesis

CONTEXT

Many health services and systems rely on the contribution of international medical graduates (IMGs) to the workforce. However, concern has grown around their regulation and professional practice. There is a need, in the absence of strong evidence and a robust theoretical base, for a deeper understanding of the efficacy of interventions used to support IMGs' transition to their host countries. This study seeks to explore and synthesise evidence relating to interventions developed for IMGs. It aims to provide educators and policy makers with an understanding of how interventions should be developed to support IMGs in their transition to the workplace, particularly looking to identify how and why they are effective.

METHODS

The realist synthesis involved an initial systematic search of the literature for the period January 1990 to April 2015. Secondary searches were conducted throughout the review in order to inform and test the developing programme theory. The context, mechanism and outcome data were extracted from all sources meeting the inclusion criteria. Fourteen case studies were included to further aid theory refinement.

RESULTS

Sixty-two articles were identified, describing diverse interventions of varying intensity. A further 26 articles were identified through a secondary search. The findings illustrate that, alongside a developed programme, ongoing support and cultural awareness at organisational and training levels are crucial. Individual differences must also be taken into consideration. This will ensure that IMGs engage in transformative learning, increase their levels of self-efficacy and cultural health capital, and reduce feelings of stress and anxiety. These factors will have an impact on work, interactions and cultural adjustment.

CONCLUSIONS

Organisational, training and individual contexts all play a role in IMGs' adjustment during the transition process. Establishing ongoing support is critical. A list of recommendations for implementation is given.

Human rights conflicts experienced by nurses migrating between developed countries

Background:

Some developed countries have recently changed their role in the context of international recruitment, becoming donors due to socio-economical and political factors such as recessions. This is also the case in Italy, where there has been a flow of immigrant nurses out of the country that has been documented over the past several years. In a short time, it has become a donor country to other developed European countries, such as the United Kingdom.

Aims:

To advance knowledge in the context of human rights conflicts and ethical implications of the decision-making process of nurses who migrate between developed countries, such as from Italy to the United Kingdom, during times of recession.

Research design:

A case study based on the descriptive phenomenological approach was undertaken in 2014.

Participants and research context:

A total of 26 Italian newly graduated nurses finding a job in the United Kingdom were interviewed via Skype and telephone.

Ethical considerations:

The Internal Review Board of the University approved the project.

Findings:

In accordance with the descriptive phenomenological approach undertaken, three main themes emerged: (1) escaping from the feeling of being refused/rejected in order to be desired, (2) perceiving themselves respected, as a person and as a nurse, in a growth project and (3) returning if the country changes its strategy regarding nurses.

Discussion:

Ethical implications in the context of human rights, such as autonomy of the decision, social justice and reciprocal obligation, non-maleficence and double effect, have been discussed.

Conclusion:

The call for investing in nurses and nurses’ care in developed countries facing recession is urgent. Investing in nurses means respecting individuals and citizens who are at risk of developing health problems during the recession.

The mental health of nurses in acute teaching hospital settings: a cross-sectional survey

Background

Nursing is an emotionally demanding profession and deficiencies in nurses’ mental wellbeing, characterised by low vitality and common mental disorders, have been linked to low productivity, absenteeism and presenteeism. Part of a larger study of nurses’ health, the aim of this paper was to describe the mental health status and related characteristics of nurses working in two acute metropolitan teaching hospitals.

Methods

A cross sectional survey design was used.

The Registered and Enrolled Nurse workforce, employed on any form of contract, at two teaching hospitals in Sydney Australia were invited to participate. The survey tool was compiled of validated tools and questions. Family and medical history and health risk-related characteristics, current psycho-active medications, smoking status, alcohol intake, eating disorders, self-perceived general health, mental health and vitality, demographic, social and occupational details were collected.

Results

A total of 1215 surveys were distributed with a usable response rate of 382 (31.4%). Altogether 53 nurses (14%) reported a history of mental health disorders, of which n = 49 (13%) listed diagnoses of anxiety and/or depression; 22 (6%) were currently taking psychoactive medication. Symptoms that could potentially indicate a mental health issue were more common, with 248 (65.1%) reporting they had experienced symptoms sometimes or often in the last 12 month.

Nurses had better mental health if they had better general health, lived with a spouse/ partner rather than alone, had fewer symptoms, sleep problems or disordered eating behaviours, were not an informal carer and did not work nights. Nurses had greater vitality if they were male, had better general health, fewer sleep problems or symptoms generally and lived with a spouse/ partner rather than alone; less vitality if they were an informal carer or had disordered eating.

Conclusion

Nurses and their managers should strive to create workplaces where working practices promote nurses’ health and wellbeing, or at least are configured to minimise deleterious effects; where both nurses and their managers are aware of the potential for negative effects on the mental health of the workforce; where cultures are such that this can be discussed openly without fear of stigma or denigration.