Descriptive Correlational Study to Examine Variables and Relationships Proposed in Conceptual Framework of Virtual Transitioning Program Developed for Foreign Educated Nurses (FEN)

Abstract

Currently, many healthcare organizations actively resource nurses from other countries due to the overwhelming nursing shortage in the United States (US). In 2016, Foreign Educated Nurses (FEN) comprised about 15% of Registered Nurses (RNs) in the US. A concern for the welfare of FENs and the financial loss of healthcare institutions is that many FENs leave the US or leave nursing altogether during their transitioning period. A better understanding of influences on FEN successful transition is needed. A long-term goal is to provide a theory-guided evidence-based transitioning program to facilitate this transition. The primary purpose of this study is to examine potential predictors of FEN well-being and acculturation. Two main research questions derived from the framework were tested: 1. What combination of independent variables (Weeks of US Nursing Practice, Demands of Immigration, Resilience, and the interaction between Demands of Immigration and Resilience) best explains FEN Well-Being? 2. What combination of independent variables (Weeks of US Nursing Practice, Demands of Immigration, Resilience, and the interaction between Demands of Immigration and Resilience) best explains FEN Acculturation? A descriptive correlational study was designed to study a convenience sample of FENs who met the following criteria: male or female nurse over the age of 18, born and completed their education in a foreign country, currently working full or part-time as a nurse for less than two years in the US. Participants completed an online survey using established measures of the variables: demands of immigration, well-being, resilience, and acculturation. Participants were recruited through social media sites and message board at their employment. Sixty participants (75% female, 88.3% full-time employed) completed the survey. Several significant bivariate correlations were found. Research Question 1 results indicated the best model predicting FEN Well-Being had two predictors, Demands of Immigration and Weeks of US Nursing Practice (Adj. R2 = .62, p<.01). Research Question 2 results were similar, with Demands of Immigration and Weeks of US Nursing Practice as the significant predictors of FEN Acculturation (Adj. R2 = 53, p<.01, but Weeks of US Nursing Practice was negatively related to Acculturation. An unexpected finding was that Resilience was not a significant predictor in the context of other variables. Additional analysis of qualitative comments in response to a question about participants’ “biggest concern in transitioning to US work” revealed the following themes: Professional Resources, Practice Knowledge and Skill, Technology Knowledge and Skill, Relational Knowledge and Support and Cultural Support and Knowledge. In conclusion, this investigation provides initial theory-guided research into this little-studied topic and supports a theoretical framework that includes: Weeks of US Nursing Practice and Demands of Immigration as the most significant predictors of FEN Well-Being and Acculturation. Future research employing a random sample, and longer-term investigation may support or extend the investigator’s current model of FEN well-being and acculturation.