Xiao Lily Dongxia, Willis Eileen, Jeffers Lesley
School of Nursing & Midwifery, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
School of Medicine, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
Int J Nurs Stud. 2014 Apr;51(4):640-53. doi: 10.1016/j.ijnurstu.2013.08.005. Epub 2013 Aug 27.
Variations in nursing practice and communication difficulties pose a challenge for the successful integration into the workforce of immigrant nurses. Evidence for this is found in cultural clashes, interpersonal conflicts, communication problems, prejudiced attitudes and discrimination towards immigrant nurses. While the evidence shows that integrating immigrant nurses into the nursing workforce is shaped by factors that are socially constructed, studies that examine social structures affecting workforce integration are sparse.
The aim of this study was to examine interplaying relationships between social structures and nurses' actions that either enabled or inhibited workforce integration in hospital settings.
Giddens' Structuration Theory with double hermeneutic methodology was used to interpret 24 immigrant and 20 senior nurses' perceptions of factors affecting workforce integration.
Four themes were identified from the data. These were: (1) employer-sponsored visa as a constraint on adaptation, (2) two-way learning and adaptation in multicultural teams, (3) unacknowledged experiences and expertise as barriers to integration, and (4) unquestioned sub-group norms as barriers for group cohesion. The themes presented a critical perspective that unsuitable social structures (policies and resources) constrained nurses' performance in workforce integration in the context of nurse immigration. The direction of structural changes needed to improve workforce integration is illustrated throughout the discussions of policies and resources required for workforce integration at national and organisational levels, conditions for positive group interactions and group cohesion in organisations.
Our study reveals inadequate rules and resources used to recruit, classify and utilise immigrant nurses at national and healthcare organisational levels can become structural constraints on their adaptation to professional nursing practice and integration into the workforce in a host country. 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.
护理实践的差异和沟通困难对移民护士成功融入劳动力队伍构成了挑战。文化冲突、人际冲突、沟通问题、偏见态度以及对移民护士的歧视都证明了这一点。虽然有证据表明，移民护士融入护理劳动力队伍受到社会建构因素的影响，但研究社会结构对劳动力队伍融入影响的却很少。
本研究旨在探讨社会结构与护士行为之间的相互关系，这些行为促进或阻碍了医院环境中劳动力队伍的融入。
采用吉登斯的结构化理论和双重诠释学方法，解读24名移民护士和20名资深护士对影响劳动力队伍融入因素的看法。
从数据中确定了四个主题。分别是：（1）雇主赞助签证对适应的限制；（2）多元文化团队中的双向学习与适应；（3）未被认可的经验和专业知识成为融入的障碍；（4）未受质疑的亚群体规范成为群体凝聚力的障碍。这些主题呈现了一个批判性的观点，即不合适的社会结构（政策和资源）在护士移民背景下限制了护士在劳动力队伍融入方面的表现。在讨论国家和组织层面劳动力队伍融入所需的政策和资源、组织中积极群体互动和群体凝聚力的条件时，阐述了改善劳动力队伍融入所需的结构变革方向。
我们的研究表明，国家和医疗保健组织层面用于招聘、分类和使用移民护士的规则和资源不足，可能成为他们适应专业护理实践并融入东道国劳动力队伍的结构性限制。在多元文化团队中相互学习以及促进跨文化理解的积极群体间互动是有助于移民护士适应和融入劳动力队伍的因素。
