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Cross borders with communication: Prepare staff for the arrival of international nurses

Nurse Leader Weekly, June 24, 2005

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Ask your nurses to try on these shoes for size: You work as a nurse and have little or no control over your career. You are faced with poor working conditions and limited resources and have little or no opportunity to advance your education. Because of these circumstances, you must leave your family to support them.

Many international nurses face these realities daily, and once they arrive at their new places of employment in the United States, they are often misunderstood and thus viewed with trepidation from their new colleagues.

One reason why relationships between domestic and international nurses are sometimes stunted is because domestic nurses often don't realize the full capabilities of international nurses, says Bette Case, PhD, RN, BC, educational consultant with AMN Healthcare, Inc., in San Diego.

For instance, the tasks nurses are expected to perform vary greatly from country to country and many U.S. nurses focus on cultural/language differences rather than knowledge and ability.

This is most evident when international nurses enter a U.S. hospital unit and-regardless of how much experience they may have-if they cannot perform a task that is considered to be basic to the job (e.g., starting an intravenous [IV]), then they are perceived by other nurses as less than competent, says Case. However, in many countries, beginning IVs is often a task only performed by residents or doctors.

According to Case, a lot of miscommunication occurs on both sides. Because one party doesn't want to disclose to the other that he or she did not understand what the other person said, this miscommunication-and frustration-become the end result.
Specifically, international nurses often do not want to ask the domestic nurses to clarify a question or request because they do not want to appear incompetent, says Case.
"The [international nurse] wants to appear competent and knowledgeable of the language because [he or she] realizes that this 'doesn't even speak English' mentality is out there," she says.

Case's advice is to tell international and domestic nurses to "clarify, clarify, clarify."

Source: Adapted from Competency Management Advisor (June 2005), published by HCPro, Inc.

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