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Immigration a plus, not a negative

The global movement of nurses provides an important opportunity to improve care for an increasingly multicultural society, writes Sophia Dywili.

A relative of a patient asked: “Where do you come from?”
“From Bankstown ma’am,” I replied, happy that I easily remembered the name of my new town.
“No, I mean, where do you come from?”
“Oh I see, I come from ... a beautiful country in Africa,” I replied smiling.
“Is that where you did your nurse training?”
... and the conversation continued.

This conversation took place within the first week of my arrival in Australia. Obviously I looked “different” and I understood. Believe me, more than six years on I continue to engage in similar conversations.

After working this long as an overseas qualified nurse in the Australian health and education systems, one tends to lose colour-ethnic consciousness. Sometimes I even forget I am from “somewhere” until someone reminds me. What’s the point here?

It has been reported in literature that the recruitment of the overseas qualified nurse in Australia brings with it problems such as cultural conflict and language barriers which contribute to stress for all concerned.

As an overseas qualified nurse working in Australia I have also encountered some negative comments about overseas recruitment such that I’ve asked myself why Australia continues with the active recruitment of overseas qualified nurses if they do not value-add to the Australian health system.

Every year thousands of nurses migrate between rural and urban areas, the public and the private sectors and between countries and continents. Research informs us that nurses move for various reasons that are related to socio-economic, professional, personal and political issues. The global nurse shortage has been identified as one of the forces behind this cross-border movement.

This shortage has been attributed to increased healthcare demands, the ageing nursing population and competition for the school leaver who now has a wide range of career choices beyond the traditional nursing and teaching careers. Around the world, schools of nursing have been failing to meet the national demands for nurses, hence the active recruitment across national borders.

The migration trend is primarily from developing countries to the industrialised countries because of the economic disparity between these countries. A past issue of Nursing Review (November 2011) reported that 30 per cent of nurses working in Australia were born overseas and that the past decade has seen a big increase in the number of migrant nurses arriving in Australia.

The overseas qualified nurse is found in almost all health sectors including acute and critical care, public health and aged care facilities. Based on this migration trend there is little doubt that the face of the Australian nurse is changing. This also occurs in the light of an Australian patient population that is becoming more multicultural.

So what are the issues for Australia and the overseas qualified nurse? Should we view cultural differences at the workplace as a problem in Australia? There is no doubt that the cultural differences create some misunderstandings within the workplace especially as all nurses are expected to offer clinically and culturally safe practice. However, it is important to consider how overseas nurse migration to Australia might enhance their workplace.

Most overseas qualified nurses bring with them vast nursing experience and cultural richness. I remember a certain day shift in a Sydney hospital ward where almost half the patients were from a culturally and linguistically diverse background (CALD). It was not easy to get an interpreter for every nursing intervention but the presence of some overseas qualified nurses saved the day. I believe this also strengthened the cultural safety for those particular patients. English is the language of communication at the workplace and yes, every nurse in Australia must be fluent in the language for obvious reasons.

What is the way forward? To address the current nursing shortage, bachelor of nursing enrolments are increasing. This strategy will not stop overseas recruitment. The recruitment rate may, however, be reduced. Nursing is a mobile profession and nurses will continue to move in and out of Australia, more so because of global nurse migration. Most organisations already view cultural diversity as an asset and they encourage tolerance and respect for cultural differences in the workplace.

Australia has an increasing number of CALD nurses in the face of an increasing CALD population. It would be good to capitalise on this diversity and make use of staff cultural skills instead of viewing them as a problem. This will strengthen a multicultural nursing workforce for a multicultural society. Accommodating cultural differences may reduce some of the challenges encountered in the workplace. This may also facilitate the integration process and increase professional development opportunities for overseas qualified nurses.

Cultural diversity will remain a fact of life in the nursing workforce. It may bring some challenges but it also brings with it cultural enrichment and sometimes patient language enhancement which contributes to better patient care. I see overseas qualified nurses continuing to play a critical role in the Australian nursing workforce. Their successful integration in the Australian healthcare system will enhance the benefits that are brought by their professional experiences, clinical and cultural skills.

By the way, in that first conversation six years ago the relative later expressed her surprise in my “good” nursing skills and command of the English language for someone who was “new” to Australia.

Sophia Dywili is a lecturer in nursing at Charles Sturt University.

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