Transitioning Foreign-Educated Nurses to U.S. Clinical Settings

Nurse immigration to the United States has tripled since 1994, to close to 15,000 entrants annually. Recruitment of foreign nurses is one of the solutions to the nursing shortage, and the Philippines is a major source country, accounting for more than 30 percent of U.S. foreign-educated nurses. Despite these benefits to the U.S. healthcare system, barriers prevent smooth cultural and professional integration of Filipino nurses and other foreign-educated nurses to U.S. clinical settings.

Penelope Pattalitan, EdD, MSN, FNP, BC, RN, associate professor at the Chamberlain College of Nursing Miramar, Fla., campus, recently conducted research on this topic. She had the opportunity to present her research findings at the Philippine Nurses Association of Ohio annual conference in July.

“My research illustrates that differences in the clinical setting, use of technology, clinical orientation, language barriers and staff support were the top five barriers to acculturation in the U.S. clinical setting,” says Dr. Pattalitan. “Challenges such as these can create barriers. However, strategies and adjustments can be implemented into the orientation period of a foreign educated nurse’s career to not only ensure career success, but improve patient outcomes, as well.”

Based on the findings of her research, Dr. Pattalitan suggests the following to help smooth the transition for foreign-educated nurses into the U.S. clinical setting:

  • Increase overall length of orientation programs for foreign-educated nurses to ensure they are adequately assimilated to the environment and equipment.
  • Supplement orientation programs with robust clinical tours that educate foreign-educated nurses about equipment, staff support, and clinical set-up.
  • Incorporate electronic health records education into the orientation period, as many foreign-educated nurses do not have prior experience in this area.
  • Integrate technology education into the orientation program to further familiarize foreign-educated nurses with equipment they may not have prior experience using.
  • Implement a focus on the cultural differences in the U.S., specifically when it comes to the patients’ care and education process.

As we inch closer to 2014, it’s expected that 30 million new patients will receive healthcare coverage through provisions outlined in the Affordable Care Act, so there is a growing need for more healthcare professionals – particularly nurses. As the U.S. population grows, this demand will become heightened.

To this point, the U.S. Census Bureau projects that by 2060, the population will be considerably older and more racially and ethnically diverse. “A nurse workforce that reflects this diversity can help break down communication barriers and ensure better patient education and advocacy,” explains Dr. Pattalitan. “Smoothing the acculturation process for foreign-educated nurses will be crucial to the continued advancement of the U.S. healthcare system.”


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