Expatriate Nurses Research Articles

Nurse-patient Relationships and Expatiate Nurse in Saudi Arabia: Challenges and Implications

The therapeutic relationships-form of the nurse-patient-relationship are formed within short durations to address patient care needs quickly and effectively, as well as psychosocial support for family or friends. The purpose of this paper is to focus on challenges that nurses can experience when trying to establish therapeutic relationships with their patients when they are in their communications due to cultural, religious or language challenges. Databases such as PubMed, Scopus, and ProQuest, were used to obtain a comprehensive overview of the literature. The synthesis of the articles grouped together to identify common patterns or themes. The data was integrated into the therapeutic relationship and its elements. The disparities between nurses and their patients may hinder nurses’ abilities to establish a therapeutic nurse-patient relationship with their Saudi patients and families. This interruption in creating such relationships may lead to a decrease in the quality of care. Effective communication seems to be associated with the intimacy of the relationship, which creates a sense of trust. A nurse’s empathy that balances power between both parties provides a perception of respect for the patients. Pre-departure education programs may help expatriate nurses learn about the culture of their hosts prior to their arrival in that country. These programs should provide opportunities for expatriate nurses to learn about, discuss and explore how to ‘fit into’ these cultural practices. Mentoring programs that electronically connect previous nurses who worked in the host country with new recruits in that country should be provided. Thus, the recruited nurses can benefit from their colleagues' experiences and have a more realistic view of what working in that host country is like. This review will help to raise leaders’ awareness about the challenges experienced by expatriate nurses who deliver care to patients with divergent belief systems than their own.

Expatriate professional nurses’ experiences of preceptorship in a tertiary hospital in Saudi Arabia

Background: Professional nurses relocate to foreign countries as expatriate nurses due to host countries’ push or pull factors. Preceptorship programs are designed to support newly hired nurses in transitioning into a new health-care environment. Aims: This study aimed to understand expatriate professional nurses’ preceptorship experiences in a tertiary hospital in Riyadh, Saudi Arabia, with the goal of providing recommendations to enhance the preceptorship program and facilitate better adaptation among expatriate nurses. Setting and Design: This study was conducted at a tertiary military hospital in Riyadh, Saudi Arabia, and employed a phenomenological research approach. Materials and Methods: Based on inclusion criteria, ten expatriate professional nurses were selected by purposive sampling. Data were collected through unstructured, audio-recorded, verbatim transcribed interviews, observations, and field notes. Statistical Analysis: Colaizzi’s seven-step methodology was employed for data analysis. Results: The results identified three themes: (1) participants experienced both positive and negative aspects of preceptorship, encountering personal adjustment challenges and issues with the initial orientation program; (2) preceptors’ abilities and dedication played a crucial role in assisting participants in adjusting to their new workplace; and (3) participants reflected on their preceptorship experience, expressing their expectations and opinions of the preceptorship program. Conclusions: Preceptorship is an effective onboarding strategy to support expatriate nurses in their adaptation process, emphasizing the importance of teamwork and continued management support.

The Challenge of Diversity in Nursing Leadership: The Need to Avoid Misinformation and False Facts

This article probes two recent (2022-2023) instances of false narratives in nursing, both with the laudable goal of promoting diversity in nursing leadership, but which presentations are flawed by false facts. The first example is the installation of portraits of Florence Nightingale, the founder of nursing, and Mary Seacole, the Crimean War businesswoman and volunteer, at Toronto’s University Health Network and Princess Margaret Cancer Centre. The second is a 2023 article by a nursing academic, Jennifer Woo, urging decolonization of “the history of nursing by magnifying the contributions of nurses of colour”. It includes mention of a number of leading nurses of colour, however with an enormous number of false claims for Mary Seacole. Brief mention is also made of Rappaport’s 2022 revised book on Seacole calling her “a Black Cultural Icon and Humanitarian”. This article goes on to present two leading diversity nurses well worthy of celebration: The Nigerian Kofoworola Abeni Pratt, the first Black nurse in Britain’s National Health Service, who led in Nigerian nurses assuming leadership roles from white, British, expatriate nurses. The other is the redoubtable Mary Elizabeth Carnegie (1916-2008), the African-American nurse who led in the racial integration of nursing in the United States. Consideration is given as well to how such major mistakes are made in the nursing literature, with a recommendation for much more critical reading of sources.

Job satisfaction among expatriate nurses during the COVID-19 pandemic: A cross-sectional study.

To investigate the association between job resources, job satisfaction, and moderating effect of COVID-19 anxiety and practice setting among expatriate acute care nurses in Qatar. Expatriate nurses are more vulnerable to reduced job satisfaction. Increased COVID-19 anxiety and reduced perceived job resources among acute care nurses impact their job satisfaction more than that of general ward nurses. An online survey was used to recruit 293 expatriate acute care nurses from four public hospitals in Qatar. Data were collected between June and October of 2021. Structural equation modeling was used for data analysis. We ensured to follow STROBE guidelines when doing this research. Job resources were a significant predictor of job satisfaction among expatriate acute care nurses (β=0.80, 95% CI: 0.73-0.85, p<0.001). There was no significant moderating effect of COVID-19 anxiety (β=0.055, 95% CI: -0.61 to 0.151, p=0.329) or workplace setting on this relationship (χ2 =0.077, df=1, p=0.781). Our study found that the relationship between job resources and acute care nurses' job satisfaction is consistent across different workplace settings regardless of the level of COVID-19 anxiety. This is in line with previous studies that have highlighted the importance of job resources in determining nurses' job satisfaction. The study emphasizes the need for sufficient job resources for improved job satisfaction among expatriate acute care nurses in Qatar, especially during the COVID-19 pandemic. Nursing leaders must prioritize adequate resources such as staffing, proper training, and policies that increase nurse autonomy to improve job satisfaction and reduce the negative effects of dissatisfaction.

The Effect of Emergency Nurses’ Job Satisfaction and Intent to Leave on Patient Safety Culture: A Cross-Sectional Study

The current nursing shortage jeopardizes the quality and safety of patient care globally. In Saudi Arabia, there are insufficient numbers of Saudi nurses to support the healthcare system, and Saudi hospitals rely heavily on expatriate nurses to meet staffing demands. The purpose of this study was to examine the effect of job satisfaction and intent to leave on the patient safety culture. The present study was carried out using a cross-sectional design. Convenience sampling method was applied, and 214 nurses participated in the study. Study was conducted in three hospitals operated by Saudi Ministry of Health in Madinah city. Three instruments were used to measure the study variables. Data were analysed using SPSS. The findings of the current research showed that the suitable work environment for the participant nurses in the current research. The findings of this study showed that nurse’s job satisfaction has a positive and significant influence on patient safety culture (β = 0.28, p = 0.003 ). Furthermore, the results from the parsimonious regression model indicated that intentions to leave had a negative and significant effect on patient safety culture (β = −0.34, p &lt; 0.01 ). Based on the study findings, patient safety should be considered as a strategic priority for the senior nurses’ managers of the health system. To enhance patient safety, the current study emphasizes that nurse managers should pay attentions to factors such as job satisfaction and intent to leave to evaluating safety culture in organizations that deliver health service, especially hospitals.

Self-reported Competences of Expatriate Practicing Nurses in Kuwait: A Descriptive Study.

The aim of the study was to explore the perceived self-reported competence of nurses who worked in Kuwaiti hospitals and the predictors influencing the level of competence. Competence in nursing is found to affect patient safety and the quality of care provided to patients. The vast majority of nurses working in the health system are non-Kuwaitis. Thus, it is of the utmost importance to assess nurses' competences as the first step toward ensuring the best quality of care. A cross-sectional, descriptive, correlational design was used. A non-random convenience sample of 220 practicing expatriate nurses working in public hospitals completed the NPC-35 scale and a demographic form. Data collection was done over a period of three weeks from January 26th, 2020 to February 16th, 2020. The findings of the study showed that nurses perceived their competence as good. The results also showed that years of experience, enrollment in a traditional program of study, exposure to training programs, working in accredited hospitals and nationality explained 56% of the variation in the level of Nursing Professional Competence (NPC). The results indicate that nurse leaders and policy makers need to improve nursing orientation and training programs so that they are competence based. The results of the study also point to the importance of revisiting the nursing recruitment policy and managing expatriate nurses while making better investment in educating and producing Kuwaiti national nurses.

Psychological Empowerment of Nurses Working in Pediatric Units in Saudi Arabia.

Background: This study investigated the psychological empowerment (PE) of nurses in pediatric units and examined the significant difference between the level of PE and the personal work profiles of nurses working in pediatric units in Saudi Arabia. Methods: A quantitative descriptive study design was employed between May and July 2020 using a self-administered electronic survey that collected personal work profile data and applied the Psychological Empowerment Scale. The data were analyzed using SPSS 22.0 software for descriptive statistics, t-tests, and ANOVA. Results: Most of the study participants (69.6%) were non-Saudi nurses, and 71.9% worked in specialized areas. The mean PE score of the four dimensions across the 12 items was high. The mean score for the dimension meaning was the highest, whereas the lowest mean score was for the dimension self-determination. Nurses from different nationalities had significantly different PE levels. Conclusions: Expatriate nurses were more psychologically empowered. The findings will be of interest to all who wish to attract and retain local nurses by fostering PE in the work environment and involving nurses in decision-making processes, thus enabling them to act as leaders for increased work motivation.

Culture, religion, language and the assessment and management of children's pain by expatriate nurses in Saudi Arabia: A qualitative study.

Unrelieved pain among hospitalized children is a common problemthat affects all aspects of children's health and their quality of life. Cultural and language differences between nurses and patients have been shown to impact the quality and safety of nursing care and management for children with pain. The aim of this study was to identify the cultural factors, barriers, and facilitators impacting the assessment and management of children's pain by expatriate nurses in Saudi Arabia. A qualitative descriptive design was employed in this study. A sample of 16 nurses was conveniently recruited and interviewed through face-to-face semistructured interviews. Each interview lasted between 30 and 60 min and was audio-recorded. Content analysis was used to analyze the transcripts. Transcripts were carefully read, significant statements were highlighted, coded, categorized, and clustered thematically. Three main themes were identified, namely, (I) low priority of children's pain, (II) culture and religious challenges, and (III) communication challenges. Cultural and language differences described by expatriate nurses hindered their care of children with pain. A systematic education for expatriate nurses, children, and families is urgently needed to enhance inter/cross-cultural understandings and improve childcare in Saudi Arabia. This study identifies the unique challenges faced by expatriate nurses in Saudi Arabia. The findings reveal how a lack of knowledge about cultural values and beliefs can lead to misunderstandings and conflicts between nurses, children, and familiesand can have animpact on childcare and pain. It also highlights the need to improve pain management practices in multicultural healthcare settings, similar to those of Saudi Arabia and neighboring Arab nations, and across the globe.

Factors Influencing Job Satisfaction of Nurses in Cardiac Center, Hail, KSA

Background: The present healthcare organizational landscape is experiencing a myriad of issues that have resulted in more and more nurses quitting. Job satisfaction is defined as the employees' feelings and behaviors towards their job. The healthcare system of Saudi Arabia is composed of considerable numbers of expatriate nurses from different countries, bringing about diversity. Compared to the past data, there has been an increment in the rate of nurses quitting, meaning a reduction in job satisfaction. This study determines the factors influencing job satisfaction among nurses working in Cardiac Center Hail in Saudi Arabia. Methods: The study utilized a retrospective study based on prospective data collection focusing on the nursing staff's responses to the staff satisfaction survey in Cardiac Center Hail (CCH). The convenience sampling technique of data collection was adopted since it is incredibly prompt, economical, fast, less sophisticated, and easy to research. This method is random and hence eliminates bias in the research. The data collection process utilized inclusion criteria to ensure high quality and reliable data s obtained. Results: It can be observed the job satisfaction in the Cardiac Center Hail is average since the highest percentage of job satisfaction scores ranges between being average and very good for most of the influencing factors. The most dissatisfying factor in the institution was the food supply, followed by the communication system, transportation, and working hours. Conclusion: This information is critical for utilization by policymaking in developing long-term sustainable strategies for promoting a higher retention rate of nurses through offering favorable conditions to promote health care quality deliverance. . Improvements include allocating allowances, reducing the workload on the nurses by maintaining the required shift time, compensate on overtime, improve the communication system, food should be properly cooked, fresh, and balanced, reduce congestion in accommodation &amp; provide appropriate accessories, and establish proper and reliable transport system.

Scope of Nursing Practice as Perceived by Nurses Working in Saudi Arabia.

The absence of scope of practice guidelines may lead to role ambiguity and legal consequences in nursing practice. This study measures the scope of practice of nurses in Saudi Arabia. The study utilized a descriptive cross-sectional design using an electronic version of the Arabic Actual Scope of Nursing Practice (A-ASCOP) questionnaire among 928 nurses. Descriptive analysis was followed by a t-test and an analysis of variance (ANOVA). Significance was assured through the Bonferroni test; the effect size was measured through partial η2 when appropriate. The A-ASCOP mean score of each dimension ranged from 4.29 to 4.72 (overall mean = 4.59). Significant overall ASCOP score variations were evident, with higher ASCOP among expatriate nurses, females, Hospital Operation Program (HOP) nurses, and nurses with postgraduate qualifications. Partial η2 showed a small effect of <0.016. Low-complexity nursing tasks showed insignificant differences no matter the nurse’s position, but were less practiced by Bachelor of Science in Nursing (BSN) and advanced-degree nurses than by those with a diploma education. High complexity of ASCOP was practiced significantly more often by postgraduate-prepared nurses than by diploma-educated nurses. The study showed that there is a range of variation in nursing practice, but that the lack of internal regulations (nursing scope of practice) has no effect on nursing duties. In a country such as Saudi Arabia, where massive national improvement initiatives are frequent, clearly defining the scope of practice for nurses is essential and needs to be done through government mandates. Further studies are essential to define what the scope of practice should include.

The relationship between practice environment, job satisfaction and intention to leave in critical care nurses.

Recent studies in the Kingdom of Saudi Arabia (KSA) have shown that the increasing nursing turnover in the health care industry has become a great source of concern. The overdependence on the supply of expatriate nurses (74%) and coronavirus disease 2019 (COVID-19) travel restrictions have exacerbated this staffing issue. To examine the relationship between perception of nursing practice environment (NPE), job satisfaction and intention to leave (ITL) among critical care nurses working in the state of Ha'il in KSA. Cross-sectional correlational (observational) design. Data were collected via electronic online survey distributed to registered critical care nurses working in King Khalid Hospital (KKH), Ha'il, KSA, between July and August 2020. Participant demographics and key variables data related to NPE, job satisfaction and ITL respectively were collected from the participants using existing and validated questionnaires. Descriptive statistics and correlational analysis and multivariable analyses were conducted. A response rate of 98% was achieved (152/160) for the study. Findings showed that the NPE was largely favourable (M=2.89, SD=0.44); however, nurse participation in hospital affairs (M=2.83, SD=0.47) and staffing and resource adequacy (M=2.88, SD=0.47) scored lowest. NPE was found to be significantly correlated with job satisfaction (rs=.287, P < .01). A significant negative relationship was found between NPE and ITL (rs=-0.277**, P < .01). However, job satisfaction was associated with ITL (rs=-.007, P=.930). Maintaining a healthy work environment and job satisfaction levels in critical care units is key to improving, recruitment and retention of nursing staff. Critical care and hospital leaders should implement programs that enhance the quality of the practice environment. This will improve nurse participation in unit and hospital affairs, job satisfaction and intention to stay.

‘Every day is a challenge’: Expatriate acculturation in the United Arab Emirates

The United Arab Emirates (UAE) has a very small population of national citizens, so it relies on foreign workers who bring a range of cultures with them, resulting in a unique multi-cultural context. Unlike Western countries, such as the UK, Canada and Australia, workers are unable to permanently migrate to the UAE, so instead they hold temporary, expatriate status. This exploratory study focuses on the experiences of internationally qualified, expatriate nurses in hospitals in Al Ain, gathered by qualitative interviews. Twenty-one registered nurses participated in this study. The nurses faced challenges associated with language requirements and differing cultural expectations, and displayed limited acculturation, which compromised their ability to provide appropriate care for patients. The temporary nature of the work, cultural expectations, language difficulties and potential improvements are discussed. The findings have important implications for organizations that employ large groups of staff from overseas in all sectors. This article contributes to knowledge of expatriates’ challenges in the UAE and highlights the difficulties of working in a diverse environment, leading to a range of actions being recommended for managers.

A pre-experimental pilot study exploring EBP Beliefs and EBP Implementation among post-graduate student nurses in Saudi Arabia

AimThis study aimed to measure the impact of a dedicated EBP module on the knowledge, skills and capability for EBP of students undertaking the inaugural MSc in Nursing: Advanced Practice programme in the KSA. BackgroundEvidence-based practice (EBP) yields multiple benefits for all key stakeholders of healthcare. Key to this are healthcare professionals armed with necessary EBP knowledge and skills. Nurses, the largest professional group in healthcare, can be instrumental in effecting sustained EBP implementation. In the Kingdom of Saudi Arabia (KSA) achieving this is hindered by a chronic shortage of nurses and a heavy reliance on expatriate nurses who are often a transient workforce, resulting in a high turnover. The Government of Saudi Arabia 2030 Vision aspires to address the indigenous nurse shortage and the quality of healthcare. In 2017 the inaugural MSc in Nursing: Advanced Practice programme was established in the KSA to prepare Saudi nurses for emerging advanced practice roles. A dedicated EBP module was a core component of the programme. MethodsA pre-experimental pilot study conducted over 18-months collected data from the same participants at three different points. Two validated EBP questionnaires measuring EBP Beliefs and EBP Implementation were administered to post-graduate students undertaking the MSc in Nursing: Advanced Practice programme in one Higher Education Institution in the KSA. Descriptive, inferential and correlational statistics were employed to analyse the demographic data, group mean scores and distribution on the EBP scales, as well the correlation between EBP Beliefs and EBP Implementation. FindingsFindings demonstrated that the educational intervention did improve participants’ EBP beliefs and implementation. Participants reported positive beliefs about EBP at all 3 data collection points (M = 57.4 SD = 7.0; M = 62.54 SD = 7.21; M = 55.31 SD = 15.81, respectively). EBP implementation was low prior to undertaking the module but improved thereafter as illustrated across the 3 data collection points (M = 15.14 SD = 11.9; M = 27.64 SD = 14.35; M = 25.9 SD = 20.43). On both measures, higher scores indicate higher EBP beliefs and implementation. ConclusionThis study established the EBP Beliefs and EBP Implementation of a sample of postgraduate nursing students in the KSA. Findings revealed a substantial improvement in both EBP Beliefs and EBP Implementation following the EBP module. Findings support the use of a dedicated module to prepare nurses to use EBP and to practice at an advanced level while simultaneously preparing them for leadership roles in healthcare in KSA. In so doing, this will help to advance the healthcare goals of the KSA 2030 vision.

Work-life balance of expatriate nurses working in acute care settings.

AimTo examine the quality of work life of acute care expatriate nurses in multiple regions of Saudi Arabia.MethodsA country‐wide cross‐sectional survey was carried out between June–August 2020 using the Brooks' quality of nursing work‐life questionnaire.ResultsThe range of quality of nursing work‐life scores (80 to 245) was moderate, with an overall mean score of 175.3 (± 23.1). Only 723 (42.4%) of the nurses experienced a high quality of nursing work life. Multivariable regression analysis showed that 21 to 40 years' age group, being a Filipino or Indian nurse and working in the northern region were the independent predictors of low quality work life.ConclusionMost expatriate nurses were not satisfied with their quality of work life. Hospital administrators should take initiatives to enhance the quality of expatriate nurses' work life towards improving their productivity and quality of patient care.

I speak a little Arabic: Nursing communication in a cross-cultural context.

This study investigated the challenges of cross-cultural communication among internationally qualified nurses, and the impact on nurse-to-nurse and nurse-to-patient relationships. Open and authentic communication between nurses and patients is required as a foundation of patient-centred practice; however, this may be a challenge in cross-cultural settings. An exploratory qualitative study with an inductive approach. Semi-structured, face-to-face interviews explored the influences on communication and practice of 21 internationally qualified nurses practising in the United Arab Emirates. Manual and software-driven processes guided coding and analysis of data. Caring theory guided the analysis of themes; while COREQ criteria guided research conduct and reporting. Four key themes emerged; (a) Challenges in communication, (b) The science versus art of nursing; (c) The impact of ineffective communication and (d) Strategies for coping. Eleven sub-themes are reported within these themes. Overall, nurses felt they had sufficient language and nursing skills to undertake the technical or scientific aspects of their work; however, they reported experiencing restricted ability to participate in complex cross-cultural conversations, such as providing explanations and reassurance about treatment options or discussing end of life and treatment decisions. This limitation diminished the nurses' ability to engage in the art of nursing and left them unable to employ themselves therapeutically to attain a sense of true presence with patients and their families. This article highlights the need for language and communication support, and Arabic-speaking advocates as partners in care for expatriate nurses. Internationally qualified nurses in this Middle Eastern setting lack cultural orientation and language skills to fully enact the art and true presence of nursing. Findings indicate that health service employers need to increase the employment of Arabic-speaking nurses and provide additional language for other expatriate nurses.

Challenges Facing the Nursing Profession in Saudi Arabia: An Integrative Review

There is a paucity of recent literature identifying the issues facing the nursing profession in Saudi Arabia. The aim of this integrative review is to highlight the ongoing challenges facing the nursing profession in Saudi Arabia despite attempts to make a difference and suggests recommendations for the future. Literature published from 2000 to 2020, inclusive, relevant for nursing challenges in Saudi Arabia was accessed and reviewed from multiple sources. In Saudi Arabia, inadequate numbers of Saudi nurses have prompted an increase in recruitment of expatriate nurses. This has created its own issues including, retention, lack of competency in English and Arabic, as well as Arabic cultural aspects, insufficient experience, and a high workload. The result is job dissatisfaction and increased attrition as these nurses prefer to move to more developed countries. For national nurses, the issues are the need to recruit more and retain these nurses. There are a range of cultural factors that contribute to these issues with national nurses. There is a need to improve the image of nursing to recruit more Saudi nurses as well as addressing issues in education and work environment. For expatriate nurses there is a need for a better recruitment processes, a thorough program of education to improve knowledge and skills to equip them to work and stay in Saudi. There is also a need for organizational changes to be made to increase the job satisfaction and retention of nurses generally. Healthcare in Saudi Arabia also needs leaders to efficiently manage the various issues associated with the nursing workforce challenges.

Home and expatriate nurses' perceptions of job satisfaction: Qualitative findings.

This paper is part of a larger doctoral study that investigated the impact of nationality on the job satisfaction of nurses and their intentions to leave Saudi Arabian government hospitals. The paper aims to gain an understanding of the impact of expatriate status on nurses' perceptions, by comparing the factors that influence job satisfaction among Saudi nurses to those that affect nurses recruited from other countries. Job satisfaction is a known predictor of nurse retention. Although there is a broad understanding of the factors that affect job satisfaction, little is known about how these vary between home and expatriate nurses working in countries which rely on a multicultural migrant workforce. A descriptive qualitative approach was taken, in which 26 semi-structured interviews were conducted with nurses selected from different nationalities, all of whom were working in Saudi Arabian hospitals. Eight participants were Saudi Arabian, six Filipino, four Indian, four South African, two Jordanian and two Malaysian. Five themes were identified that differentiated the perceptions of expatriates regarding their job satisfaction from those of the home nurses: separation from family, language and communication, fairness of remuneration, moving into the future and professionalism. Focusing on the enhancement of job satisfaction experienced by expatriate nurses can result in a healthier work environment and greater retention of these nurses. To enhance nurse retention, policy makers in countries with migrant nurses should address their socio-economic needs. This includes providing both greater access to their dependent family members, and language lessons and cultural orientation to reduce linguistic and cultural challenges.

Exploring the cultural competency of Expatriate Nurses working in Saudi Arabia

Objective: The research was to undertake a descriptive survey of International nurses working in a different hospital in Saudi Arabia to explore cultural competency. Methods: A prospective cross-sectional survey design was utilized. The convenient sample included 736 expatriate nurses working in several healthcare settings in Saudi Arabia, on one occasion using a prevalidated self-assessment questionnaire. Findings: Current study reported that most nurses were Indians and Philippino Nurses with 51.5% and 42.1%, respectively. Expatriate nurses have shown a higher-level competence in a. Awareness and sensitivity b. Behavior c. Patient-centered communication. A significant statistical association was found between cultural competence and the selected demographic characteristics. Novelty: Care provider and care receiver’s culture impacts the healthcare delivery system’s contemporary philosophy. The institutional guidelines and the appropriate professional support would be the core context of generating culturally competent care to enhance quality care management. Keywords: Cultural diversity; quality care; competency; nurses; patient satisfaction

Host country language proficiency and identity: Spanish self-initiated expatriate nurses in Germany

PurposeDespite over 50 years of expatriation research, the implications of expatriation for identity remains an under-researched topic in mainstream international human resource management (IHRM) literature. Expatriation can cause disruption to expatriates' familiar sociocultural environment, which can often pose challenges to their self-concept and identity. The study underpinned by identity and social identity theories explores the perceptions of Spanish self-initiated expatriate (SIE) nurses living in Germany and other Spanish nurses who repatriated from Germany to understand the influence of expatriation on their self-concept and identity.Design/methodology/approachSemi-structured interviews were conducted with Spanish SIE nurses in Germany (n = 20) and others who had repatriated from Germany (n = 10). Data analysis was assisted by NVivo software.FindingsThe study identified that low proficiency in the host country language (HCL) and the problematic workplace interactions that ensued, challenged the participants' self-conceptions as competent professionals and prompted their reliance on social networks of fellow Spaniards for social validation.Research limitations/implicationsAlthough focused on a specific context, the study not only enhances practical understanding of Spanish SIE nurses in Germany but also offers valuable insights to organisations working with SIEs. It adds to extant knowledge on language and identity in the expatriation context and discusses the implications for global HRM related to underutilisation of SIEs' knowledge and skills within organisations.Originality/valueThe study contributes to theory building on the under-researched link between expatriation and identity, while adding to the growing literature on SIEs.

Using social network tools to facilitate cultural adjustment of self-initiated Malaysian female expatriate nurses in Saudi Arabia

BackgroundThis research study aims to:(1) identify and explore the social network communication tools used to facilitate the adjustment process of Malaysian female expatriate nurses working in the Kingdom of Saudi Arabia (hereafter “the Kingdom” or “SA”) who are accompanied by neither their spouses nor families and (2) determine how these tools facilitate their adjustment to their new environment. Emphasis is placed on this particular group of respondents primarily due to the dearth of research conducted on female expatriate nurses. MethodWe conducted a preliminary study using semi-structured interviews with sixteen (16) Malaysian female expatriate nurses working in SA to obtain a broader understanding of their experiences with cross-cultural adaptation and their use of social media tools to connect with their families and friends in their home country. ResultsThis study uncovers numerous social media communication tools being used by female expatriate nurses to help curb their loneliness and lessen the culture shock of living and working in a foreign country. Continuous engagement with these tools helps Malaysian female expatriate nurses maintain their emotional stability, thereby enabling them to remain mentally strong and ultimately prolonging their stay in SA. ConclusionsThis study’s outcomes contribute significantly to the knowledge of the government, various organizations, and aspiring female expatriate nurses in the healthcare industry because the results can assist female expatriate nurses during the adjustment period, enabling them to work efficiently and successfully in the host country.