TRANSITION TO U.S. PRACTICE AMONG INTERNATIONALLY EDUCATED NURSES: A CONCEPT ANALYSIS
Keywords:
Internationally educated nurses, transition to U.S. practice, concept analysis, Walker and Avant’s approach, acculturationAbstract
Background: The World Health Organization estimated there is a shortage of 5.9 million nurses around the world. The United States (U.S.) alone predicted a shortage of almost one million nurses by 2030, which is exacerbated by the COVID-19 pandemic. It is not surprising that healthcare institutions recruit nurses from other countries to fill in for their nursing shortage. Recruiting internationally educated nurses (IENs) is not a new strategy since the U.S. has continuously used this strategy to fill since the Second World War. The concept of transition to practice among IENs is important because of the differences in nursing education and practices between the U.S. and other countries. These differences in nursing education and practice across the world make it more imperative to understand the concept of transition to practice among IENs.
Objectives: To conduct a concept analysis on the concept of transition to U.S. practice among IENs.
Methods: Walker and Avant’s approach to concept analysis was used. Electronic databases such as NCBI, PubMed, CINAHL, and Google Scholar were searched. A total of 320 articles were initially generated from the search of these databases; of which a total of 30 articles were used in determining the uses, the defining attributes, antecedents, consequences, and empirical referents of the concept.
Results: The defining attributes identified of transition to U.S. practice among IEN were 1) preparation, 2) onboarding, and 3) acculturation. Model, related, and contrary cases were developed. Antecedents and consequences were identified. Empirical referents of the concept were also discussed and presented the need for a tool specific for IENs. Based on the review of the literature and defining attributes that emerged, the new definition of transition to U.S. practice among IENs was developed.
Conclusion: A proposed first definition of the concept of transition to U.S. practice among IENs was developed based on the defining attributes. This concept analysis may be used to develop an instrument to examine the transition to U.S. practice among IENs as well as a guide for developing transition programs.
Impact: Internationally educated nurses play an essential role in the impending nursing shortage in the U.S. All IENs must transition to their new environment and workplace. This concept analysis helps understand the concept of transition to U.S. practice among IENs. Ensuring that IENs successfully transition to U.S. practice is essential to assure safe and quality nursing care. It also adds to the body of limited knowledge on the concept of transition to U.S. practice among IENs.
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