Navigating New Horizons: Experiences of African-Educated Nurses Transitioning To the American Healthcare System

The increasing global nursing shortage has led to a rise in the migration of African-educated nurses (AENs) to the United States. Despite being essential to the U.S. healthcare workforce, AENs face significant challenges during their transition, including cultural, professional, and emotional adjustments. This study aimed to explore the lived experiences of AENs transitioning into the American healthcare system and to identify the specific support needs required for their successful integration. A phenomenological approach guided by Ricoeur's interpretive phenomenology framework and Afaf Meleis's transitions theory was used. A combination of purposive and convenience sampling was employed to select 19 AENs who were trained in Africa but are currently working in various U.S. health institutions, and they participated in in-depth, unstructured interviews. Data were analyzed thematically to capture the essence of participants' experiences. Five main themes emerged: (1) Navigating an Unfamiliar Ground, including culture shock, language barriers, and differences in patient care standards; (2) Developing a Thriving Mindset, highlighting resilience, determination, and the importance of social support; (3) Institutional Factors Affecting Transitioning, such as the role of mentorship programs and perceived racial biases; (4) Heavy Performance Demands, reflecting the need for constant skill demonstration and managing high workloads; and (5) Leveraging Opportunities for Growth, focusing on career progression, financial benefits, and access to advanced healthcare technologies. AENs experience a complex transition into the U.S. healthcare system characterized by significant challenges and growth opportunities. Targeted support interventions, including cultural competence training, mentorship, and institutional support systems, are essential to facilitate their successful integration and enhance their contributions to patient care.