Foreign-born nurses as COVID-19 survivors in the Nordic region: A descriptive phenomenological study.

OBJECTIVE: In 2020, amid limited COVID-19 vaccination access, many nurses from Black, Asian and Minority Ethnic (BAME) groups in the United States of America and United Kingdom succumbed to the virus. No fatalities among Filipino foreign-born nurses (FBNs) in the BAME groups were recorded in the Nordic region. This study explored the experiences of Filipino FBNs in the Nordic region who, during the initial 2020 pandemic wave, cared for COVID-19 patients, contracted the virus and subsequently recovered. METHODS: The research employed a descriptive phenomenological methodology to explore the experiences of six Filipino FBNs who had recovered from COVID-19 in various regions of the Nordic countries, including Finland (n = 1), Sweden (n = 1), Denmark (n = 2), Norway (n = 1) and Iceland (n = 1). Data collection occurred through online videoconferencing between September 2020 and February 2021, utilising a semi-structured approach. The data analysis was conducted following Sundler and colleagues' qualitative thematic analysis, which is grounded in descriptive phenomenology. RESULTS: The data analysis yielded three primary themes and twelve sub-themes, which explored the experiences of Filipino FBNs with COVID-19 infection. The study demonstrated that unclear national guidelines impacted nurses' preparedness in caring for COVID-19 patients, contributing to their susceptibility to contracting the virus. The lack of occupational healthcare services for nurses during and after the pandemic affected their work morale in an unfamiliar setting. CONCLUSION: The study provided valuable insights into the experiences of Filipino FBNs during the COVID-19 pandemic, emphasising the need for clearer guidelines, enhanced training and improved support for healthcare workers. It highlighted the psychological impact of COVID-19, emphasising the importance of mental health support and stigma reduction efforts. The study also emphasised the significance of improving occupational health services to support the well-being and recovery of healthcare workers during and after the pandemic, with implications for developing comprehensive strategies to protect frontline healthcare workers in health crises.

Innovative nursing employment initiatives to strengthen and sustain the health workforce in Canada.

Health systems worldwide are at a critical juncture due to an increasing demand for health services and a diminishing pool of health human resources. While COVID-19 exacerbated nursing deficits, the need to strengthen and sustain the health workforce in Canada was evident decades prior and supported by numerous studies that warned of significant shortages. Post pandemic, building health system capacity has become paramount. This article examines innovative nursing employment initiatives in Canada. It provides a snapshot of federal, provincial and territorial approaches, with a particular focus on Internationally Educated Nurses (IENs) due to burgeoning interest in and competition for their skills and services. However, recognizing that health human resource planning is a persistent challenge, further initiatives are suggested. These include complementary policy development to improve retention and policy frameworks that support proactive long-term strategies to address the cyclical shortage of nurses.

A critical race analysis of structural and institutional racism: Rethinking overseas registered nurses' recruitment to and working conditions in the United Kingdom.

Language tests for overseas registered nurses (ORN) working outside their home country are essential for patient safety, as communication competency needs to be established in any workforce. We argue that the current employment of existing language tests is structurally and institutionally racist and disadvantages ORNs from non-European Union (EU) and non-White countries seeking to work in the United Kingdom. Using Critical Race Theory (CRT), we argue that existing English language tests for ORNs seeking registration in the United Kingdom are discriminatory due to the UK's racist migration policies and a regulatory body for nursing and midwifery that fails to acknowledge and understand its own institutionally racist practices.

Attending to our conceptualisations of race and racism in the pursuit of antiracism: A critical interpretative synthesis of the nursing literature.

Race and racism are matters of urgent concern for the international nursing community. Recent global events have presented the discipline with an opportunity to generate and sustain long overdue discussions. However, with this opportunity comes a need to consciously attend to what we mean by race and racism, especially in the context of the nursing literature. Indeed, the development of antiracism depends on how we conceptualise race and racism; it is these conceptualisations that actively shape the scope and priorities of antiracist organising and action. The aim of this critical interpretative synthesis (CIS) is to examine conceptualisations of race and racism in the nursing literature by drawing on contemporary race scholarship. The synthesis of diverse literature is enabled through the explorative and expansive process of the CIS method. This review generates three synthesising arguments-a problem 'of' not 'for'; conceptual inconsistencies and drift; and reliance on the lens of experience-that both critique and contribute to the nursing literature. In the pursuit of antiracism, this article urges us to pay close attention to our conceptualisations of race and racism by illuminating the pitfalls that occur when our conceptualisations are inconsistent, contradictory, or simply neglected.

Changes in NMC language proficiency standards will benefit everyone.

Sam Foster, Chief Nurse, Oxford University Hospitals, welcomes the outcome of the nursing regulator's review of English language requirements for international nurses seeking registration in the UK.

Faculty experiences of teaching internationally educated nurses: a qualitative study.

OBJECTIVES: The aim of this study was to explore the experiences of faculty teaching in programs designed to support internationally educated nurses' transition to nursing practice in Canada. METHODS: This was a qualitative study that gathered data through semi-structured interviews. RESULTS: Four themes were developed from the data: learning the learner, feeling moral unrest in my role, inviting reciprocal relationships, and finding our way. CONCLUSIONS: There is an urgent need to ensure that faculty are well prepared for their role and that the needs of internationally educated nurses, both personal and pedagogical, are central. Despite the challenges experienced by faculty, they also describe great growth as a result of their new role. IMPLICATIONS FOR AN INTERNATIONAL AUDIENCE: Findings from this study are particularly relevant for those in high income countries seeking to support internationally educated nurses. Faculty preparedness and holistic support for students are critical for ethical, high-quality education.

Building research capacity and culture: Exploring nurses' experience of implementing a nurse-led clinical trial.

AIM: To explore the experiences of a nursing team who implemented an international nurse-led clinical trial in practice and understand the facilitators to their involvement. BACKGROUND: The role and responsibilities of the clinical nurse are advancing to encompass research activity to help inform evidence-based practice. However, several personal and organisational challenges can inhibit nurses' capacity to implement and undertake research within clinical practice. METHODS: Three focus groups were conducted with members of a nursing team (N = 18). Thematic analysis was employed, and themes were identified and agreed upon by the research team. RESULTS: Five themes were identified: 'Previous experience of and attitudes to participation in clinical research', 'Decision-making regarding participation in the clinical trial', 'Facilitators of participation in the clinical trial', 'Challenges of research in nursing practice' and 'Future orientation towards research'. CONCLUSION: Through their experiences of implementing a nurse-led clinical trial within practice, nurses recognized a number of facilitators and challenges to their participation. The perceived relevance of the clinical trial to the nurses' practice, potential to improve patient care and appreciation of the nurse leader's expertise and understanding of their context were key motivators. Reciprocal trust with the nurse leader who was encouraging, motivating, supportive and accessible resulted in the engagement and commitment of the nursing team. IMPLICATIONS FOR NURSING MANAGEMENT: This paper offers a perspective that can inform senior nursing management teams when implementing and conducting evidence-based research amongst nursing teams and in doing so meet the needs of developing research capacity amongst clinical nurses.

International Nurses Day: Nurses can change the world, given the investment and support they deserve.

Every year on International Nurses Day (IND), the International Council of Nurses (ICN) releases a report with resources that can be used by nurses around the world. This year's report responds to the World Health Organization's (WHO) latest strategy for nursing and midwifery, and the findings of the State of the World's Nursing report. In this article, ICN Chief Executive Officer Howard Catton describes the main points of the IND report and recommends that nurses everywhere read it, alongside the WHO strategy, and use that information to increase their knowledge of the global nursing workforce and influence global healthcare policy. It is a toolkit that can assist nurses, other healthcare providers, governments and international organisations to turn global strategy into meaningful local action and improved clinical practice on the ground.

Surviving the employment gap: a cross-sectional survey of internationally educated nurses.

AIM: To examine the extent to which the type of financial assistance (personal resources, social programmes and earnings) and source country influence the length of time for internationally educated nurses to secure employment as regulated nurses in Canada. BACKGROUND: Internationally educated nurses must professionally recertify in order to work as regulated nurses in Canada. For many, it can be a lengthy, cumbersome and costly process that delays employment, while others recertify and secure employment quickly. Financial assistance in the form of personal resources, or from social programmes or earnings from working could contribute to the length of time to recertify. When internationally educated nurses cannot readily recertify, they turn to survival jobs where they can remain and never practice their profession in Canada or leave the country to work in jurisdictions where it easier to obtain professional credentials. METHODS: Data were collected via cross-sectional survey of internationally educated nurses (n = 1186) who were immigrants, permanent residents and employed as regulated nurses. Multiple linear regression was employed to examine the influence of the type of financial assistance (personal resources, social programmes and earnings) and source country on time to regulated nurse employment. RESULTS: Regression model explained 9.3% of variance in time to regulated nurse employment. Three predictors were statistically significant: source country, social programmes and earnings. Personal resources was not a significant predictor. CONCLUSION: Financial assistance helps internationally educated nurses survive the regulated nurse employment gap. The type of financial assistance and source country influences the length of time to regulated nurse employment. IMPLICATION FOR NURSING AND SOCIAL POLICY: Provides initial evidence to support the development of policies, and educational and social programmes to assist internationally educated nurses with financially surviving the gap in regulated nurse employment.

International nurse education leaders' experiences of responding to the COVID-19 pandemic: A qualitative study.

AIMS: To explore the experiences of strategic leads for nurse education as they sought to respond to the COVID-19 pandemic. DESIGN: We utilised a qualitative interpretative approach to explore education leaders' experiences of leading during the early months of the pandemic. METHODS: Nineteen leaders with significant strategic responsibility for nurse education in Australia, Canada, New Zealand, Singapore and the United Kingdom were identified via purposive sampling and agreed to participate. Interviews were held between May and July 2020. RESULTS: Four overarching themes arose from the analysis: (1) Crisis driven adaptability & flexibility; (2) Responsive, complex and changing communication; (3) Making decisions for student and staff safety; (4) Looking to the future; stronger partnerships. CONCLUSION: Internationally, while nursing education leaders faced different problems, they shared a common goal amidst the crisis to remain student-centred. They demonstrated they were able to face major challenges, respond to large scale logistical problems and make decisions under significant and ongoing pressure. IMPACT: In responding to the pandemic, nurse leaders shared knowledge and offered mutual support. This bodes well for future collaboration. The move to online learning accelerated an existing trend and it seems likely that this will continue. Given the pressures they experienced over an extended period, the sector may wish to consider how it prepares and supports existing and future leaders.

The experiences of foreign-educated nurses in Japan: a systematic review.

AIM: To conduct a systematic review to understand the experiences of foreign-educated nurses in Japan. BACKGROUND: The experiences of foreign nurses in host countries, and the challenges they face, have been widely investigated around the world. However, no systematic review has focused on the experience of foreign-educated nurses in Japan. METHODS: A systematic literature review was conducted by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines. Japan Medical Abstract Society, Citation Information by National Institute of Informatics, Cumulative Index to Nursing and Allied Health Literature, and PubMed databases were used for the literature search. Inclusion criteria were research articles published between 2013 and 2020 written in Japanese or English. A quality assessment was performed using Version 2018 of the Mixed Methods Appraisal Tool. Selected articles were read repeatedly, and relevant contents were extracted and summarized thematically. RESULTS: Twenty-five studies were selected for the review. The themes generated included (1) reasons for nurses to come to Japan, (2) experiences and current situations among the Economic Partnership Agreement nurses/nurse candidates living in Japan, and (3) experiences and current situation of nurses who had returned to their home countries. The second theme was classified into four categories: language and communication barriers, low pass rates for the national qualification exam, adaptation to workplaces and social environments, and psychological distress. CONCLUSION: Foreign nurses in Japan face various challenges and difficulties, even after they return to their home countries. Solving these problems may improve the wellbeing of foreign-educated nurses in Japan. IMPLICATIONS FOR NURSING POLICY: The results from the current review highlight the necessity for immediate intervention by policymakers to improve the current support system for Economic Partnership Agreement nurses/nurse candidates. A thorough pre-arrival orientation should be provided for the nurse candidates to able them to make a well-informed choice.

International Nurses Day 2021 literary contribution: At a fork in the research journey: a poem in resistance to publishing in highly ranked journals.

In celebration of International Nurses Day 2021 and in critique of scholars who are driven to publish as many articles as possible in highly ranked journals, a short poem is offered here. This poem has resonance for the scholarly world in terms of questioning why we keep trying to be seen as successful scholars in the eyes of others employing a publish or perish mentality rather than pursuing the true purpose of our scholarly existence. The author asks nurses, 'Why are you doing science'?

Nursing beyond the pandemic: Resilience and determination will shape our future options.

The years 2020-21 have been significant for nurses, midwives and all healthcare professionals across the world. While nurses and midwives faced immense pressure and challenges in performing their roles, the pandemic has contributed to bringing a spotlight to the work that nurses, midwives do and the significance of that work. In this article, the author introduces herself as the Editor-in-Chief of International Nursing Review and shares her vision for the journal.

COVID-19: Looking to the future of nursing: innovations & policy recommendations.

The impressive work of nurses, midwives and other health and emergency workers is far from over in the COVID-19 pandemic. But opportunities to learn from adversity are being explored and enacted in many settings and locations. Many ideas, opinions, research findings, innovations in practice, and policy recommendations are described in this Special Issue of International Nursing Review, The Official Journal of the International Council of Nurses in Switzerland. The contents will help inform educators, policymakers, health reformers, researchers, governments, leaders and practitioners about nursing's future. On International Nurses Day 2021, we dedicate this issue to the memory of the yet unknown number of nurses and midwives around the world who have died during this pandemic.

Factors associated with the recruitment of foreign nurses in Japan: a nationwide study of hospitals.

BACKGROUND: Nurse migration under bilateral agreements is a recent global trend, although lack of consultation with the health industries has led to challenges in the recruitment of foreign nurses by hospitals. To analyze the prevailing perception of hospitals on the Economic Partnership Agreement (EPA), under which Japan opened the doors to foreign nurses, we surveyed hospitals that are yet to employ foreign nurses. METHODS: An anonymous questionnaire was developed and distributed to eligible hospitals; it assessed managers' perception of Japan's policy on the recruitment of foreign nurses and their intentions to hire foreign nurses under the EPA (hereafter called EPA nurses). We randomly selected 1879 hospitals, or 22% of the hospitals in Japan (n = 8540), with more than 20 beds. We used descriptive statistics, a Chi-square test, and logistic regression analysis to identify the predictors and developed a model to predict the likelihood of their intention to recruit EPA nurses in the future. RESULTS: In total, 432 hospitals were eligible for further analysis (response rate: 22.9%). Half (50%) of the hospital managers were considerably interested in Japan's policy on recruiting EPA nurses, although only 20% intended to recruit EPA nurses in the future. Willingness to recruit EPA nurses was associated with the degree of interest in the policy (OR 9.38; 95% CI 4.42-19.90) and managers' perception of EPA nurses (OR 5.32, 95% CI 2.38-11.89). CONCLUSIONS: To attract more hospitals to recruit foreign nurses, it is essential for the Japanese government and the sending countries to review their EPA systems. Utilizing returning nurses to assist language acquisition by the forthcoming EPA nurses could be a provisional solution. For a more fundamental solution, long-term provision, from prior to their migration until their return migration, is needed to encourage brain circulation, as opposed to brain drain, between sending and receiving countries.

A courageous journey: Experiences of migrant Philippine nurses in Norway.

AIMS AND OBJECTIVES: To explore how Philippine-educated nurses explain their choice of Norway as their migration destination and their experience with the credential assessment process in Norway. BACKGROUND: Norway has an increasing need for nurses, and nurses educated in non-EU countries are an important resource for the Norwegian health service. Philippine nurses compose the largest group of internationally educated nurses from outside the EU, but their Philippine nursing education is only credited as equivalent to 2 years in Norway. Migration is known to engender stressful experiences amongst migrant nurses, which may affect their health. However, studies on Philippine nurses' experiences of migrating to and working in Norway are lacking. DESIGN AND METHODS: The study used a hermeneutic design, conducting qualitative research interviews with ten Philippine nurses. All of them had a certification as auxiliary nurses, but not as registered nurses. The Consolidated Criteria for Reporting Qualitative Research is used. RESULTS: The nurses' choice of a migration country appeared to be both random and based on the opportunity to find well-paid work, as well as having acquaintances who had already migrated to Norway. The migrated Philippine nurses seemed experienced and competent. In Norway, they were disappointed as they felt undervalued. The nurses struggled to learn Norwegian, while striving for survival when acquiring jobs or accommodations. They were excluded from acting as legal nurses in the Norwegian healthcare system; they fulfilled the governmental requirements, but they were repeatedly rejected. The informants saw this as harsh, but still hoped to be successful. CONCLUSIONS: There is a need to facilitate effective language training and a well-founded, predictable system of credentialing. RELEVANCE TO CLINICAL PRACTICE: Attention should be paid to the integration of immigrants and safeguarding and strengthening the professional competence the nurses bring with them.

Overseas recruitment activities of NHS Trusts 2015-2018: Findings from FOI requests to 19 Acute NHS Trusts in England.

Migrant nurses form an increasing proportion of the nursing workforce, with the United Kingdom (UK) being the third most popular destination for overseas nurses in the world. The migrant nurse workforce is highly susceptible to policy changes at the macro or professional level of the donor and recipient countries. Freedom of information requests were issued to 19 National Health Service [NHS] Trusts in England to determine their involvement in overseas nurse recruitment activity from 1998 onwards. These indicate a notable shift away from active European Union (EU) recruitment and towards overseas countries particularly the Philippines and India. Reasons given were as follows: diminishing returns from EU sources, high attrition among EU nurses and the introduction of English language tests for EU nurses in July 2016. This led to Trusts revisiting their recruitment strategies by increasing more direct/less resource-intensive methods and expanding their focus outside of the EU. Trusts frequently utilised private recruitment companies for their recruitment drives, including consulting and influencing the Trusts' workforce strategies. Policy adjustments have numerous influences on the composition of the overseas nursing workforce. While the NHS continues its efforts in expanding its international nursing workforce, this should not be at the expense of ethical and sustainable recruitment practices, which may be compromised indirectly as a result.

A model operationalizing sustainability in global nursing.

BACKGROUND: The concept of sustainability has received growing attention since the adoption of the United Nations' (UN) Sustainable Development agenda. Yet, in the context of sweeping changes regarding the status and profile of global nursing, sustainability has not been fully conceptualized. PURPOSE: To explore the concept of sustainability in global nursing in order to develop an operational definition and model. METHODS: Concept analysis using Rodger's Evolutionary method to explicate the term "sustainability" in a global nursing context. FINDINGS: Key features of sustainability were described. Existing models of global nursing focus on partnerships and lack a clear conceptualization and integration of sustainability. An operational definition and model of sustainability in global nursing were developed. DISCUSSION: Evolutionary review and analysis led to clarity in operationalizing sustainability in global nursing. The definition and model compliment existing models and provide a road map for global nursing to contribute toward the UN Sustainable Development agenda.

Recency of Practice and the Maintenance of Professional Competence for Nurses and Midwives: A Scoping Review Protocol.

Australian and international nursing regulators have specific requirements for continuing competence and the professional, safe practice of nurses and midwives. Requirements can dictate duration of practice, time away from/recency of practice, revalidation policies, and time between study program completion and practice commencement. Requirements vary between contexts and are periodically updated. To identify and examine Australian and international evidence for best regulatory practices relating to recency and the maintenance of professional competence among nurses and midwives, a scoping review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews will be undertaken. This protocol details the scope, inclusion criteria, and methodology that will guide the scoping review, which will inform an update to the Nursing and Midwifery Board of Australia's Registration Standard: Recency of Practice.

International Nursing: A Study of Sleep Quality Among Nurses and Its Correlation With Cognitive Factors.

The objective of this study was to evaluate sleep quality and its relationship to cognitive factors among nurses. Sleep quality among nurses is an important issue, which requires more extensive study. Its correlation with cognitive ability has not been sufficiently considered. Five hundred forty nurses (66.3% female) working in 6 hospitals were selected as the sample of the study. Results show that nurses do not experience good quality of sleep. That is, 77.4% of the sample population of nurses have a poor quality of sleep, and nurses working the night shift have more sleep problems than other nurses. The results show that there is a relationship between dysfunctional beliefs and attitudes about sleep and metacognitive process and the quality of sleep, and that these variables can predict sleep quality. Based on the results of the study, it can be said that cognitive and metacognitive processes play an important role in sleep quality. Lack of sufficient sleep can create numerous problems for nurses and patients. Attention to the role of cognitive and metacognitive processes can help improve the sleep quality of nurses.