Expert to novice: Experiences of professional adaptation reported by non-English speaking nurses in Australia

摘要

Objective: Adaptation to a new area of clinical practice creates a significant challenge for any nurse, but this is particularly so for migrant nurses of non-English speaking background (NESB). The aim of the study was to understand the perceptions of overseas qualified nurses, from non-English speaking backgrounds of their educational experiences in a competency based assessment program (CBAP) in Melbourne with a particular focus on the clinical component. Design: The study was conducted using a modified grounded theory approach. Data were collected using in depth audio taped interviews, observation in clinical practice and personal journal entries. Initially a purposive sample was chosen followed by theoretical sampling. Thirteen NESB nurses, one Australian born nurse and three of their teachers took part in the study. The constant comparative method was used to analyse data. Setting: The CBAP was conducted in two Melbourne based universities. The study was carried out in four hospitals in Melbourne representing public and private facilities. Participants: Thirteen NESB nurses, one Australian born nurse and three of their clinical teachers participated. Main outcomes: Nurses reported feelings of disempowerment caused by discriminatory practices, professional isolation and unrealistic expectations by local nurses. The experience challenged feelings of competence as much as it expanded feelings of competence. Results: Three themes emerged. Themes revolved around language use, quality of communication and non-recognition of professional skills by local nurses, which resulted in disempowerment, damaged perceptions of competence and stunted progress towards regaining a full professional identity. There were some suggestions of workforce discrimination. Conclusions: Strengths of the program revolved around the opportunity for NESB nurses to undertake a formal assessment process in order to achieve registration in Victoria. Limitations related to lack of support in the clinical environment. It was revealed that although the adaptation process was complicated for individuals by cultural, linguistic and professional issues, the main challenge seemed to relate more to the clinical workforce culture that operated at some hospitals. Nurses reported feelings of disempowerment caused by discriminatory practices, professional isolation and unrealistic expectations by local nurses.