Transition Programs for Internationally Educated Nurses: What Can the United States Learn from the United Kingdom, Australia, and Canada?

By Xu, Yu; He, Flore | Nursing Economics, July/August 2012 | Go to article overview

Transition Programs for Internationally Educated Nurses: What Can the United States Learn from the United Kingdom, Australia, and Canada?


Xu, Yu, He, Flore, Nursing Economics


EXECUTIVE SUMMARY

* It is critical to conduct competency assessments of internationally educated nurses (IENs) to ensure public safety, as well as uphold accountability to nursing as a regulated profession.

* Transition programs are needed because of the required proficiency of the working language, as well as differences in nursing education, national health care systems, nursing practice and culture, etc.

* Transition programs in the United States are grossly under-developed because of lack of recognition of their importance, lack of funding and standardization, and decentralized regulation in nursing.

* United States can learn from the United Kingdom, Australia, and Canada regarding how to best transition IENs.

* Its current hit-and-miss approach is inadequate and inconsistent with the emerging global trend to systematically deal with the transitional challenges of IENs at the national level.

AUSTRALIA, CANADA, UNITED Kingdom, and United States are leading host countries for internationally educated nurses (IENs). The proportions of IENs in the national nurse workforce range from 5.6% in the United States (Health Resources and Services Admini - stration, 2010) to 17.6% in Australia (Australian Institute of Health and Welfare [AIHW], 2009), with an average of 10.7% in Organisation for Economic Cooperation Countries in 2000 (Yeates, 2010). Moreover, IENs are providing vital direct care. For instance, a significantly higher proportion of IENs (71.1%) worked in direct patient care positions compared to their American counterparts (54%) (Xu, Zaikina-Montgomery, & Shen, 2010).

Challenges of IENs during their transition into foreign health care environments are well documented from systematic review studies (Alexis & Vydelingum, 2005; Konno, 2006; Likupe, 2006; Woodbridge & Bland, 2010; Xu, 2007), especially on those IENs from non-English backgrounds. These challenges present real and potential risks to patient safety and quality of care (Davis & Nichols, 2002; Edwards & Davis, 2006; Hearnden, 2007; Shen et al., 2012; Takeno, 2010; Tregunno, Peters, Campbell, & Gordon, 2009; Xu, 2007; Xu, Gutierrez, & Kim, 2008). Based on the emerging evidence, Xu (2010a) not only argues that transitioning IENs is a regulatory issue but also proposes an evidence-based transition program for the acute care setting (Xu, 2010b). Yet, there is scant literature on transition programs in both the United States and other countries as an intervention to address these formidable challenges (Zizzo & Xu, 2009).

Currently, only Australia, New Zealand, and the United Kingdom require IENs to participate in transition programs before official registration. The situation in Canada, however, is somewhat different. Because the majority of IENs are "landed immigrants" (permanent residents) (Blythe & Baumann, 2008) rather than contracted skilled workers sponsored by health care employers on work visas, Canadian efforts have been focused on developing pre-registration, pre-hire "bridging/upgrading programs" that are primarily designed to help IENs to "bridge" gaps in education and experiences for the national registration exam (Baumann & Blythe, 2009). In the United States, there is no required transition program for post-hire IENs, who must obtain either a U.S. nurse license or a Com - mission on Graduates of Foreign Nursing Schools certificate and secure a job offer before coming to the country. No government funding has been provided to develop such programs. Essentially, transitioning IENs is entirely leftto each health care employer, who frequently provides the same orientation or post-hire training to IENs that are no different from domestic hires. In fact, transition programs in the United States are grossly under-developed because of lack of recognition of their importance, lack of funding and standardization, and decentralized regulation in nursing.

There are many different terms used in various countries to refer to IENs: overseas qualified nurses (Australia), overseas nurses (United Kingdom), internationally educated or foreign-educated nurses (Canada, United States), internationally recruited nurses, foreign-born nurses, etc. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

Transition Programs for Internationally Educated Nurses: What Can the United States Learn from the United Kingdom, Australia, and Canada?
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.