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The nursing profession in Greenland, particularly in rural and remote areas, faces challenges due to geographical limitation and a lack of interdisciplinary collaboration. The registration process and status of internationally educated nurses (IENs) in Greenland are unclear. This article aimed to analyze existing policies and propose recommendations for an independent registration process for IENs in Greenland. A qualitative discourse analysis was used to critically discuss existing policies and regulations governing nursing registration in Greenland. Relevant legislation, government reports, and official documents were reviewed. Legislative regulations protect the title of registered nurse in both Greenland and Denmark. To work in Greenland, an IEN must have a residence permit. With recent health agreements between Greenland and Denmark, both countries have streamlined the permit acquisition process for foreign healthcare professionals, making it more accessible. However, the process of acquiring a license to work as a registered nurse for IENs lacks clarity. Policy reform is needed to establish a group of diverse nurse experts under the National Board of Health responsible for the assessment and registration of IEN qualifications. There is also a need for a bridging education program or national licensure examination which could facilitate faster IEN recognition. Mutual recognition of nurse licenses between Greenland and Denmark should be established to ensure efficient healthcare delivery and maintain professional standards. Embracing IENs can address nursing shortages and improve healthcare services in Greenland.
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BACKGROUND: The environmental impacts of climate change such as extreme weather, affects human physical and mental health; therefore, including climate change and health is important in nursing education. Despite the recognition of the link between climate change and health, this important knowledge has not yet been systematically integrated into nursing curricula, highlighting the need for immediate action to prepare nurses for these emerging human health challenges. OBJECTIVES: The objective of this review was to gain an overview of the existing literature exploring climate change in nursing curricula and answer following questions: DESIGN: Scoping review. METHODS: A protocol was created and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist (PRISMA-SrC). Five data bases were searched: CINAHL, Academic Search Premier, PubMed, Scopus and Cochraine, in addition to databases, grey literature was searched from different sources (reference lists, Google). A total of 1055 articles were derived from the search and 47 articles were included in this review. After selection results from selected studies on educational interventions and climate change education, and opinion pieces were charted, followed by a team review and consensus on the findings. CONCLUSION: This review shows the importance of integrating the topic of climate change into nursing curricula. This integration of climate change-related content into nursing curricula is essential for preparing students, not just for their future roles in healthcare, but also their role in policy and climate justice. These results also reflect strong support from students for that integration. But while progress has been made, further research is essential to evaluate the impacts of these teaching strategies on nursing education.
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AIM(S): Teamwork among healthcare professionals is a key aspect of patient safety that influences the prevalence of missed nursing care. The association between teamwork and missed care in acute care hospitals is now well established in the literature. Therefore, this review aimed to synthesise the existing empirical evidence on the association between teamwork and missed care in the acute care setting. DESIGN: A mixed-method systematic review study. METHODS: The search was carried out in February 2023 in four scientific databases, PubMed, ProQuest, Web of Science and Scopus based on their institutional availability. The search produced 1542 studies. The method of thematic analysis was used in data synthesis. RESULTS: A total of 18 studies were selected that revealed the relationship between teamwork and missed care. The teamwork score was weak to moderate but significantly associated with the overall score of missed care and was found to be a statistically significant predictor of missed care in an acute care setting. Additionally, teamwork represented an important reason for missed care, primarily in the context of poor communication, lack of trust and cooperation in the nursing team and lack of leadership. CONCLUSION: The review findings contribute to a deeper understanding of the intricate dynamics between teamwork and missed care and provide valuable information to healthcare professionals and institutions looking to optimise teamwork and mitigate instances of missed care in the acute care setting. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Recognising how teamwork influences the occurrence of missed care, healthcare organisations can strategically implement targeted interventions to enhance collaboration, address communication gaps, foster trust, and provide effective leadership. IMPACT: This review suggests that improving teamwork seems to be one of the most important strategies focused on mitigating missed care in acute care settings. REPORTING METHOD: The reporting of this review followed the PRISMA 2020 checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
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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.
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Finland is experiencing a nurse shortage, leading to the recruitment of internationally educated nurses (IENs). The Finnish education system aims to attract more international students, including those in healthcare. International nursing students (INS) face challenges due to language barriers and cultural differences. This paper introduced the bilingual modified flipped learning (BMFL) approach to address these issues. The BMFL, grounded in constructivist learning theory, incorporated flipped learning and learning stations to facilitate INS integration. It emphasized autonomy and collaboration, with students engaging in pre-class content and in-class interactive activities. The strategy enhanced language skills, clinical decision-making, and communication. Policy and practice recommendations were proposed to support the integration of BMFL, targeting the alleviation of nurse shortages and facilitating the harmonious integration of INS into the Finnish healthcare workforce.
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AIM: To understand the experiences of Filipino internationally educated nurses (FIENs) on their recognition and credentialing pathway in the recruitment process in Finland. BACKGROUND: The nursing shortage in Finland results in the recruitment of internationally educated nurses (IENs) such as those from the Philippines. In the context of migration, IENs experience a rigorous process to become qualified nurses in the destination country. METHODS: A thematic analysis of the secondary data from qualitative interviews was conducted. Ten FIENs (n = 10) were recruited from university hospitals in Finland through purposeful and snowball sampling. The study adhered to the consolidated criteria for reporting qualitative research (COREQ) checklist. RESULTS: Three main themes were identified. First, pre-migration victories and predicaments described the experiences of FIENs during the recruitment process and the pathway to acquiring a Registered Nurse qualification. Second, ambiguous integration implied integrating into the workplace while working on the top-up education programme as a prerequisite to nursing registration. Lastly, migration uncertainty discussed the interest among FIENs to continue practising as Registered Nurses (RNs) in Finland. CONCLUSIONS: Pre-migration orientation and workplace integration experiences influenced FIENs' choice to practise as RNs in Finland. The licensure pathway for FIENs required collaboration from various stakeholders in Finnish society. It is recommended to structure the system for the recognition and qualification process of IENs by creating a national model in line with international standards and requirements in collaboration with higher education institutions. IMPLICATION FOR NURSING POLICY: Recognition of previous education and clinical experience can facilitate the transition to becoming an RN for IENs, but the lack of a clear education model and recognition of foreign nursing qualifications leads to deskilling and hinders IENs from practising. Policies prioritising education and integration into the local healthcare system can facilitate the integration and professional growth of IENs, enabling them to contribute significantly to the healthcare system.
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BACKGROUND: The shortage of nurses in Finland has prompted the recruitment of Internationally Educated Nurses (IENs) from developing countries mostly with fragile health systems. However, linguistic racism has emerged as a growing threat to the safety and well-being of IENs in the country. AIM: To discuss the consequences of linguistic racism directed towards IENs and to propose solutions to address this issue. METHOD: This discussion employed self-reflection as a means of engaging in critically reflective analysis. DISCUSSION: The discussion highlighted the factors contributing to linguistic racism, including poor language proficiency, misrepresentation of the nursing profession due to skin color, and political tensions. The phenomenon of linguistic racism affects IENs' communication with patients and colleagues and has a detrimental impact on the mental health and overall health of IENs. CONCLUSION: To address the issue of linguistic racism, this discussion proposed a comprehensive strategy that includes anti-racism training for healthcare personnel, the establishment of a conducive workplace culture that fosters diversity and inclusivity, and the provision of adequate assistance and support for IENs.
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Nurses , Racism , Humans , Racism/psychology , Finland , Workplace , Nursing , LinguisticsABSTRACT
BACKGROUND: There are three related factors affecting climate change and its relationship to the migration of IENs: 1) corporate social responsibility; 2) the code of ethics for nurses; and 3) nursing education. As the highest producer of carbon dioxide emissions, the Global North especially the Nordic Region must also consider its climate change responsibilities when recruiting nurses from the Global South. AIM: The aim of this article is to discuss the factors affecting climate change and its relationship to the migration of IENs, as well as possible solutions to mitigate its impact. RESULTS: Climate change is impacted indirectly by the movement of internationally educated nurses (IENs). The Nordic countries need to consider checking climate change measures in the sustainability plans for recruitment companies when approving permits allowing the recruitment of nurses. CONCLUSION: Policymakers and decision-makers need to consider climate change and GHG emissions factors when collaborating with recruitment agencies to recruit IENs from the Global South. International nurse recruitment policies must be ethical, economically sustainable, and planet-centered.
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Education, Nursing , Nurses , Humans , Climate Change , Nurse's RoleABSTRACT
AIM: To communicate trends in nurse licence revocation in Finland and examine policies and legislation that have implications for future nursing responses to workplace hazards. BACKGROUND: The causes of the shortage of nurses working in Finland are multifactorial and complex. Nurses are joining trade unions and taking industrial action in response to the devaluation of their profession and the underpayment of nurses during the pandemic. The Health Care Professions Act in Finland allows nurses to apply voluntarily to withdraw or revoke their licence using online digital tools - and many are doing so as a last resort. DISCUSSION: A declining nursing workforce is anticipated, with retiree trends increasing while nurse recruitment decreases over the next few decades. Nurses' remuneration and working conditions have suffered during the pandemic, and industrial actions organised by trade unions that include nurses have advocated for the policy and decision-making process to improve, but with mixed results. The process of how legislation enables licence revocation in Finland is essential to understanding this new phenomenon. CONCLUSION: Advocacy for nurses, who are disadvantaged within the current pandemic emergency response policy environment, is needed across every nursing context and every career stage. Without support, nurses confronted with precarious working conditions are more likely to draw attention to their plight by using recent legislation to revoke their nursing licences voluntarily. A revocation may be temporary or permanent. Nurses need advocates and mentors to address attrition issues around the voluntary withdrawal of licences. The situation in Finland offers trade unions and nursing associations an opportunity to validate their existence in society. IMPLICATIONS FOR NURSING PRACTICE: Public displays of distress about the political undervaluing of the nursing profession discourage applications to study nursing and pursue a nursing career or remain in the nursing profession. International experience tells us that when proficient nurses exit the profession, the level of patient safety and health benefits and national productivity suffer. IMPLICATIONS FOR NURSING POLICY: Finland's Nursing Act is an aspect of policy that needs exploring and the basis for amending policies to enable collective bargaining agreements to protect the rights and future of nurses. Reactive policies for recruiting foreign nurses to bolster a failed domestic nursing workforce policy have their own problems. These policy issues reflect the problems facing nurses worldwide.
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Nursing Staff , Workplace , Humans , Finland , Working Conditions , LicensureABSTRACT
AIMS: To collate evidence about patient outcomes resulting from the phenomenon of incomplete nursing care described in the literature variously as missed, rationed, or unfinished nursing care. BACKGROUND: Nursing care which is not completed is known to have a negative impact on patients. However, to date, there has been no thorough exploration of the extent and potential seriousness of patient outcomes. METHODS: The search was performed in four scientific databases; 44 studies were included in the final content analysis. RESULTS: Missed, rationed and unfinished care negatively influence the patient outcomes in the context of patient safety and quality of nursing care. Despite the differences among concepts, the negative association with patient outcomes was significant and common for all concepts. CONCLUSION: Awareness of potential harm of the phenomena to patient outcomes may help the management to develop preventive strategies to reduce or eliminate its actual occurrence. IMPLICATIONS FOR NURSING MANAGEMENT: Hospital management should consider the phenomenon as an indicator of the quality of nursing care as well as establish the routine monitoring of the phenomena in the assessment of patient safety in healthcare facilities.
