The challenges IQNs face

November 1, 2020

Internationally qualified nurses face many challenges when they begin nursing in New Zealand. But there are also opportunities. A research study is looking at both.

Dana TaylorAccording to NZNO, internationally qualified nurses (IQNs) are valued as capable and competent participants in the New Zealand nursing workforce.1

IQNs come to New Zealand with professional experience in their home countries, yet they must cope with transforming their communication style to integrate into the workplace culture here.2 This is an issue because IQNs’ difficulties assimilating at work and becoming members of a nursing team, may challenge their pre-existing identity as experienced health-care workers.

I am currently researching IQNs’ communication experiences and their professional identity and am seeking more research participants. The aim of the research is to develop relevant and applied knowledge of how migrant nurses’ professional identity is transformed through the experience of working in another country. The research aims to benefit IQNs and health-care providers in primary, hospital, and aged care settings.

IQNs in the workforce here seek to gain their peers’ acceptance and recognition.

From my research so far, several themes are emerging. One of the strongest is that IQNs are eager to participate fully in the nursing community despite experiencing difficulties in communication. In this article, I share some of the experiences of three research participants – Lilly, Mons, and Carmel.* These include stories of challenging workplace interactions, such as bullying and misunderstanding, and positive workplace experiences, including leadership opportunities and team membership, as they participants integrate into New Zealand nursing.

Widespread discrimination against IQNs is detrimental to nurses’ professional identity and wellbeing.3

IQNs are often more susceptible than New Zealand-trained nurses to workplace harassment and inequality.4 Carmel’s story of workplace bullying reflects such harassment: “When I was starting, I thought I just keep it to myself. Because [colleagues] will sometimes mock you. ‘Is she really an RN?’ ‘Does she really know what she’s doing?’ I think what I learned on that experience is to speak up for myself. Tell them that I’m doing the right thing. Yes, and to ask that [bullying] co-worker, ‘Why did you do that?'”

Communication breakdowns can result in IQNs encountering challenging workplace interactions.2 Carmel noted that language differences meant that sometimes she could not understand colleagues’ requests. However, she has developed communication strategies to respond appropriately: “I understand English, but sometimes the accent is different. Sometimes I need to ask them what they mean. And then if I don’t understand, I will just [ask], ‘Please repeat it.’ And ‘I’m going to repeat what you said.’ I don’t care if they get annoyed, but I need to be correct.”

IQNs in the workforce here seek to gain their peers’ acceptance and recognition.5 Lilly, a nurse with management responsibilities, is interested in developing team members’ professional skills: “At the moment I am clinical lead. So, my plan is to go higher and higher – maybe clinical manager, or any other, like, educator, or clinical educator, instructor.”

Carmel, too, explained the need for IQNs to learn how to be optimistic and assertive when building rapport with colleagues, for the long-term benefit of staff and patients.6

According to Carmel, “There are also kind, supportive co-workers. And everybody’s different. Be positive. And also have confidence in yourself.”

Research into IQNs’ experiences acculturating to the New Zealand workforce found that, after a period of transition, migrant nurses worked effectively with peers and managers.2 Mons acknowledged the backing of her IQN colleagues: “[We] have been close enough to be able to support each other very strongly in our individual roles. United we stand. It sometimes takes a hard experience to pull through. To get that common ground. Because I said to her, ‘What hasn’t killed us yet is only going to make us stronger’.”

These three IQNs’ demonstration of proactive communication and self-confidence in creating collegial relationships reflects NZNO’s vision for nurses to “work respectfully with colleagues to best meet patient needs”.7

IQN participants in my study have so far shared stories of challenging and positive workplace interactions, which support research findings that IQNs’ collegial conversations impact on their (trans)formation of professional identity.8

In line with other research9, my research so far may have constructive outcomes for their career pathways and health-care facilities’ operations.

* Pseudonymns have been used to protect participants’ confidentiality.

Dana Taylor is head of academic assurance and a lecturer at tertiary provider IPU New Zealand in Palmerston North. Her PhD research (in applied linguistics) is through the College of Humanities and Social Sciences at Massey University, Palmerston North. For further information on the research, or to become a research participant, please contact: danataylorphdproject@gmail.com

References

  1. NZNO. (2017). NZNO policy, regulation & legal: Discussion document on internationally qualified nurses: Immigration and other issues.
  2. Walker, L., & Clendon, J. (2012). A multi-cultural nursing workforce: Views of New Zealand and internationally qualified nurses. Kai Tiaki Nursing Research, 3(1), 4–11.
  3. Garner, S. L., Conroy, S. F., & Bader, S. G. (2015). Nurse migration from India: A literature review. International Journal of Nursing Studies, 52, 1879–1890. https://doi.org/10.1016/j.ijnurstu.2015.07.003
  4. King-Dejardin, A. (2019). The social construction of migrant care work. At the intersection of care, migration and gender. Geneva: International Labour Organization.
  5. Block, D. (2007). The rise of identity in SLA research, post Firth and Wagner (1997). Modern Language Journal, 91(5), 863–876.
  6. Nørgaard, B. (2011). Communication with patients and colleagues. Danish Medical Bulletin, 58(12), 1–20.
  7. NZNO. (2018). New Zealand Nurses Organisation strategy for nursing: Advancing the health of the nation. Hei oranga motuhake mō ngā whānau, hapū, iwi 2018-2023 (PDF, 2.69 MB).
  8. Winkelmann-Gleed, A., & Seeley, J. (2005). Strangers in a British world? Integration of international nurses. British Journal of Nursing, 14(17), 899–906.
  9. Johnson, M., Cowin, L. S., Wilson, I., & Young, H. (2012). Professional identity and nursing: Contemporary theoretical developments and future research challenges. International Nursing Review, 59, 562–569.