Experiences of nurses educated outside the European Union of a Swedish bridging program and the program’s role in their integration into the nursing profession: a qualitative interview study

Abstract

Background Countries all over the world are experiencing a shortage of registered nurses (RNs). Therefore, some countries, including Sweden, have tried to solve this by recruiting internationally educated nurses (IENs). Countries offer bridging programs as educational support to qualify IENs for nursing work in the destination country. However, there is little research on IENs’ experiences of bridging programs in European countries and how these programs facilitate their integration into the world of work and their new society. The aim of this study is to explore the experiences of nurses, originally educated outside the EU (European Union)/EES, of the Swedish bridging program and of the program’s role in facilitating their integration into the nursing profession in Sweden. Methods A qualitative descriptive design was used to explore the topic based on 11 informants’ perspectives and experiences. Purposive sampling was used to recruit participants at one university in Sweden. Data were collected by individual interviews using a semi- structured interview guide during the year 2019 and were analysed using an interpretative thematic approach. Results Two main themes emerged from the analysis: 1) Return to nursing, and 2) The bridging program as a tool for transition to nursing in Sweden. The first theme includes conditions and experiences such as personal motivation and determination, and support from others that the participants described as important in order to achieve the goal of re-establishing themselves as registered nurses in Sweden. Furthermore, the second theme describes the participants’ experiences of the bridging program as mostly positive because it led to new learning and achievements that were valuable for the transition to nursing in Sweden; however, the participants also emphasised the challenges of their transition into the nursing profession, which were related to instances of misrecognition of their professional competence and the uncertain outcome of the program. Conclusions This study found that the bridging program facilitated integration into the nursing profession for nurses educated outside the EU/EES, especially knowledge gained in clinical-based training. Thus, it is important to recognise and value the IENs’ experience and previous knowledge and training when developing the bridging program’s curriculum.

Nurse leaders' perceptions of competence‐based management of culturally and linguistically diverse nurses: A descriptive qualitative study

“…Bridging programmes have successfully facilitated the integration of CALD nurses into relevant work environments (Hadziabdic et al, 2021). Intraorganisational, socio-cultural and professional development strategies and models which support CALD nurses' integration into healthcare organisations have also been established (Kamau et al, 2022).…”

“…Many countries, particularly in the Organisation for Economic Co‐operation and Development countries (OECD), rely on internationally educated nurses to ease shortages of healthcare professionals (Hadziabdic et al, 2021; OECD, 2019; Primeau et al, 2021). The number of internationally educated nurses working in OECD countries increased by 20% between 2011 and 2016 (OECD, 2019), making the demographic profile of today's nursing workforce diverse in terms of nationalities, cultures and religions (Meretoja et al, 2015).…”

Nurses’ experiences of a recertification process involving a series of examinations to obtain a nursing license in a new country

“…Previous research on IENs' experiences of the recertification process has, however, mainly been conducted in English-speaking countries such as Canada (Covell et al, 2015;Salami et al, 2018), the US (Liou & Cheng, 2011), the UK (Allan & Westwood, 2016) and Australia (Chun Tie et al, 2019), which differ from the Nordic countries in, for example their language, culture, migration policies, recertification processes and the nursing profession. Furthermore, there has been some research on bridging programmes (Hadziabdic et al, 2021;Högstedt et al, 2021), but less on IENs who undergo recertification mainly by taking examinations to obtain a nursing license. Thus, the focus here is to expand the knowledge of how IENs experience the recertification process when undergoing a series of examinations to test their nursing knowledge and skills and, thereby, obtain a Swedish nursing license.…”

“…Australia, Canada, the UK, Sweden), IENs are offered some kind of educational programme, for example bridging programmes, competency-based assessment programmes and overseas nurse programmes. These programmes have been shown to help IENs in their professional recertification (Chun Tie et al, 2019;Covell et al, 2018;Hadziabdic et al, 2021;Högstedt et al, 2021), however, not all countries offer these programmes, and not all IENs are able to attend a programme. In Sweden, IENs from non-EU countries can, after approval from the Swedish Board of Health and Welfare (SBHW), choose between two paths to obtain a Swedish nursing license: complete a series of examinations or complete a 1year full-time bridging programme (Figure 1).…”

“…Earlier qualitative research has mostly focused on recertification through additional training, for example bridging programmes (e.g. Hadziabdic et al, 2021), or studies describing the recertification process more briefly; covering both the experience of migrating to a new country, recertification and working as a nurse in the new country (e.g. Higginbottom, 2011), or studies describing a mix of different paths of recertification (e.g.…”