Internationally educated nurses’ workplace acculturation and strategies for integration: Application of the Fourfold Model of Acculturation Theory (FMAT)

Abstract

Introduction. Internationally educated nurses (IENs) bring diverse skills, experiences, and cultural perspectives to healthcare institutions in the host country. However, their integration involves multiple adjustments encompassing physical, sociocultural, linguistic, psychological, and economic changes. Aims. This paper aims to explore the acculturation processes experienced by IENs and create strategies to support them as they adjust to their new workplace environment. Methods. The Fourfold Model of Acculturation Theory (FMAT) was utilized to develop effective strategies to improve professional, psychosocial, cultural, and organizational outcomes for IENs. Findings. Poor IEN integration stemming from cultural disparities leads to acculturation stress. This stress involves physical health issues, mental exhaustion, identity confusion, social isolation, and marginalization by their colleagues. Implications. The successful integration of IENs requires the involvement of stakeholders at the host workplace. Two-way workplace integration requires efforts from and partnership between stakeholders and IENs. Conclusion. The Fourfold Model of Acculturation Theory underscores that IENs who embrace both their native and dominant cultures are better integrated into their new workplace environments. Such integration positively impacts the individual, institutional, and societal domains. Stakeholders, policymakers, program planners, and healthcare institutions must foster a pluralistic culture and provide support to domestic and international nurses in understanding their professional roles and practices.