Internationally trained nurses make a world of difference

NURSES FROM ABROAD BRING GLOBAL UNDERSTANDING TO THEIR JOBS HERE IN THE GRANITE STATE

Nursing leaders recognize a strong connection between a culturally diverse nursing workforce and the ability to provide safe, quality, culturally-concordant patient care. During a recent seminar titled “Understanding the Lived Experience of Internationally Educated Nurses at Dartmouth-Hitchcock Medical Center,” Jennifer Orbeso, DNP, Nursing and Diversity Inclusion Specialist; Cigal Okojie, RN, Clinical Nurse; and Nicolette Demeritte, RN, Clinical Nurse shared their stories of self-stewardship, struggles and success, and spoke about their knowledge and expertise about inclusive and borderless caring to educate providers around the Granite State about the trajectory of international nursing at Dartmouth-Hitchcock Medical Center (DHMC).

“As we come out of the COVID-19 pandemic, there is a new shortage of millions of nurses and we know that our healthcare landscape in this space is screaming for more people to make our hospitals and other facilities function day in and day out,” shares Jennifer Orbeso. “International nurses are hired for their expertise and professional experience, and it is clear that the system is in dire need of our community.” Dartmouth-Hitchcock’s International Nurses Committee (INC) was formed in 2018 to further ensure the hospital’s commitment to build a patient care community that recognizes the value of human diversity, and the committee is now one of the leaders in promoting the Diverse Workforce Initiatives at DHMC.

We are always willing to fill in wherever there is a need wherever we can be of assistance.” – Nicolette Demeritte, RN, Clinical Nurse

After doing their own survey, the INC found that international nurses are primarily women between 30 and 45 years old, and come from countries ranging from North America, Africa, the Caribbean and Far East Asia with around two years of professional experience. They also found that common characteristics of the international nurse include being strong-willed, motivated, smart, flexible and optimistic. “When we think about what it means to be strong-willed and motivated, I think that it would have to start with the journey itself,” says Nicolette Demeritte. “In order to carry these out, you have to have determination in yourself and for your family. We are always willing to fill in wherever there is a need wherever we can be of assistance.” Shared values of the international nurse include being family-oriented, having a happy disposition and being inclined to celebration, as well as having shared interests of learning a new culture, meeting new people and focusing on personal and professional growth. “We are not afraid to learn about new cultures and experience new things, like possibly even shearing a sheep,” notes Nicolette. “In doing that, I know I have personally met so many friends at DHMC, and I think that is something that we all have as a common characteristic.”

When an international nurse first starts to pursue a career at DHMC, they are met with the pre-departure challenges of experience, expenses and exams. Once they arrive, they go through stages ranging from the honeymoon stage to the culture shock stage. “Learning that patients prefer that you call them by their names was a culture shock to me,” says Cigal Okojie. “I would call them ‘sir’ or ‘ma’am,’ and they would ask where I was from. I consider it rude to call someone around my mom’s age by her name, so that took a year or more to get used to calling my patients, and even peers, by their name. You have to unlearn a little bit of what you brought over from your home culture.”

International nurses are hired for their expertise and professional experience, and it is clear that the system is in dire need.” – Jennifer Orbeso, DNP, Nursing and Diversity Inclusion Specialist

International nurses have a thematic lived experience when they start working at DHMC that includes focusing on relationships with their preceptors, patient interaction, colleague interaction and open communication, nursing leadership support and contributions to their community. For Cigal, part of her experience is making sure she looks at her peers, coworkers and patients as family. “We consider our patients family, therefore our interactions with them is like interaction you would have with your father or mother. Treat them like you would treat yourself on that bed that day.”

As international nurses start to integrate into the DHMC community, it’s important to be aware of challenges in areas like variance in academic preparation, safe and effective communication, medication safety and abundance of technology and new equipment as well as electronic

charting. Implementing a strategic plan that addresses clinical, leadership, and organizational competencies and creating a transition evaluation can help combat these problems. Understanding that the retention of a high-quality, talented and diverse workforce begins at recruitment, and that there is a correlation between diverse workforce and high-quality patient care will also help create an inclusive workplace, one that makes employees more valued and welcomed now and in the future. “One way to make an international nurse feel included is to educate the unit or floor about the nurse’s home country,” says Nicolette. “Include fun facts about the country where the international nurse came from. It would be nice for someone to walk onto a unit to see their country represented in that way. Don’t shy away from things that you are unfamiliar with or outside of your comfort zone. We are very approachable and love being seen, accepted and appreciated.”

As the session wrapped up, the chat box was filled with comments like “thank you for helping our international nurses transition” and “I’m so excited for this opportunity to learn and share more about diversity,” and the final slide reminded attendees that, “Our world has become smaller. Our differences are exactly the same.” As Cigal shared, “We are doing this to talk about the lived experiences of nurses like us and so that we can incorporate that into the onboarding process and help nurses coming into DHMC in the future.” 603

We are doing this to talk about the lived experiences of nurses like us.” – Cigal Okojie, RN, Clinical Nurse