The purpose of this study was to explore the lived experiences of internationally educated nurses (IENs) in the USA, focusing on the challenges they faced and the coping strategies they used to cope with those challenges, to understand how IENs manage the challenges from the lens of psychological capital (PsyCap) development for their well-being, given the increasing reliance on IENs in addressing global nursing shortages.
The authors used a qualitative research design to capture the lived experiences of IENs and conducted semi-structured interviews with 19 IENs from diverse backgrounds. The authors analyzed their narratives of challenges and coping strategies to adjust to the US health-care system, using a thematic analysis.
The IENs interviewed encountered significant challenges, such as having to adapt to cultural differences and facing systemic barriers in credentialing and integration. Their coping strategies included embracing hard work, reframing challenges through gratitude and seeking support from ethnic peer networks. Those coping strategies helped them manage the stress of adjusting to a new health-care environment. To help IENs cope with the challenges they face when entering a new health-care system in the USA, the authors recommend enhancing health-care leaders’ cultural awareness and implementing formal peer networks and systemic reforms.
This study contributes to existing literature on IENs by offering a better understanding of the unique challenges they face, highlighting the need for tailored support for IENs in health-care settings. Future research is called for to test the effectiveness of the proposed recommendations for supporting IENs’ PsyCap development and well-being.
Insights from this study will guide health-care professions education and human resource development (HRD) practitioners in designing and developing targeted interventions to support IENs, such as cultural competence training for both peers and leaders and inclusive HRD practices, improving IENs’ well-being and patient care.
This study revealed unexpected insights into how IENs cope with challenges in US health care, including persistent language barriers, cultural belonging and systemic obstacles related to credentialing and immigration. Ethnic-specific peer support, emotional resilience and mental reframing, where IENs compare current challenges to past hardships, emerged as key coping strategies. These coping strategies enabled IENs to maintain their PsyCap and well-being, offering new perspectives that were not previously captured in the literature.
