Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
BMC Nurs. 2011 Jun 21;10:14. doi: 10.1186/1472-6955-10-14.
Beyond well-documented credentialing issues, internationally-educated nurses (IENs) may need considerable support in transitioning into new social and health care environments. This study was undertaken to gain an understanding of transitioning experiences of IENs upon relocation to Canada, while creating policy and practice recommendations applicable globally for improving the quality of transitioning and the retention of IENs.
A focused ethnography of newly-recruited IENs was conducted, using individual semi-structured interviews at both one-to-three months (Phase 1) and nine-to-twelve months post-relocation (Phase 2). A purposive sample of IENs was recruited during their orientation at a local college, to a health authority within western Canada which had recruited them for employment throughout the region. The interviews were recorded and transcribed, and data was managed using qualitative analytical software. Data analysis was informed by Roper and Shapira's framework for focused ethnography.
Twenty three IENs consented to participate in 31 interviews. All IENs which indicated interest during their orientation sessions consented to the interviews, yet 14 did not complete the Phase 2 interview due to reorganization of health services and relocation. The ethno-culturally diverse group had an average age of 36.4 years, were primarily educated to first degree level or higher, and were largely (under) employed as "Graduate Nurses". Many IENs reported negative experiences related to their work contract and overall support upon arrival. There were striking differences in nursing practice and some experiences of perceived discrimination. The primary area of discontentment was the apparent communication breakdown at the recruitment stage with subsequent discrepancy in expected professional role and financial reimbursement.
Explicit and clear communication is needed between employers and recruitment agencies to avoid employment contract misunderstandings and to enable clear interpretation of the credentialing processes. Pre-arrival orientation of IENs including health care communications should be encouraged and supported by the recruiting institution. Moreover, employers should provide more structured and comprehensive workplace orientation to IENs with consistent preceptorship. Similar to findings of many other studies, diversity should be valued and incorporated into the professional culture by nurse managers.
除了有据可查的资质问题外，国际教育护士（IEN）在进入新的社会和医疗环境时可能需要大量支持。本研究旨在了解 IEN 重新安置到加拿大后的过渡经历，同时为改善过渡质量和留住 IEN 提出适用于全球的政策和实践建议。
采用聚焦民族志方法，对新招募的 IEN 进行个体半结构化访谈，分别在入职后一至三个月（第 1 阶段）和九至十二个月（第 2 阶段）进行。在当地大学的定向培训期间，以及在加拿大西部的一个卫生当局招募他们在该地区就业期间，采用目的性抽样招募 IEN。访谈进行了录音和转录，并使用定性分析软件进行数据管理。数据分析受 Roper 和 Shapira 的聚焦民族志框架的指导。
23 名 IEN 同意参与 31 次访谈。所有在定向培训期间表示有兴趣的 IEN 都同意参加访谈，但由于卫生服务重组和搬迁，有 14 名 IEN 没有完成第 2 阶段的访谈。这群种族文化多样的参与者平均年龄为 36.4 岁，主要接受过第一学位或更高学历教育，大多（未）从事“研究生护士”工作。许多 IEN 报告了与工作合同和抵达后整体支持相关的负面经历。护理实践存在显著差异，并且存在一些被认为是歧视的经历。主要的不满领域是招聘阶段的明显沟通中断，随后导致预期的专业角色和财务报销之间存在差异。
雇主和招聘机构之间需要进行明确和清晰的沟通，以避免雇佣合同误解，并能够对认证过程进行清晰的解释。应鼓励并由招聘机构为 IEN 提供入境前的定向培训，包括医疗保健沟通。此外，雇主应为 IEN 提供更具结构化和全面的工作场所定向培训，并提供持续的导师制。与许多其他研究的发现类似，护士管理人员应重视多样性，并将其纳入专业文化。
