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A Mixed-Methods Study of International Nurse Integration in the United States

Challenges, Support, and Recommendations

Bibliographic Data

ID22419986
AuthorsYifei Fiona Wen (Duke University), Qing Yang (0000-0001-6621-080X, Duke University), Deborah H Allen (0000-0002-3360-2951, Duke University Health System), Sarah Haithcock (Duke University Health System), Blaise Nieve (Duke University Hospital), Staci S Reynolds (0000-0002-0366-1328, Duke University, corresponding author)
Year2026
Pages10436596261465671-10436596261465671
Publication date2026-07-14
Open AccessYes
TypeARTICLE
VenueJournal of Transcultural Nursing (JOURNAL)
Journal identifiersISSN: 1043-6596 • E-ISSN: 1552-7832
PublisherSAGE Publications (PUBLISHER • US)
DOI10.1177/10436596261465671
PMID42445994
OpenAlexW7168291067
LanguageEN
References cited28

INTRODUCTION: Recruiting international registered nurses (RNs) is one solution health care systems employ to address nursing shortages; however, these nurses often encounter challenges. The purpose of this study was to explore international RNs' experiences at a large health system in the United States and identify strategies to effectively integrate these RNs into U.S. health care systems. METHODS: A mixed-methods study design was used. Nurses involved in the health system's International RN Program, all of whom were from the Philippines, were invited to participate in a survey and interviews. RESULTS: A total of 114 Filipino RNs completed the survey, and nine participated in interviews. Findings highlighted supportive workplace relationships, but challenges remained in community integration, orientation, and adapting to new clinical practices and communication styles. DISCUSSION: Recommended strategies to support international RNs include extending orientation programs, providing refresher sessions, offering structured mentorship programs, and providing cultural adaptation programs.

Adaptation (eye) · Health care · Healthcare system · MEDLINE · Mentorship · Orientation (vector space) · Transcultural nursing · Cultural Competency in Health Care · Global Health Workforce Issues · Nursing education and management

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Highly citedNo
Open DOIOpen Access
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