title: Challenges faced by international nurses when migrating: an integrative literature review.
abstract: OBJECTIVE
  Results from this literature review were used to identify the challenges faced by international nurses in their host countries following migration.
  
  
  BACKGROUND
  The increasing strain of nursing shortages in the healthcare system has led to the recruitment of international nurses among many countries. However, following migration, international nurses are faced with challenges that may result in poor integration with their host countries.
  
  
  METHODS
  Using Cooper's five stages for integrative research reviews, a literature search was conducted across seven databases using a PRISMA search strategy. Additional manual searches were also conducted on the end-references of the retrieved articles. The authors then independently reviewed the selected articles using the Joanna Briggs Institute appraisal form to extract and generate the themes for the review.
  
  
  RESULTS
  Twenty-four articles were selected for the review. The themes generated included: (i) difficulty orientating; (ii) a longing for what is missing; (iii) professional development and devaluing; (iv) communication barriers; (v) discrimination and marginalization; (vi) personal and professional differences; and (vii) a meaningful support system.
  
  
  CONCLUSIONS
  By identifying the challenges faced by international nurses, interventions that ensure equal treatment (e.g. multifaceted transition programmes and culturally sensitive 'buddy' systems) can be implemented to help international nurses adapt to their new environments. Adequate communication can be achieved by encouraging international nurses to speak English and learn the colloquial language and non-verbal behaviours used by native nurses.
  
  
  CONCLUSIONS
  With good integration international nurses may be able to reach their full career potential as professional nurses in their host countries. The adaptation process is a dynamic process that requires effort from both international and native nurses. Thus, any strategies that are developed and implemented must be multifaceted.
authors: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors: L-X
authors: LX
authors: Pung
authors: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.|Alice Lee Centre for Nursing Studies, National University Health System, Singapore.
authors: Y-S
authors: YS
authors: Goh
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role / Q000523:psychology*; D064700:Nurses, International / Q000523:psychology*; D036301:Qualitative Research; D013315:Stress, Psychological; D014171:Transients and Migrants / Q000523:psychology*
keywords: Challenges; Communication; Discrimination; Experience; Integration; International Nurses; Migrant Nurses