Transition of internationally qualified nurses in Australia : Meta-synthesis of qualitative studies

Background
Recruitment of internationally qualified nurses as a labour source is a long-standing strategy and with continued shortages predicted, will continue. Nurses transitioning into the workforce face significant challenge to success, yet the transition journey has not been fully synthesised and mapped from the perspective of the internationally qualified nurse.

Aim
To develop a synthesised understanding of the internationally qualified nurse transition journey.

Methods
A systematic search was conducted in five electronic databases (EBSCO, CINAHL Complete, ProQuest, Google Scholar, and Cochrane library). The Critical Appraisal Skills Programme qualitative assessment tool was used for quality appraisal. Data were analysed using content analysis. Critical interpretive synthesis was then used for meta-synthesis of systematic review findings into a map of the transition journey.

Findings
Eleven studies were included. Eight were appraised as high-quality, two medium, and one low-quality. Findings were constructed into five themes – Communication, A new normality, Valuing the individual, Support, and Assimilation. These themes were critiqued and mapped to chronologic stages in the internationally qualified nurse transition journey.

Discussion
Challenges to transition exist. Some are addressable by the internationally qualified nurse through migration preparation. Others such as discrimination and lack of support, compound adjustment difficulties and are beyond their capacity to control. Deskilling and unequal opportunities increase complexities, an organisational culture that values and welcomes diversity supports better transition.

Conclusion
This meta-synthesis consolidates the internationally qualified nurse transition journey, highlighting barriers encountered adjusting to clinical practice in a new country. The nurse, education provider, and host organisation have shared responsibilities facilitating assimilation.