Barriers and facilitators to the professional integration of internationally qualified nurses in Australia: A mixed methods systematic review

• Published in: Australian journal of advanced nursing 2024-02, Vol.41 (1), p.39-53
• Main Authors: Correa-Betancour, Marcela, Marcus, Kanchan, Balasubramanian, Madhan, Short, Stephanie D
• Format: Article
• Language: English
• Subjects: Communication; Corporate culture; Cultural competence; Cultural differences; Elder care; Employment; Evaluation; Health care; High income; Industrialized nations; International cooperation; Language proficiency; Licenses; Life expectancy; Mentoring programs; Nurses; Nurses, Foreign; Nursing; Nursing care; Patient safety; Professional development; Racism; Retention; Social integration; Study and teaching; Systematic review; Systematic reviews (Medical research); Training; Workforce
• ISSN: 1447-4328; 0813-0531; 1447-4328
• DOI: 10.37464/2024.411.933

Objective: This review aimed to better understand barriers to and facilitators of the professional integration of internationally qualified nurses (IQNs) in Australia. Background: Nursing shortages are a critical global issue, including developed countries such as Australia, where about 20% of the nursing workforce has been trained overseas. IQNs face many challenges associated with the migration process itself; and their professional integration is crucial in retaining them in the workforce and in maintaining the quality of nursing care in Australia. Study design and methods: This review followed the JBI methodology for mixed methods systematic review. Web of Sciences, Scopus, Informit, ProQuest, Ovid, and Cinahl databases were searched from inception. Qualitative, quantitative, and mixed methods original studies, published in English, were considered. Screening, data extraction and quality assessment were conducted independently by two reviewers. The assessment of methodological quality used the JBI Qualitative Checklist and Checklist for Analytical Cross-Sectional studies, and the data were extracted using the JBI data extraction tool. Disagreements were resolved by a third researcher and the synthesis used a convergent integrated approach. Results: From an initial 110 studies, eight studies were included. Individual and social factors emerged as the main themes. The first theme was analysed in terms of two sub-themes: psychological adaptation plus communication and language. Social factors were analysed in terms of three sub-themes: a) cultural differences in the nursing role; b) support, mentoring and appreciation and c) discrimination and racism. Discussion: psychological adaptation and language proficiency are linked to personal factors. Cultural differences in the nursing role should be addressed with strong support and mentoring programs. Recognition of previous experience and appreciation of pre-existing skills are important facilitators. Discriminatory and racist behaviours continue in the work setting, yet are rarely reported. Conclusion: Discrimination and racism from colleagues, co-workers, and patients should be addressed with a more direct approach than is currently in place. Training of locally and internationally qualified nurses in intraprofessional cultural competence May improve interaction and communication, reduce racism and discriminatory practices, and increase quality of care. Implications for research, policy, and practice: This