Commentary on Alexis, O and Shillingford, A (2012) Exploring the perceptions of work experience of internationally recruited neonatal nurses: a qualitative study. Journal of Clinical Nursing 21, 1435–1442

Abstract

Alexis and Shillingford’s (2012) study highlights the experiences of internationally recruited neonatal nurses in London NHS hospitals. The sample for this study was drawn from Jamaican and Filipino nurses. Participants in this study had varying support mechanisms, which had an impact on their confidence. This is consistent with research carried out by Likupe (2011); however, overseas nurses are a diverse group, and the title of this study could be misleading because only two groups of overseas nurses were interviewed. This should have been made explicit as other studies demonstrate that the experiences of internationally recruited nurses may be related to several factors including country of origin, training and the ethnicity of the nurse RCN (2008), Likupe (2011). The discussion in the paper about communication difficulties illustrates the above-mentioned problem as the authors state that participants had problems because English was not their first language. This is not strictly the case with nurses from Jamaica. Jamaicans use a form of English called Patois which, in principle is just slang or vernacular English. As such, their communication problems could be different from that of Filipino nurses who speak an entirely different language. When the quotations are analysed, the problems seem to be more related to cultural aspects of care than communication. The authors should perhaps have used countries as participant identifiers instead of numbers as this would allow the reader to know from which country a particular nurse was from and relate this to the nurses’ experience. Nurses in this study also had difficulties adapting to family-centred care, which contradicts Taylor’s (2005) study that described how nurses from the Philippines, China and Nigeria identify the important role that family plays in the care of the older people in those countries - in contrast to the UK, where many older people are cared for in nursing or residential homes. In addition, Likupe (2011) found that the main problems in this area were the often unrealistic expectations of outcomes of care from family and relatives. This serves to emphasise the point that the experiences of overseas nurses from different countries and backgrounds should not be generalised, the differences in settings of care notwithstanding. The authors report that some interactions between UK nurses and the group of nurses were paternalistic – with overseas nurses feeling they were being treated like children. This is common for non-white overseas nurses, which may indicate elements of racism (Likupe 2011). This finding is also consistent with work by Withers and Snowball (2003) where Filipino nurses reported being treated as students by other nurses. This finding is worrying as it does not foster a team spirit between UK and overseas nurses and patient care could suffer in the process. If nursing is to become truly multicultural in the UK, embracing diversity needs to be at the heart of the NHS and training needs to be provided to all nurses. It is essential that overseas nurses feel valued and part of the NHS. At the same time, British-born nurses need to appreciate different cultures and needs of overseas nurses. None.