Integration of internationally educated nurses (IENs) in the workplace over the long term, has not been a clear focus in nursing. The role of the employer organization in facilitating workplace integration for IENs has also not been emphasized in research. The overall aim of this paper is to highlight findings from an instrumental qualitative case study research informed by critical social theory, which examined workplace integration of IENs. The study explored what is meant by 'integration' and how the employer organizational context affects workplace integration of IENs. A purposeful sample of twenty-eight participants was involved. The participants included: stakeholders from various vantage points within the case organization as well as IENs from diverse backgrounds who were beyond the process of transitioning into the Canadian workplace-they had worked in Canada for an average of eleven years. Four methods of data collection were used: semi-structured interviews; socio-demographic survey; review of documents; and focus group discussions (FGDs). Thematic analysis methods guided the within subcase analysis first, followed by an across subcase analysis. FGDs were used as a platform for member-checking to establish the credibility of study findings. The resulting definition and conceptual framework point to workplace integration of IENs as a two-way process requiring efforts on the part of the IENs as well as the employer organization. This paper elaborates on selected themes of how beyond transition, workplace integration entails IENs progressing on their leadership journey, while persevering to overcome challenges. Organizational factors such as workforce diversity, leadership commitment to equity and engagement with the broader community serve as critical enablers and the importance of workplaces striving to avoid common pitfalls in addressing the priority of IEN integration are also discussed. This paper concludes with implications and key considerations for workplace integration of IENs.
This paper presents findings from a qualitative case study that explored long term integration of internationally educated nurses in an Ontario healthcare facility. Using critical social theory as the philosophical underpinnings for this research, we selected the case based on the hospital’s history of employing and supporting internationally educated professionals. Data sources included: documents review, twenty-eight interviews, socio-demographic survey and five focus groups involving IENs and other stakeholders. An overarching theme points to a ‘two-way’ notion of workplace integration whereby efforts are required on the part of the employer as well as the IENs. An in-depth analysis of the data reveals sub-processes of two-way integration: respecting diversity and difference, adopting inclusive practices and striving to achieve equity. Challenges in achieving two-way integration are discussed. Implications for nursing leaders to tap into IENs’ diverse talents for the benefit of their local healthcare systems are highlighted.
The inequitable distribution of nurses globally compels high-income countries like Canada to ensure that internationally educated nurses gain professional satisfaction and stay in nursing. To fill a critical gap in nursing literature, the authors conducted a qualitative case study of an inner-city teaching hospital in Canada, to examine workplace integration of IENs beyond the transition phase. They found that workplace integration is a “two-way” process, which has implications for interventions at both the individual IEN and organizational levels. The workplace organizational context requires deliberate “policies promoting equity principles” and when an IEN is integrated, s/he has worked hard to go beyond the transition phase and get recognized as “a Canadian nurse with international experience”. Understanding these individual and organizational factors is essential for how nurses educated in another country especially in the global south, can be successfully integrated in healthcare settings in the global north.
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