Internationally Educated Nurses and Resilience: A Systematic Literature Review

Overview

Journal Int Nurs Rev

Specialty Nursing

Date 2022 Jul 22

PMID 35868023

Authors

Kari Dahl

Line Nortvedt

Judith Schroder

Ann Kristin Bjornnes

Affiliations

Soon will be listed here.

Abstract

Aim: To synthesize knowledge extracted from the literature about protecting factors and challenges to resilience, among migrant nurses, and specifically how knowledge synthesized through the process of the literature review is relevant to nursing and health policy.

Background: How nurses, in general, face challenges is well documented and is often linked to the concept of resilience; however, there seems to be a lack of systematic knowledge synthesis focusing on the resilience of internationally educated nurses following migration.

Method: The review was guided by the PRISMA guidelines, and a systematic search of peer-reviewed qualitative and mixed-method articles reporting empirical research was performed in the MEDLINE, CINAHL, PsycINFO and Academic Search Ultimate databases. Methodological rigour was assessed by the Joanna Briggs' checklist, and a structured theme-based ecological framework, inspired by Ungar's model of resilience, was chosen.

Results: Following critical appraisal, 37 studies were included that identified both challenges and individual, contextual and structural protective factors in host countries and are linked to resilience.

Discussion: Resilience of internationally educated nurses depends on a combination of individual and contextual protective factors, with the major emphasis being placed on individual protective factors. It is crucial to consider resilience in ensuring that internationally educated nurses' experience is appreciated, as this is necessary if nurses are to deliver the best possible health service while integrating into their host country.

Implication For Nursing And Health Policy: Authorities, managers in clinical practice and education, trade unions and nurses in general should be aware of the coping strategies, the strengths and supportive factors that can promote resilience and be aware of the challenges that undermine resilience and negatively impact internationally educated nurses' practice and social interactions.

Citing Articles

Retention of international nurses in receiving country: Voices of Indonesian nurses in Japanese healthcare facilities.

Efendi F, Has E, Pradipta R, Houghty G, Oda H, Tsujita Y Int J Nurs Sci. 2025; 12(1):3-11.

PMID: 39990985 PMC: 11846551. DOI: 10.1016/j.ijnss.2024.12.008.

Impact of immigration-specific stress on safety attitudes: a national cross-sectional study on overseas qualified nurses in Japan.

Chang X, Gu X BMJ Open. 2025; 15(1):e088329.

PMID: 39832963 PMC: 11752004. DOI: 10.1136/bmjopen-2024-088329.

Relationship between transition shock, resilience, career calling, and retention intention among new nurses: a moderated mediation model.

Xin D, Li W, Zhu W, Li M, Xu N, Yue L BMC Nurs. 2024; 23(1):873.

PMID: 39623415 PMC: 11613888. DOI: 10.1186/s12912-024-02555-y.

Hope, passion and perseverance: experiences of internationally educated nurses pursuing nursing authorisation in Norway-a qualitative study.

Lillekroken D, Nortvedt L BMC Nurs. 2024; 23(1):637.

PMID: 39256762 PMC: 11389265. DOI: 10.1186/s12912-024-02297-x.

Internationally recruited nurses and their initial integration into the healthcare workforce: A mixed methods study.

Pressley C, Newton D, Garside J, Stephenson J, Mejia-Olivares J Int J Nurs Stud Adv. 2024; 5:100154.

PMID: 38746581 PMC: 11080417. DOI: 10.1016/j.ijnsa.2023.100154.

References

Choi M, Cook C, Brunton M . Power distance and migrant nurses: The liminality of acculturation. Nurs Inq. 2019; 26(4):e12311. DOI: 10.1111/nin.12311. View

Al-Hamdan Z, Al-Nawafleh A, Bawadi H, James V, Matiti M, Hagerty B . Experiencing transformation: the case of Jordanian nurse immigrating to the UK. J Clin Nurs. 2015; 24(15-16):2305-13. DOI: 10.1111/jocn.12810. View

Magnusdottir H . Overcoming strangeness and communication barriers: a phenomenological study of becoming a foreign nurse. Int Nurs Rev. 2005; 52(4):263-9. DOI: 10.1111/j.1466-7657.2005.00421.x. View

Lin L . Filipina nurses' transition into the US hospital system. J Immigr Minor Health. 2013; 16(4):682-8. DOI: 10.1007/s10903-013-9793-9. View

Allen L . Experiences of internationally educated nurses holding management positions in the United States: Descriptive phenomenological study. J Nurs Manag. 2018; 26(5):613-620. DOI: 10.1111/jonm.12591. View

Liou S, Cheng C . Experiences of a Taiwanese nurse in the United States. Nurs Forum. 2011; 46(2):102-9. DOI: 10.1111/j.1744-6198.2011.00211.x. View

Xu Y, Gutierrez A, Kim S . Adaptation and transformation through (un)learning: lived experiences of immigrant Chinese nurses in US healthcare environment. ANS Adv Nurs Sci. 2008; 31(2):E33-47. DOI: 10.1097/01.ANS.0000319570.99254.e5. View

Aburn G, Gott M, Hoare K . What is resilience? An Integrative Review of the empirical literature. J Adv Nurs. 2016; 72(5):980-1000. DOI: 10.1111/jan.12888. View

Ungar M . The social ecology of resilience: addressing contextual and cultural ambiguity of a nascent construct. Am J Orthopsychiatry. 2011; 81(1):1-17. DOI: 10.1111/j.1939-0025.2010.01067.x. View

10.

Yi M, Jezewski M . Korean nurses' adjustment to hospitals in the United States of America. J Adv Nurs. 2000; 32(3):721-9. DOI: 10.1046/j.1365-2648.2000.01533.x. View

11.

Iheduru-Anderson K, Wahi M . Experiences of Nigerian Internationally Educated Nurses Transitioning to United States Health Care Settings. J Transcult Nurs. 2018; 29(6):603-610. DOI: 10.1177/1043659618766225. View

12.

Eriksson E, Engstrom M . Internationally educated nurses' descriptions of their access to structural empowerment while working in another country's health care context. J Nurs Manag. 2018; 26(7):866-873. DOI: 10.1111/jonm.12617. View

13.

Winkelmann-Gleed A, Seeley J . Strangers in a British world? Integration of international nurses. Br J Nurs. 2005; 14(18):954-61. DOI: 10.12968/bjon.2005.14.18.19880. View

14.

Elo S, Kyngas H . The qualitative content analysis process. J Adv Nurs. 2008; 62(1):107-15. DOI: 10.1111/j.1365-2648.2007.04569.x. View

15.

Salami B, Meherali S, Covell C . Downward occupational mobility of baccalaureate-prepared, internationally educated nurses to licensed practical nurses. Int Nurs Rev. 2017; 65(2):173-181. DOI: 10.1111/inr.12400. View

16.

Alexis O, Shillingford A . Exploring the perceptions and work experiences of internationally recruited neonatal nurses: a qualitative study. J Clin Nurs. 2011; 21(9-10):1435-42. DOI: 10.1111/j.1365-2702.2011.03922.x. View

17.

Rodriguez G, Angelica-Munoz L, Hoga L . Cultural experiences of immigrant nurses at two hospitals in Chile. Rev Lat Am Enfermagem. 2015; 22(2):187-96. PMC: 4292601. DOI: 10.1590/0104-1169.2980.2401. View

18.

Alonso-Garbayo A, Maben J . Internationally recruited nurses from India and the Philippines in the United Kingdom: the decision to emigrate. Hum Resour Health. 2009; 7:37. PMC: 2680394. DOI: 10.1186/1478-4491-7-37. View

19.

Niitsu K, Houfek J, Barron C, Stoltenberg S, Kupzyk K, Rice M . A Concept Analysis of Resilience Integrating Genetics. Issues Ment Health Nurs. 2017; 38(11):896-906. DOI: 10.1080/01612840.2017.1350225. View

20.

Abdolrahimi M, Ghiyasvandian S, Zakerimoghadam M, Ebadi A . Therapeutic communication in nursing students: A Walker & Avant concept analysis. Electron Physician. 2017; 9(8):4968-4977. PMC: 5614280. DOI: 10.19082/4968. View