Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Expectations and Experiences of Recently Recruited Overseas Qualified Nurses in Australia

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Expectations and Experiences of Recently Recruited Overseas Qualified Nurses in Australia

Article excerpt

INTRODUCTION

Over the past decade a deficit of Australian nurses has prompted active policies of international recruitment. In Australia a shortfall of 40 000 nurses by 2010 is predicted (Jeon & Chenoworth 2007). In consequence, the overseas' qualified nurse (OQN) has become an increasingly vital component of the Australian nursing workforce (Hawthorne 2001). Investment in providing appropriate support to enable overseas nurses to adapt to working in a different health care system and settling in to life in Australia is regarded as essential (Jeon & Chenoworth 2007; Gerrish & Griffith 2004).

In a recent systematic review of the literature Konno (2006) found 64 papers on the topic of OQNs in Australia. Two core themes emerge from this meta-synthesis. Firstly, overseas nurses found entry into Australian culture very difficult; and secondly they felt lonely and isolated, and experienced difficulty in settling in to nursing in Australia. Konno (2006) contends that the clash of cultures between OQNs and the dominant Australian culture should be addressed in dedicated transition programmes.

Daniel, Chamberlain and Gordon (2001) in the United Kingdom (UK) explored the expectations and experiences of newly recruited Filipino nurses. Key factors that influenced their decision to work in the UK were improved prospects and better wages. Differences were also noted in their expectations of their new nursing role and their actual experience. Strategies reported as being helpful during this adjustment phase were: support services, culturally appropriate orientation programmes, training and opportunities for promotion.The literature suggests that problems in adjustment for OQNs may include: culture shock, homesickness, communication difficulties, social isolation, anxiety and accommodation issues (Daniel et al 2001). Similarly, Pilette (1989) reports that international nurses undergo a process of adjustment that frequently leads to cultural, professional and psychological dissonance. Pilette (1989) recommends that health care managers seek to understand this process of adjustment, and implement assimilation programmes to support international nurses, and ultimately retain them within the workforce.

At an international level the International council of Nurses (ICN 2007), has set out a position statement on the ethical recruitment of nurses.The ICN recognises the right of nurses to migrate and notes the benefit to nursing outcomes of the multicultural and learning opportunities gained by the process of migration.The ICN equally denounces where countries have failed to adequately plan for human resources gaps and also countries that haven't addressed reasons why nurses leave the profession. The ICN makes it clear in this position statement that nurses have the right to proper orientation and ongoing constructive supervision/mentoring within the work environment (ICN 2007).

CULTURE-CARE STRATEGIES TO PROMOTE RETENTION OF OQNS

Ideas that aim to strengthen retention rates and reduce the pressure on the continuous recruitment effort warrant consideration. A variety of interventions have been described in the literature and they include: employment of an international support nurse, mentorship programmes, country-specific orientation programmes, social programmes, intercultural communication courses and clinical supervision.

Oxtoby (2003) explores the role of an 'International Support Nurse' in the UK. The role offers support and guidance to the new recruit to help them understand and deal with any culture shock they may experience.The educational component of the role involves the delivery of assertiveness training, rehearsing clinical scenarios and improving communication between different cultural groups. Ryan (2003) reports on a North American buddy programme describing the following as necessary for the OQNs adjustment. These are socialisation to the professional nursing role, acquisition of language and other communication skills, development of clinical and organisational workplace competence, availability of support systems and resources within the organisation. …

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