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Clinical Transition Experiences of Internationally Educated Nurses Into Major Trauma Care: A Descriptive
Adam Ash1,2, Kay De Vries2, Jane Rutty2,3
1School of Nursing and Midwifery, University of Birmingham, Birmingham, England, UK, birmingham.ac.uk.
Aim:
To explore the lived clinical transition experiences of internationally educated nurses entering major trauma care without prior trauma nursing experience.
Design:
Descriptive phenomenological study.
Methods:
Unstructured in-depth interviews were conducted twice with nine internationally educated nurses (seven female; mean age 32.5 years) working in a Level I major trauma centre in Saudi Arabia between February and April 2021. All participants had prior clinical experience but no trauma background. Colaizzi's seven-step method guided analysis, supported by field notes and member checking. Husserl's phenomenological attitude was maintained to ensure bracketing of preconceptions.
Results:
Three interrelated themes described transition: facing a new reality, adjusting towards growth and achieving belonging. Despite established nursing backgrounds, participants reverted to novice status in trauma care, marked by fear, uncertainty, and procedural unfamiliarity. Repeated exposure, mentorship and team inclusion gradually enhanced competence and confidence. Emotional labour was central, enabling nurses to suppress fear, maintain composure and progressively reconstruct resilience and professional identity in high-acuity practice.
Conclusion:
The transition of internationally educated nurses into trauma care involves navigating high-stakes demands as novices, with emotional labour functioning as both a protective and developmental mechanism.
Implications For Nursing Management:
Structured trauma-specific transition pathways, including simulation and mentorship, are needed to support internationally educated or novice nurses entering high-acuity services. Organisational recognition of the emotional demands of clinical transition can strengthen integration, retention and workforce sustainability in trauma systems.
Impact:
This study addressed the challenge of how internationally educated nurses adapt to major trauma care without prior experience. It found that transition required returning to novice status and relying on emotional labour to build resilience and professional identity. These findings have global relevance for workforce integration in trauma or high-acuity care systems reliant on internationally educated staff.
Reporting Method:
The study adhered to COREQ guidelines.
Patient Or Public Contribution:
No patient or public contribution.
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