Opinion
Valuing internationally educated nurses and diversity in the community nursing workforce Ben Bowers, 1,2 Noor Ul Haq, 3 Amanda Young, 2 Crystal Oldman 2
with NHS England to develop resources for providers employing internationally educated nurses, often for the first time. 11 In 2023, the QNI released a film show- casing the opportunities of working in the community as international nurses. These are useful starting points. However, evidence-based initiatives to develop, nurture and retain internationally educated nurses are needed. The QNI has recently worked with Leeds Commu- nity NHS Health Care Trust to deliver a development programme specifically for internationally recruited nurses. Opportunities for career progression were discussed alongside practical advice on the UK recruit- ment process. The nurses on the programme had all been in the UK for longer than 6 months and they agreed that a period of settling into the NHS was needed before thinking about career progression. The use of person specifications in job descriptions was not culturally familiar and having the opportunity to look at transfer- able skills in alignment with job descriptions was consid- ered very useful. Opportunities for further education and training in community nursing were also reported as being beneficial as this was a new area of clinical prac- tice for many of the internationally educated nurses on the development programme. We have shared some promising initiatives and developments for meaningfully supporting interna- tionally educated nurses in the community. These are primarily pilot projects and resources informed by expert consensus. Further high-quality research is needed to understand what works well in supporting successful transitions and equal career opportunities in community settings, especially from internationally educated nurses’ perspectives. Nothing about us without us applies here; we need to empower and support inter- nationally educated nurses to co-design and lead this important research. Funding Ben Bowers is supported by the Wellcome Trust [225577/Z/22/]. Competing interests None declared. Ethics approval Not applicable. Provenance and peer review Commissioned; internally peer reviewed. © Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ. References 1 Safari K , McKenna L, Davis J. Transition experiences of internationally qualified health care professionals: a narrative scoping review. Int J Nurs Stud 2022;129:104221. 2 Health Foundation . Thinking local and global: exploring the UK’s reliance on international nurses and the impact of COVID-19. 2023. Available: https://www.health.org.uk/news- and-comment/charts-and-infographics/thinking-local-and- global-exploring-the-uks-reliance-on-international-nurses
The contributions of internationally educated nurses are one of our under-recognised strengths in the community health and social care workforce. Interna- tional colleagues possess valuable skills and expertise, multi-cultural perspectives and insights that strengthen patient-centred care and teams. The UK and many high- income countries actively recruit international nurses to meet expanding healthcare needs. 1 2 For example, healthcare services in the UK and Norway employ high proportions of people from overseas 3 4 ; many inter- nationally qualified nurses work in care homes and increasingly in the community. 1 4 But do we really value the diversity and skill set of our international workforce? Sadly, evidence suggests we do not. Many internationally educated nurses experi- ence deskilling and loss of status when they arrive in the UK. 1 5 6 Nurses describe transitioning from highly expe- rienced nurses in their countries of origin to providing predominantly basic care interventions, often working at unregistered nurses level, equivalent to healthcare assistants, with limited opportunities to use their clin- ical expertise and progress their careers. 5 6 Experiences of discrimination in the workplace, being marginalised, undervalued and overlooked by managers and nursing colleagues are all too commonplace in published studies. 1 3 6 7 Adjusting to new healthcare cultural norms, language differences and colloquialisms in new host countries takes time. Some clinical interventions and interac- tions with families, including relatives’ roles and social responsibilities in providing care, can be very different from international nurses’ countries of origin. This can come as a culture shock, especially in palliative and end- of-life care situations. The responsibility for supporting successful transitions and equal opportunities for inter- national nurses lies with employers, managers and colleagues. Ugiagbe et al 8 (2023) highlight how this support is uneven or inadequate. Research to date consistently recommends insti- gating a range of concurrent strategies to value cultural diversity and support workplace integration. This includes preceptorship programmes, continual learning and career development opportunities, workshops for all staff on working cross-culturally and valuing diver- sity, alongside tailored long-term mentorship and buddy schemes for international nurses. 1 6 9 NHS England, NHS Employers and numerous NHS Trusts are working together to support, develop and retain international educated nurses in different ways. These initiatives include the International Nurses’ Recruitment Toolkit, 10 Stay and Thrive programme and Pastoral Support Quality Award. Recognising the need to act and better support inter- national nurses in adjusting to working in the commu- nity, The Queen’s Nursing Institute (QNI) partnered
10.1136/ebnurs-2024-104158
1 Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK 2 Queen’s Nursing Institute, London, UK 3 Leeds Community Healthcare NHS Trust, Leeds, UK
Correspondence to: Dr Ben Bowers; b b527@ medschl.c am.ac.u k
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Evid Based Nurs Month 2024 | volume 0 | number 0 |
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