Resilience & Internationally Educated Nurses: A Phenomenological Qualitative Research Study

February 26, 2024

By: Adam Kless, Vice President of Clinical Operations at Avant Healthcare Professionals

Avant Healthcare Professionals was honored to attend the International Council of Nurses 2023 Nursing Congress, where we presented our latest research study on the relationship between resilience and culture in internationally educated nurses. Roughly 6,000 nurses assembled from around the world in Montreal, Quebec. In this article, I'll describe the key takeaways of our research study.  

Takeaways:

Resilience is Vital: Internationally Educated Nurses (IENs) play a crucial role in the nursing workforce, and understanding and fostering their resilience is essential for sustainability, especially in challenging environments like the COVID-19 pandemic.

Cultural Nuances Matter: The study highlights the importance of acknowledging and appreciating cultural variations in resilience among IENs, emphasizing the need for tailored transitional support that respects diverse cultural perspectives.

Cultural Humility for Sustainability: The research underscores the significance of practicing cultural humility in supporting newly immigrated nurses, recognizing that it is not just culture or country alone but the unique individual experiences that influence a nurse's journey, ensuring a resilient and sustainable nursing workforce in the post-pandemic era.

Resilience as the Backbone of Nursing Dynamics

Internationally educated nurses (IENs) play an important role in the nursing workforce in the United States. IENs face many challenges during their migration journey in their home and host countries. These challenges are often linked to resilience; however, there is a need for a systematic understanding of their resilience, particularly through a social-ecological and cultural lens. Our qualitative study aimed to explore the attributes and cultural constructs related to resilience in IENs from the most heavily recruited countries.

The term “resilience” is increasingly used to define frontline healthcare workers who have been able to provide care despite limited resources, such as during the COVID-19 pandemic when resources were scarce. Yet, the demand for nursing care was exceptionally high. Understanding how and why IENs adapt to migration and exhibit resilience is crucial. This understanding can provide insight into supporting the nursing workforce's well-being and ensuring the profession's sustainability, especially when many nurses have left or are considering leaving the profession post-pandemic.

Cultural Variations in Resilience

Our study aimed to determine if there are differences in how various cultures understand the idea of resilience. Specifically, we wanted to know if resilience is understood similarly across cultures. We noticed that the word "resilience" is not always easily translated into other languages and sometimes requires multiple words to describe. In the Philippines, where Tagalog is the official language, the concept of resilience may be expressed through multiple words that describe a state of being. Cultural resilience among Filipino IENs may be characterized by a strong emphasis on familial and community support, adaptability in challenging situations, and a positive outlook shaped by cultural values. This research is important because we want to support our IENs in a culturally appropriate way. 

The American Psychological Association defines resilience as successfully adapting to difficult situations and the result of that process. It involves being mentally, emotionally, and behaviorally flexible and adjusting to internal and external demands. We found that understanding what resilience means varied depending on the culture and country and could be related to the situation, the family, the expectations, or the individual's personality. This highlights the importance of understanding cultural differences when studying resilience. 

The Importance of Cultural Humility in Transitional Support 

This current study has demonstrated the need for continued research on these social determinants to support newly immigrated nurses in successfully transitioning to US nursing practice. It further validates that in remaining culturally humble, we must seek to understand each individual's experience to provide the best possible type of transitional support. It is not only culture or country that influences a nurse’s experience but their unique reaction to life circumstances through the lens of experience. Our commitment to the globalization of nursing and the successful transition of internationally educated nurses is to practice cultural humility through understanding country, culture, and individual differences in the needs of the nurse transitioning to US practice.   

The Bottom Line 

Our research, presented at the International Council of Nurses 2023 Nursing Congress, shows that resilience plays a crucial role in the experiences of internationally educated nurses (IENs). This is especially true in the context of their migration journey and in the demanding landscape of global healthcare - which was exemplified during the COVID-19 pandemic. As we provide transitional support, we must understand resilience and its cultural variations to sustain a resilient nursing workforce. We should respect individual experiences and account for diverse cultural perspectives. Cultural humility is important to achieve this, and our commitment to the globalization of nursing involves recognizing the unique challenges IENs face and actively incorporating cultural humility into our support systems. This will help foster a resilient and sustainable nursing profession in the post-pandemic era.