Nurse educators' views of integrating culturally and linguistically diverse future registered nurses into healthcare settings: A qualitative descriptive study.

AIM: To describe nurse educators' views of how culturally and linguistically diverse future registered nurses are integrated into healthcare settings. DESIGN: A qualitative descriptive design was adopted. PARTICIPANTS: A total of 20 nurse educators were recruited from three higher education institutions in Finland. METHODS: Participants were recruited in the spring of 2021 through snowball sampling. Individual semi-structured interviews were held and recorded. The collected data were analysed using inductive content analysis. RESULTS: The performed content analysis identified a total of 534 meaning units from the data, which were categorized into 343 open codes and 29 sub-categories. Furthermore, nine categories were identified and categorized into three main categories. The first main category was pre-graduation and represented a time point during which educators experienced early integration, nurse educator support and cooperation with stakeholders. The second main category was integration strategies into healthcare settings, which included workplace strategies, language competence and individual competencies and attributes. The third main category was the post-graduation experience, during which educators reported organizational readiness, migration and efficacy of the integrational model. CONCLUSIONS: The results revealed a need for increased resources linked to how nurse educators support the integration of culturally and linguistically diverse future registered nurses. Moreover, a nurse educator's presence during the last clinical placement, early transition and integration was found to exert a significant effect on the smooth integration of culturally and linguistically diverse future nurses. IMPACT: This study establishes the need to enhance stakeholder cooperation between universities and other organizations towards supporting the integration process. Maximizing nurse educators' support during the final clinical practice, early transition and post-graduation allows for successful integration and intention to stay. REPORTING METHOD: This study was reported according to the Standards for Reporting Qualitative Research (SRQR). PATIENT OR PUBLIC PARTICIPATION: Participating educators shared their experiences of culturally and linguistically diverse future nurses' integration.

Ethical and cultural competence of social- and health care educators from educational institutions - Cross-sectional study.

BACKGROUND: The international mobility has increased cultural diversity in social- and health care. As such, ethical and cultural competence is an essential skill among educators. They are promoting the ethical and cultural competence and professional growth of students with diverse backgrounds and, therefore, must be ethically and culturally competent. AIM: The aim of the study was to identify distinct ethical and cultural competence profiles of social- and health care educators and explore the associated factors. RESEARCH DESIGN: A descriptive cross-sectional survey design was used to collect quantitative observational data in 2020-2021. Competence profiles were identified by K-means clustering based on answers to an instrument focussing on educators' ethical and cultural competence. PARTICIPANTS AND RESEARCH CONTEXT: Participants (N = 1179, n = 243) were social- and health care educators based at 10 universities of applied sciences and 10 vocational colleges in Finland. ETHICAL CONSIDERATIONS: The research adhered to good scientific practice. A research permit was received from each educational institution that participated in the study. The privacy of the participants was protected throughout the study. RESULTS: The analysis identified three profiles of educators (A, B, C) based on self-assessed ethical and cultural competence. Profile A educators demonstrated high scores across all three competence areas. Profile B educators had high scores for ethical knowledge and intermediate scores for other competence areas. Profile C educators demonstrated intermediate scores across all three competence areas. An educator's pedagogical education was found to significantly influence which profile they belonged to. CONCLUSIONS: The educators generally evaluated their ethical and cultural competence highly. Educators understand the importance of professional ethics in their work, but they need additional support in developing ethics skills in their daily work. Among all educators, there is a need for developing international and culturally diverse collaboration.

The experiences and perceptions of nurse educators of culturally and linguistically diverse nursing students' competence development - Qualitative study.

BACKGROUND: Many countries are becoming increasingly culturally and linguistically diverse due to globalisation and migration. The global shortage of nurses and the consequent migration of nursing professionals is leading to increasing cultural and linguistic diversity in health care and nursing education. Nurse educators play a significant role in supporting nursing students' competence and working life readiness. RESEARCH AIM: To describe nurse educators' experiences and perceptions regarding competence and competence development of CALD nursing students. METHODS: The study was conducted using a descriptive qualitative approach utilising individual thematic interviews for data collection. A purposive sample consisting of 20 volunteer nurse educators from five higher education institutions was used for the purpose. Data was collected in semi-structured interviews based on a literature review of previous studies. The data were analysed using inductive content analysis. The COnsolidated criteria for REporting Qualitative research (COREQ) criteria were used in the reporting of this study. RESULTS: According to the content analysis, three main categories describing aspects related to the competence and competence development of CALD nursing students were identified: 1) educator's competence to support student's learning process and competence development, 2) development of supportive structures and safe learning environments, and 3) student-specific competence and competence development. The educators emphasised that setting clear goals, providing encouragement, having an open discussion, and student-centered approach to support their learning process and create a safe learning environment. CONCLUSIONS: Supporting the learning process of CALD nursing students and developing safe learning environments were considered essential for the development of competence. These areas must be supported by developing educators' pedagogical and cultural competence and providing sufficient resources for both students and educators. In addition, the curriculum must be designed to support these aspects.

Nurse leaders' experiences of how culturally and linguistically diverse registered nurses integrate into healthcare settings: An interview study.

AIM: To describe nurse leaders' experiences of how culturally and linguistically diverse registered nurses integrate into healthcare settings. DESIGN: A qualitative descriptive study design. PARTICIPANTS: A total of 13 nurse leaders were recruited from four primary and specialized healthcare organizations in Finland. METHODS: Data were collected through individual semi-structured interviews and analyzed using inductive content analysis. RESULTS: Nurse leaders' experiences were categorized into seven main categories as follows: leadership, which concerns a leader's roles, style, and experience; organizational strategy and culture, which includes structure, policies, and intra-organizational culture; support strategies, including workplace and outside-of-work integration strategies; relationships and interactions, which considers interpersonal relationships and interactions; nurse competence requirements and development, which concerns both organizational and ward level competence demands, and support for competence development; language competence, which concerns challenges relating to language proficiency and development of language competence; and cultural diversity, which considers the importance of competence development brought about through experiences of being in a multicultural workplace. CONCLUSIONS: Culturally and linguistically diverse nurses are important within healthcare systems. These nurses constitute additional human resources, bring diverse experiences and expertise, and add to organizational cultural capital. Nurse leaders require competencies that are suitable for leading a diverse workforce, utilizing its competencies, establishing staff members' needs, and ensuring their continuous development. Resourcing, planning, and structuring the integration process affects nurses' experiences of the organizational socialization process. IMPACT: The findings of our study can offer guidance to healthcare organizations with regard to structural integration strategies at an institutional level. Leadership and management educators can benefit from the findings towards developing a curriculum that supports leaders' diversity, equity and inclusion, knowledge management and formal leadership competencies. Finally, nurse leaders may benefit from this study through being more aware towards supporting a multicultural, cohesive, and competent workforce through strong social capital.

Culturally and linguistically diverse registered nurses' experiences of integration into nursing workforce - A qualitative descriptive study.

BACKGROUND: The nursing shortage is a global and ongoing phenomenon that is expected to worsen. In many countries, imbalances in the nursing workforce will require international recruitment and plans to increase domestic and international nursing graduates. Nurses from culturally and linguistically diverse backgrounds have been reported to experience challenges while integrating into the workforce. AIM: To describe culturally and linguistically diverse registered nurses' experiences of their integration into the Finnish nursing workforce. METHODS: The study adopted a qualitative descriptive design. Data were collected during the spring of 2021 from 24 culturally and linguistically diverse registered nurses working in various healthcare settings in Finland. Data were analyzed using content analysis, which resulted in 596 open codes, 21 sub-categories, and 8 categories. RESULTS: According to the performed analysis, culturally and linguistically diverse nurses in Finland face cultural, ethnic and linguistic challenges. Organizational acceptance and acknowledgement of culturally and linguistically diverse nurses' competence can help decrease the practice of deskilling and the perception that foreign nurses have purely opportunistic goals. Cultural and language learning support, tailored orientation programs, and mentorship are the most common organizational strategies for supporting integration and competence development. The role of the nurse manager and organizational strategies were also identified as essential components of smooth integration, work wellbeing and retention. CONCLUSIONS: Finnish healthcare organizations need to implement strategies that support culturally and linguistically diverse nurses' integration into the workforce. Nurse managers are important leaders that can foster culturally and linguistically diverse nurses' competence development, ensure the efficient use of their specialized skills, promote work wellbeing, and improve nurse retention.

Nurse leaders' perceptions of competence-based management of culturally and linguistically diverse nurses: A descriptive qualitative study.

AIM(S): To describe nurse leaders' perceptions of culturally and linguistically diverse (CALD) nurses' competence-based management. DESIGN: A descriptive qualitative study of the competence-based management of CALD nurses, from the perspectives of nurse leaders in three primary and specialised medical care organisations. This study followed the COREQ guidelines. METHODS: Qualitative semi-structured individual interviews were conducted with 13 nurse leaders. Eligible interviewees were required to have management experience, and experience of working with or recruiting CALD nurses. Data were collected during November 2021-March 2022. The data were analysed using inductive content analysis. RESULTS: Competence-based management was explored in terms of competence identification and assessment of CALD nurses, aspects which constrain and enable competence sharing with them, and aspects which support their continuous competence development. Competencies are identified during the recruitment process, and assessment is based primarily on feedback. Organisations' openness to external collaboration and work rotation supports competence sharing, as does mentoring. Nurse leaders have a key role in continuous competence development as they organise tailored induction and training, and can indirectly reinforce nurses' work commitment and wellbeing. CONCLUSION(S): Strategic competence-based management would enable all organisational competencies potential to be utilised more productively. Competence sharing is a key process for the successful integration of CALD nurses. RELEVANCE TO CLINICAL PRACTICE: The results of this study can be utilised to develop and standardise competence-based management in healthcare organisations. For nursing management, it is important to recognise and value nurses' competence. IMPACT: The role of CALD nurses in the healthcare workforce is growing, and there is little research into the competence-based management of such nurses. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Integration strategies and models to support transition and adaptation of culturally and linguistically diverse nursing staff into healthcare environments: An umbrella review.

AIMS: The aim of this umbrella review was to establish recent evidence on integration strategies and models to support transition and adaptation of culturally and linguistically diverse nursing staff into healthcare environments. DESIGN: Umbrella review conducted according to Joanna Briggs institute guidelines. DATA SOURCES: Data were collected from CINAHL, PubMed, Medic, ProQuest and Scopus electronic databases in 2021. REVIEW METHODS: Two researchers simultaneously screened studies' eligibility by title, abstract and full text. Quality appraisal for the selected studies was assessed according to Joanna Briggs institute critical appraisal. Data were synthesized by conducting content analysis. RESULTS: Twenty-seven reviews were included in the final synthesis. Strategies and models for supporting the transition and adaptation of culturally and linguistically diverse nursing staff into healthcare environments were structured as intra-organizational, sociocultural, and professional development. Intra-organizational strategies and models were unique to a particular organization and included policies and support, diversity, collegial and peer support, employee treatment and workplace environment. Sociocultural strategies and models addressed social, cultural and group dynamics using cultural training, learning and support, social support and friendships, language and communication, and personal skills development. Professional development enhanced nursing competence, ability to practice and workplace professional development. This was supported through licensure and orientation to work, career and competence development, and workplace mentorship and preceptorship. CONCLUSION: There is a need to understand culturally and linguistically diverse nurses' needs and motivation to integrate, which is essential toward developing efficient integrational strategies and models. Strategies and models also need to support cultural and personal competence development of native nurses to aid efficient integration of culturally and linguistically diverse colleagues. Future studies can evaluate nursing workforce shortages and their implications on integration process.