| In 2000, 74,799 nurses passed the NCLEX-RN exam of whom 5,230 (7.51%) were internationally educated. By contrast, in 2008 30,007 nurses born and educated outside the U.S. successfully passed the NCLEX-RN allowing them to practice in the United States. This was 23.23% of all nurses who passed the exam. The rapid growth in the percentage of Internationally Educated (IE) nurses eligible for practice in the U.S. is expected to continue. Nursing research in the U.S. has primarily focused on numbers of nurses migrating to the U.S. but little is known about their experiences. The purpose of this study was to understand the perceptions of IE nurses about the process of adjustment to the U.S. healthcare workplace. Additionally, this study examined what the IE nurses identified as helpful or hindering during the process of adjustment.;Using naturalistic inquiry and a qualitative descriptive design, this study revealed a non-linear, iterative, process of adjustment to the U.S. healthcare workplace by IE nurses working in the U.S. as registered nurses. Purposeful sampling was conducted among IE nurses in the northeastern United States until data saturation was achieved. Personal interviews were conducted with twelve IE nurses from eight countries: Ghana, India, Ireland, Nigeria, the Philippines, Poland, Romania, and Taiwan. Constant comparative data analysis was conducted until themes, sub-themes, and categories emerged from the data. Trustworthiness was assured by reflexive journaling, an audit trail, and member checks.;Five major themes emerged: (1) Reflecting on Being Here, (2) Struggling to Understand the Differences, (3) Connecting to Others, (4) Praying and Having Faith, and (5) Feeling Devalued. This study suggests that LE nurses' experience professional and personal challenges as they adjust to the U.S. healthcare workplace including adjusting to differences in communication, the culture of U.S. healthcare, and differences in nursing education/practice. Feeling connected to others facilitated adjustment while feeling devalued hindered it. Implications from this study include the importance of developing more comprehensive orientation programs for newly-arrived IE nurses, developing educational programs for American nurses about the experiences of IE nurses, and the role of mentoring in IE nurse adjustment. |
