Wraparound Supports: The Key to the Transition and Integration of Internationally Educated Registered Nurses in Rural...

Internationally educated nurses (IENs) face multiple challenges during their transition and integration to nursing settings in host countries. Two foci are prevalent in the extant literature: IENs' experiences in urban nursing settings and internationally educated healthcare professionals' experiences. There is a distinct gap with understanding IENs' experiences while transiting and integrating into rural nursing practice and communities.

This study aimed to understand IENs' experience of rural nursing practice and the strategies they used to enhance their transition and integration into the rural workforce and community settings.

Semistructured interviews and participant photographs representing their experiences from the qualitative phase of a sequential mixed methods design were conducted in Alberta, Canada.

The transition and integration of IENs depend upon the wraparound support they received through interactions and connections with healthcare leaders, managers, administrative members, nursing colleagues, and community members. Embedded in these interactions and connections were various strategies IENs used to help them navigate and manage their desire to "fit in" and to be accepted in their rural nursing and community settings.

IENs were highly motivated to become accepted as contributing members of the nursing team and rural communities. To achieve this goal, they engaged in behaviors to become a valuable member of the nursing team by acquiring additional practice knowledge and skills to enhance their competencies. They also used strategies to connect and "fit into" their new community. Wraparound supports included not only the employer and nursing colleagues but also key community members with social capital. These supports were key to IENs' engagement in and navigation of the transition and integration processes.

Healthcare leaders, managers, and key community members play pivotal roles in the development of cross-cultural, inclusive work, and living places by providing wraparound supports that reduce the cultural and rural practice distance between IENs and their nursing colleagues as well as creating opportunities for establishing cultural-sensitive work and living environments.