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Abstract

Background: Migration trends toAustralia have seen an increase in international nurses, with twenty-ninepercent of current registered nurses having received their first nursing qualification outside of Australia.The process international and local nurses navigate to enable successful integration into the Australianhealthcare system is unclear.Aim: To explore how international nurses and Australian nurses adapt to work together in the Australianhealthcare system and to develop a theory that explains this process.Methods: Grounded theory methodology was used. Concurrent data collection/generation and analysisof online-survey data (n = 186) and in-depth interviews (n = 15) was undertaken. Storyline was usedas a technique of analysis to develop, construct and present the theory. Focus groups (n = 9 + 7) wereconducted to confirm the relevance of the theory.Findings: Nurses work together to enable successful integration of international nurses. Four phasesunderpin this adaptation to the cultural norms of the workplace: (i) Joining the game; (ii) Learning thegame, (iii) Playing by the rules, and (iv) The end game. These phases comprise the grounded theory Playingthe game: Integration of internationally qualified registered nurses in the Australian healthcare system.Discussion: Additional orientation programs and collegiate support for international nurses were significant factors influencing successful adaption to the cultural context of the work environment. Definingthe role and scope of practice of the registered nurse in the Australian context provided challenges.Conclusion: Supportive colleagues were critical to successful integration and retention of experiencednurses irrespective of where nurses obtain their nursing qualification. Additional orientation programsfor international nurses could improve the experience of nurses migrating to work in Australia.

Item Type:	Article
Authors/Creators:	Chun Tie, Y and Birks, M and Francis, K
Keywords:	adaption, Australia, grounded theory, healthcare systems, integration, nurses, internationa
Journal or Publication Title:	Collegian
Publisher:	Elsevier BV
ISSN:	1322-7696
DOI / ID Number:	https://doi.org/10.1016/j.colegn.2018.12.006
Copyright Information:	© 2018 Australian College of Nursing Ltd. Published by Elsevier Ltd.
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