Experiences lived by international nurses concerning professional integration and interpersonal relationships in the workplace: qualitative research
| Date | 24 August 2023 |
| Pages | 1371-1391 |
| DOI | https://doi.org/10.1108/ER-12-2022-0536 |
| Published date | 24 August 2023 |
| Subject Matter | HR & organizational behaviour,Industrial/labour relations,Employment law |
| Author | Ana Luiza Ferreira Aydogdu,Ulku Baykal |
Experiences lived by international
nurses concerning professional
integration and interpersonal
relationships in the workplace:
qualitative research
Ana Luiza Ferreira Aydogdu
Department of Nursing, _
Istanbul Sa
glık ve Teknoloji €
Universitesi,
_
Istanbul, Turkey, and
Ulku Baykal
Department of Nursing, _
Istanbul Arel €
Universitesi,
_
Istanbul, Turkey
Abstract
Purpose –The recruitment of international nurses has been used for a long time to address the global nurse
shortage. In 2012, the employment of international nurses was released in Turkey. Cultural differences can
hinder interpersonal relationships, and fostering strong interpersonal relationships among nurses in the
workplace is known to have a positive impact on productivity, job satisfaction and the quality of care provided.
This study aims to explore the lived experiences and perceptions of international nurses working in Turkey
regarding their professional integration and interpersonal relationships in the workplace.
Design/methodology/approach –Itis a qualitativedescriptive study.Face-to-faceinterviewswere conducted
with 19 international nursesusing a semi-structuredform. Data were analyzedusing thematic analysis.
Findings –Data were presented into two themes: (1) Interpersonal relationships in the workplace and (2)
Professional integration. Participants reported positive and negative experiences regarding interpersonal
relationships in the work environment, such as warm and supportive approaches, or exclusionary and
discriminatorybehaviors. The existenceof different nursingpractices, positive andnegative factors concerning
orientationprogramsand the gain of experienceand professionalsatisfactionwere mentionedby the participants.
Originality/value –This is the first study to explore the lived experiences and perceptions of international
nurses working in Turkey. The study highlights the unique needs and challenges faced by international nurses
during workplace adaptation and provides practical recommendations to facilitate interpersonal relationships
in the workplace and other aspects related to professional integration from hiring to the end of the adaptation
period.
Keywords International nurses, Interpersonal relations, Nurse migration, Professional integration,
Qualitative research, Turkey
Paper type Research paper
Experiences
lived by
international
nurses
1371
This article was written by the authors as a doctoral thesis.
Declaration of interest: The authors declares that there is no conflict of interest.
Funding: The authors received no financial support for the research, authorship and/or publication
of this article.
Erratum: It has come to the attention of the publisher that the article “Experiences lived by
internationalnurses concerningprofessional integrationand interpersonal relationshipsin the workplace:
qualitative research”,Employee Relations, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/
ER-12-2022-0536, incorrectly entered commentarytext in place of a reference duringthe proofing process.
On page three of the article “publisher and location were added”has been replaced with the correct
reference to “Regulation on Principles and Procedures Regarding the Work of Foreign Health
Professionals in Private Health Institutions in Turkey (2012), Turkish Official Diary, Ankara, 28212,
February 02 2012”.This error was introduced in the editorialprocess and has now been correctedin the
online version.The publisher sincerely apologisesfor this error and for any inconvenience caused.
The current issue and full text archive of this journal is available on Emerald Insight at:
https://www.emerald.com/insight/0142-5455.htm
Received 3 December 2022
Revised 9 May 2023
4 July 2023
Accepted 4 August 2023
Employee Relations: The
International Journal
Vol. 45 No. 6, 2023
pp. 1371-1391
© Emerald Publishing Limited
0142-5455
DOI 10.1108/ER-12-2022-0536
Introduction
The nursing shortage is a serious issue faced by many countries around the world. According
to the World Health Organization (WHO), in 2018 was estimated a global gap of 5.9 million
nurses, and the situation was worse in low- and lower-middle-income regions such as Africa,
South-East Asia and Eastern Mediterranean (WHO, 2020). Turkey also faces difficulties to
meet the demand for nurses. A report prepared by the Organisation for Economic Co-
operation and Development (OECD), in 2017 showed that while the average number of nurses
in the OECD member countries was 8.8 per 1,000 inhabitants, in Turkey there were only 2.1
nurses per 1,000 inhabitants (OECD, 2019).
Governments resort to diversified str ategies to solve the nursing shortage; one of them is
the overseas recruitment of nur ses. However, some hospitals’manage rs do not agree with
employing international nurse s, believing that they will face communicatio n and interaction
problems that will make it diffi cult for them to adapt to the host country (Hirano et al .,2020).
Job opportunities and better soc ial conditions are often the main reasons why nurses de cide
to work abroad (Rodr
ıguez et al.,2014;Keshet and Popper-Giveon, 2016). Neverthele ss, the
lived experiences of intern ational nurses are not always positiv e; they may face, among
others, difficulties related to i nterpersonal relationships in the work envi ronment, which can
interfere with their careers an d also impact their social life. On the oth er hand, good relations
with colleagues and patients may faci litate international nurses’adaptati on processes. Other
factors, such as differences in n ursing practice, the implementation of orien tation programs,
the possibility of gaining exp erience working abroad and job satisfact ion also influence
the professional integration of inte rnational nurses (Alanazi and Yates, 2022 ;Solum et al.,
2020;Zakaria and Yusuf, 2022). It is im portant to discuss the experiences, b ackgrounds
and perceptions of internation al nurses, especially because the topic i s not sufficiently
documented (Keshet and Popper-Giveon, 2016).
Background
The employment of international nurses has been adopted for many years in countries such
as the USA, Canada and the United Kingdom (UK) (OECD, 2019). In the past, the strategy was
more common in developed countries; nowadays developing countries have also turned to the
employment of foreign-educated nurses to fill nursing vacancies (Zhou, 2014). However, some
countries are still known as recipient countries while others are seen as source countries.
Nurses usually migrate from the Philippines, the Caribbean, South Africa, Ghana, India,
Korea and China to countries such as the US, the UK, Norway, Australia, Ireland and Saudi
Arabia (Li et al., 2014). The Philippines is the biggest source of migrant nurses in the world (Li
et al., 2014), and the USA and the UK are the countries that recruit overseas nurses the most
(Germack et al., 2017).
Although precise data on the country of origin of international nurses working in Turkey
is lacking, it is evident that Turkey differs from other countries in terms of the origins of
foreign nurses. Primarily, these nurses originate from neighboring countries such as Albania,
Azerbaijan, Bulgaria, Georgia, Macedonia, Romania, Russia, Syria, Ukraine and Uzbekistan
(Tarhan et al., 2021). This characteristic is likely attributable to Turkey’s history of receiving
migrants, particularly from Balkan countries. From 1822 to 1938, approximately 384,000
individuals migrated from Greece. Between 1923 and 1945, 800,000 people migrated from
Balkan countries. In 1988, 51,542 individuals came from Iraq. A year later, in 1989, 345,000
individuals migrated from Bulgaria, and between 1992 and 1998, 20,000 people migrated
from Bosnia. Additionally, in 2001, 10,500 individuals migrated from Macedonia, and from
2011 to 2013, around 1,000,000 people migrated from Syria to Turkey (Directorate General of
Migration Management, 2013).
According to statistics from 2022, there are currently 1,823,836 foreign individuals
residing in Turkey. Among them, 275,305 are Iraqis, 151,049 are Russians, 99,360 are Syrians,
ER
45,6
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