Reconstructing a typology of approaches to navigating diversity: a comparative qualitative study of German nursing...

Germany faces a severe nursing shortage, increasingly addressed by international recruitment. This shift results in growing socio-cultural and educational diversity within nursing teams. While the experiences of migrant nurses are well-documented, how receiving teams manage this diversity in daily practice remains under-researched. This study investigates team-level patterns of navigating diversity and identifies factors influencing successful integration.

A qualitative, comparative case study design was employed across six nursing teams (four hospitals, two nursing homes) in Germany. Teams were selected through purposive sampling based on high levels of socio-cultural and educational diversity. Data collection (March 2022-August 2023) included 203 h of participant observation, 25 semi-structured interviews, and 8 focus groups with both nursing management and non-managerial nursing staff focusing on daily cooperation, professional and socio-cultural differences, and team integration processes. Inductive analysis followed the documentary method to reconstruct implicit orientation patterns. Social Identity Theory (SIT) served as the theoretical framework for describing the different team dynamics.

Three distinct team-level approaches to diversity were identified: (1) Routine-based Teams normalise diversity within a stable framework, valuing individual competencies as a natural asset and seamlessly integrating differences into everyday practices. (2) Transition-based Teams actively engage with shifting team configurations through supportive structures but experience operational ambivalence as newly developing learning processes occasionally collide with ingrained routines. (3) Friction-based Teams exhibit a defensive, problem-oriented stance toward diversity, characterised by rigid boundary maintenance, perceived competence conflicts, and a tendency toward social fragmentation under structural strain. Key influencing factors include the facility's location and patienthood and the role of nursing management.

Successful team collaboration depends on fostering a shared professional framework that recognises and utilises diverse individual competencies. Nursing management must provide stable resources for reciprocal knowledge transfer and actively address structural barriers regarding the valuation of international qualifications. To ensure high-quality care and sustainable staff retention, managerial interventions should implement targeted support measures tailored to the specific dynamics of a team type.

Not applicable.