Integrating internationally qualified nurses: a qualitative exploration of nurse managers’ influence from nurses’ experiences

Abstract Background Healthcare systems globally are confronted with a shortage of nurses. Various strategies to address this have been applied, including active recruitment of internationally qualified nurses. Nurse managers may have a central role in supporting workplace integration. This study aim...

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Main Authors: Catharina Roth, Amanda Breckner, Katja Krug, Cornelia Mahler, Michel Wensing, Sarah Berger
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Nursing
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Online Access:https://doi.org/10.1186/s12912-025-02875-7
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author Catharina Roth
Amanda Breckner
Katja Krug
Cornelia Mahler
Michel Wensing
Sarah Berger
author_facet Catharina Roth
Amanda Breckner
Katja Krug
Cornelia Mahler
Michel Wensing
Sarah Berger
author_sort Catharina Roth
collection DOAJ
description Abstract Background Healthcare systems globally are confronted with a shortage of nurses. Various strategies to address this have been applied, including active recruitment of internationally qualified nurses. Nurse managers may have a central role in supporting workplace integration. This study aimed to explore how domestically qualified nurses and internationally qualified nurses viewed the role of nursing management and its impact on workplace integration. Method Semi-structured interviews with 21 domestically and 14 internationally qualified nurses were conducted. Nurses were selected using purposive sampling. Snowball sampling was applied to reach a sufficient sample size. Interviews were pseudonymized and transcribed. Transcripts were coded according to Qualitative Content Analysis with data structured into themes and subthemes. Results Five key themes related to impact of nursing management on workplace integration were identified: (a) Appropriate Placement, (b) Recruitment Process, (c) Leadership Support, (d) Workforce Shortage, and (e) Additional Burden/ Increased Workload. Active support by nursing leadership and the opportunity for shared-decision making was seen as a key factor. Increased workload, additional time and resources requirements associated with orientation of internationally qualified nurses and pressures from staff shortages were highlighted as hindrances. Inappropriate placement of internationally qualified nurses was perceived as key hindrance that could be addressed by nursing management. An imbalanced ratio between domestically and internationally qualified nurses was perceived as challenging by domestically qualified nurses. Conclusion Integration of internationally qualified nurses to clinical practice brings several challenges that may be positively impacted by nursing management through appropriate placement of internationally qualified nurses, supportive nurse managers and adequate preparation of domestically qualified nurse mentors/preceptor. Implications for practice Nurse managers should ensure that internationally qualified nurses’ work experience matches local clinical unit vacancies before hiring them. Peer support is a supportive factor for internationally qualified nurses. Nurse managers should find a balanced ratio between internationally and domestically qualified nurses in the roster. Introducing mentors or preceptors at ward level may be a strategy decrease work-related stress in both nursing groups. Registration number The study has been prospectively registered (27 June 2019) at the German Clinical Trial Register (DRKS00017465).
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spelling doaj-art-6c405e93d9834b9784719de2e694fd372025-08-20T02:33:24ZengBMCBMC Nursing1472-69552025-02-0124111410.1186/s12912-025-02875-7Integrating internationally qualified nurses: a qualitative exploration of nurse managers’ influence from nurses’ experiencesCatharina Roth0Amanda Breckner1Katja Krug2Cornelia Mahler3Michel Wensing4Sarah Berger5Department of General Practice and Health Services Research, University Hospital HeidelbergDepartment of General Practice and Health Services Research, University Hospital HeidelbergDepartment of General Practice and Health Services Research, University Hospital HeidelbergDepartment of Nursing Science, University Hospital TuebingenDepartment of General Practice and Health Services Research, University Hospital HeidelbergDepartment of Nursing, University of Otago-Christchurch CampusAbstract Background Healthcare systems globally are confronted with a shortage of nurses. Various strategies to address this have been applied, including active recruitment of internationally qualified nurses. Nurse managers may have a central role in supporting workplace integration. This study aimed to explore how domestically qualified nurses and internationally qualified nurses viewed the role of nursing management and its impact on workplace integration. Method Semi-structured interviews with 21 domestically and 14 internationally qualified nurses were conducted. Nurses were selected using purposive sampling. Snowball sampling was applied to reach a sufficient sample size. Interviews were pseudonymized and transcribed. Transcripts were coded according to Qualitative Content Analysis with data structured into themes and subthemes. Results Five key themes related to impact of nursing management on workplace integration were identified: (a) Appropriate Placement, (b) Recruitment Process, (c) Leadership Support, (d) Workforce Shortage, and (e) Additional Burden/ Increased Workload. Active support by nursing leadership and the opportunity for shared-decision making was seen as a key factor. Increased workload, additional time and resources requirements associated with orientation of internationally qualified nurses and pressures from staff shortages were highlighted as hindrances. Inappropriate placement of internationally qualified nurses was perceived as key hindrance that could be addressed by nursing management. An imbalanced ratio between domestically and internationally qualified nurses was perceived as challenging by domestically qualified nurses. Conclusion Integration of internationally qualified nurses to clinical practice brings several challenges that may be positively impacted by nursing management through appropriate placement of internationally qualified nurses, supportive nurse managers and adequate preparation of domestically qualified nurse mentors/preceptor. Implications for practice Nurse managers should ensure that internationally qualified nurses’ work experience matches local clinical unit vacancies before hiring them. Peer support is a supportive factor for internationally qualified nurses. Nurse managers should find a balanced ratio between internationally and domestically qualified nurses in the roster. Introducing mentors or preceptors at ward level may be a strategy decrease work-related stress in both nursing groups. Registration number The study has been prospectively registered (27 June 2019) at the German Clinical Trial Register (DRKS00017465).https://doi.org/10.1186/s12912-025-02875-7Workplace integrationInternationally qualified nursesMigrationGermanyInterview studyOrganisational role, nursing management
spellingShingle Catharina Roth
Amanda Breckner
Katja Krug
Cornelia Mahler
Michel Wensing
Sarah Berger
Integrating internationally qualified nurses: a qualitative exploration of nurse managers’ influence from nurses’ experiences
BMC Nursing
Workplace integration
Internationally qualified nurses
Migration
Germany
Interview study
Organisational role, nursing management
title Integrating internationally qualified nurses: a qualitative exploration of nurse managers’ influence from nurses’ experiences
title_full Integrating internationally qualified nurses: a qualitative exploration of nurse managers’ influence from nurses’ experiences
title_fullStr Integrating internationally qualified nurses: a qualitative exploration of nurse managers’ influence from nurses’ experiences
title_full_unstemmed Integrating internationally qualified nurses: a qualitative exploration of nurse managers’ influence from nurses’ experiences
title_short Integrating internationally qualified nurses: a qualitative exploration of nurse managers’ influence from nurses’ experiences
title_sort integrating internationally qualified nurses a qualitative exploration of nurse managers influence from nurses experiences
topic Workplace integration
Internationally qualified nurses
Migration
Germany
Interview study
Organisational role, nursing management
url https://doi.org/10.1186/s12912-025-02875-7
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