The experience of expatriates qualified nurses in Malta : an exploratory study.

Abstract

This study offers the opportunity to discover and comprehend the experiences of expatriate nurses employed in an acute general hospital, in Malta. The evidence in the literature suggests that when nurses migrate to other countries to work, they often encounter difficulties in adjusting to the new environment to which they have migrated. Efforts to enhance their adjustment to work have been recommended in the literature. Due to the fact that there has been no local studies carried out in this area of expatriation, an interpretive phenomenological approach was considered most appropriate, with the aim of producing rich and meaningful data. Data was collected from a purposive sample often expatriate nurses originating from Bulgaria, Romanian and the Philippines, who had been working within the acute care hospital for a minimum of two years through in-depth semi-structured interviews. All the ten interviews were recorded and transcribed. Following transcription, only nine interviews were analysed as during this stage one of the nurses from the initial sample decided to terminate participation in the study. Analysis and interpretation of the data from the nine interviews was achieved through use of interpretative phenomenological analysis (IPA), a distinctive approach in conducting qualitative research that is concerned with understanding lived experiences. The findings demonstrate that several contributory factors exist in influencing the nurses to migrate to Malta, mostly related to financial incentives and better working conditions. However, on migration, it was evident that these nurses had to face some

challenges; a major challenge which was common to all the participants is related to the difficulty in communication, especially because of the wide use of the Maltese language across patients and staff. Nevertheless, although for some, the initial experience was shocking and frustrating mostly because of the referred language barrier, most of the participants adapted quite positively to the new environment. There are some factors that have emerged from the analysis of the data which had influenced the adaptation process of these participants mainly their own clinical knowledge and their previous working experience in their home and other countries. A positive collegial relationship and trying to cope with the language barrier by pursuing a programme of studies in the Maltese language, or learning some phrases have also emerged as measures which have facilitated the nurses' adaptation to the new environment. The findings clearly indicate that nurses lacked formal organizational support on arrival to Malta and that they had to be self-efficient in finding their way and adapting to their new environment. The findings suggest that nurses need support during their initial period on the clinical area and this could be provided through the induction of preceptorship programme that will also serve as a performance analysis of these nurses' competencies. More research could also be done exploring the Maltese nurses' experience of working alongside the expatriate nurses, while taking a longitudinal approach to studying such an experience. The findings will hopefully inform administration and management accordingly.

Keywords: expatriate nurses, international recruited nurses, experience, challenges, adaptation, qualitative, interpretative phenomenology