Integration of overseas Registered Nurses; evaluation of an adaptation programme

Background: The growth in overseas nurse recruitment to address staff shortages in the United Kingdom (UK) has led to the proliferation of adaptation programmes for overseas nurses to gain appropriate experience and enable them register with the Nursing and Midwifery Council. This paper reports on selected findings from an independent evaluation of an adaptation programme for overseas Registered Nurses offered by a large acute National Health Service trust. Aim: This paper reports on a study to evaluate the programme with reference to its objectives, outcomes and overall success from the perspective of various stakeholders. Methods: A pluralistic evaluation research model was adopted to identify the criteria that stakeholders used to judge the success of an adaptation programme, and then to use these criteria to judge the programme in question. Data were collected by means of focus group and individual in-depth interviews with overseas nurses, ward managers, mentors, senior nurse managers and educators over a 12 month period and analysed by drawing on the principles of dimensional analysis. The criteria for success identified by the various stakeholders provided a framework through which the overall success of the initiative could be judged. Findings: Five meanings of success were identified: gaining professional registration; fitness for practice; reducing the nurse vacancy factor; equality of opportunity and promoting an organizational culture that values diversity. Key findings relating to each of these are presented. The ease with which nurses gained UK registration and integrated into the nursing workforce was influenced by the characteristics of the work environment, level of support, and organizational context. Conclusion: Industrialized nations recruiting from the global nursing market need to invest in providing appropriate support to enable overseas nurses to adapt to working in a different health care system and social and cultural context.