Cultural competence of internationally educated nurses: assessing problems and finding solutions.

Competency to practise nursing is typically assessed by professional regulators who examine educational standards, credentials, and experience. But bureaucratic fit based on verification of documents and determination of clinical competence does not always coincide with cultural fit and ability to fulfil the role of health professional according to a country's standards. The authors examine the challenges that lack of cultural fit can pose to the integration of internationally educated nurses (IENs) transitioning to a new health-care system. Semi-structured interviews with 71 IENs and 70 key stakeholders in Canada revealed that the cultural fitness of immigrant nurses presents a unique set of challenges for regulatory bodies, immigrant nurses, and employers. Bridging programs for IENs to upgrade their skills were found to be a means of preparing IENs to practise in the Canadian cultural context.