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Updated: Jan 20, 2026
The Professional Nurse
Professional Adaptation of Foreign Nurses Working in Iceland: A Focus Group Study Guided by the Cross-Cultural
Wendill Galan Viejo1,2, Helga Bragadóttir1,2, Marianne Elisabeth Klinke1,2
1Faculty of Nursing & Midwifery, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
Aim:
To explore how internationally qualified ('foreign') nurses adapt to their professional and personal everyday life in Iceland, using the Cross-Cultural Adjustment Model (CCAM) reflecting general, interactional and work-related domains.
Design:
Qualitative focus group study.
Background:
The global nurse migration has created multicultural workforces, with foreign nurses facing significant challenges that may affect their well-being, sense of professional belonging and retention.
Methods:
A CCAM-informed, semi-structured guide was used. Audio-recorded discussions were analysed in two stages: (1) content analysis to derive data-close categories; and (2) interpretive description to identify practice-relevant themes and cross-domain patterns of adaptation. Five focus group interviews were conducted with 30 foreign nurses.
Results:
An overarching theme, Interplay between self and system, described reciprocal adaptation, where nurses both learn from the system and also shape it through peer mentoring, advocating for translated patient materials and modelling culturally sensitive practices. Three subthemes captured participants' multifaceted experiences: (1) Workplace dynamics and discrimination, (2) An uphill professional and personal adaptation process and (3) Need for systemic support and training. Across themes, participants called for structured onboarding, consistent mentorship and leadership that embeds inclusion in everyday practice.
Conclusions:
Findings highlight the importance of culturally responsive leadership and systemic initiatives in supporting adaptation. Leveraging the skills of foreign nurses is essential for fostering inclusive, sustainable work environments.
Implications For The Profession:
Nurse leaders and educators should prioritise culturally and linguistically responsive onboarding, mentorship and inclusive feedback cultures to support sustainable workforce adaptation.
Impact:
By applying the CCAM to a small, linguistically distinct Nordic system, this study identifies actionable, cross-domain levers to improve adaptation and inclusion of foreign nurses. Findings inform leaders on how to strengthen support structures, improve retention and foster inclusion.
Reporting Method:
The Consolidated Criteria for Reporting Qualitative Research.
No Patient Or Public Contribution:
This study involved healthcare professionals only.
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