How does culture influence work experience in a foreign country? An umbrella review of the cultural challenges faced by internationally educated nurses.

BACKGROUND

Internationally educated nurses experience multidimensional challenges affecting their acculturation process in a foreign country. Cultural differences have been highlighted by research as a common barrier. There is a need to understand the cross-cultural challenges experienced by internationally educated nurses to promote a culturally inclusive workplace, particularly when these nurses practice in another country wherein cultural attitudes and beliefs are different from their own.

OBJECTIVES

To identify and synthesise the challenges to cultural values, beliefs, and practices of internationally educated nurses working in a foreign country.

DESIGN

An umbrella review was undertaken by synthesising evidence from systematic reviews.

DATA SOURCES

Databases searched were MEDLINE, Embase, PsychINFO, CINAHL and Scopus. Reviews published between 2000-2019 were considered.

METHODS

The review protocol was guided by the guidelines from the Joanna Briggs Institute. The Joanna Briggs Institute Critical Appraisal Instrument for Systematic Reviews and Research Syntheses was used to evaluate the methodological quality of the retrieved reviews. The extracted findings were tabulated, categorised into themes, and presented in a narrative synthesis.

RESULTS

Ten reviews met the inclusion criteria. These reviews examined the experiences of internationally educated nurses from different countries. The reviews highlighted that cultural differences had impacted the adaptation and professional experiences of internationally educated nurses. Four themes were identified: cultural differences lead to the feeling of being an outsider, intercultural communication issues transcend beyond fluency, differing nursing cultures complicate adaptation, and ethnic identity challenges work adjustment.

CONCLUSIONS

Despite having a great interest in the literature on the experiences and issues faced by internationally educated nurses, a distinct gap still exists. There is an absence of knowledge on the challenges experienced by internationally educated nurses concerning their cultural beliefs, values, and practices. Further work is needed to enhance understanding and to promote a culturally sensitive workplace.