Understanding the Reentry Experiences of Immigrant Nurses in the U.S. A Qualitative Case Study

Labor market projections see a growing need for nurses to satisfy demand in the U.S. health care sector into the next few decades. It is assumed that this demand will be met in part by immigrant nurses who received their nursing education outside the United States. Like many immigrants to the United States, internationally educated nurses face a number of challenges that make it difficult for them to obtain a nursing license and practice nursing in a U.S. health care setting. Learning to surmount these barriers represents a learning and a coping process.This qualitative case study was designed to explore how a sample of internationally educated nurses learned to reenter the nursing profession in the U.S. The participants consisted of alumni of a retraining program for internationally trained health care professionals housed in a community college in the Northeastern United States. The primary sources of data came from semi-structured interviews consisting of questions about their experiences pursuing reentry into the nursing profession. The study’s major findings included the following: (1) Participants described being dissatisfied with their initial employment upon immigrating to the United States. (2) Participants reported that the language barrier and the nursing certification process, including the licensure exam, were major challenges to reentering the profession. (3) Participants reported that the most important things they learned were the difference between nursing practice in their countries of origin and in the U.S., and professional skills, including National Council Licensure Examination (NCLEX) test-taking skills. (4) Participants reported that they learned in both informal and formal methods. (5) Participants reported that having a positive attitude, support from others, and time management enabled their learning, while gaps in their practice hindered it.The findings of the study suggest that the participants learned to surmount the barriers they faced through a learning process characterized by increasing professional autonomy and self-directedness, as well as critical reflection on prior education and training. This process is facilitated by educators who are able to both help them develop professional autonomy and provide emotional support along what is a difficult and prolonged journey toward RN licensure