title: The experiences of internationally educated nurses in the southeastern United States of America.
abstract: BACKGROUND
  US healthcare facilities have addressed nursing shortages in part by recruiting internationally educated nurses (IENs), and studies suggest IENs may make up a significant percentage of the nursing workforce in urban hospitals. Despite the economic recession of 2008-2012, international nurse migration is expected to continue. Little is known about IENs in the southeastern USA, and no studies have compared their perspectives to those of their US counterparts.
  
  
  OBJECTIVE
  The purpose of this study was to gain a deeper understanding about the experiences of IENs compared to those of US registered nurses (RNs) practising in two urban hospitals in southeastern USA.
  
  
  METHODS
  This study involved two rounds of semi-structured interviews of 82 IENs and US RNs. Interviews focused on themes relating to education, barriers to practice, intent to stay in nursing and IENs' migration experiences.
  
  
  CONCLUSIONS
  Most IENs interviewed migrated to the USA after 1990 to join their family and do not plan to return to their home countries to practise. Most IENs initially received their Associate Degree in Nursing; many have obtained their Bachelor of Science in Nursing degree. IENs and newly licensed US RNs faced similar barriers when they began practising in the USA, but IENs faced additional challenges adjusting to the attitudes of US patients, the perceived lack of respect for nurses and delivering total patient care.
  
  
  CONCLUSIONS
  IENs would benefit from orientation regarding the cultural differences in the USA. In other ways, their challenges are similar to those of US RNs; policies regarding education, recruitment and retention could target both groups together.
authors: Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA. rmw1203@gmail.com
authors: R M
authors: RM
authors: Wheeler
authors: J W
authors: JW
authors: Foster
authors: K W
authors: KW
authors: Hepburn
mesh_terms: D000069:Acculturation; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants; D005260:Female; D005551:Foreign Professional Personnel; D006786:Hospitals, Urban; D006801:Humans; D008875:Middle Aged; D009740:Nursing Staff / Q000193:education; D010559:Personnel Management; D036301:Qualitative Research; D015144:Southeastern United States
keywords: Barriers; Internationally Educated Nurses; Nursing Workforce; Qualitative Research; US Migration