There is a global and national shortage of nurses, and the situation is getting more difficult with aging population and 25 % of nurses getting retired in the next ten years in Finland (Keva 2021, Sairaanhoitajat 2021). For that reason, and to ensure culturally sensitive care for multicultural population, it is important to recruit and to educate culturally and linguistically diverse (CALD) nurses. However, CALD nursing students face language and communication challenges (Onovo et al. 2019) and often find it difficult to integrate into the foreign culture (Scherer et al. 2019). We exploredCALD nursing students’ experiences of clinical practice as well as their perceptions of their career path to find out, how academic support and clinical experiences affect CALD nursing students’ intentions to stay in the profession and a foreign country.
The study was done by conducting focus group interviews in six universities of applied sciences (UAS) during May and June 2021. After the transcription an inductive content analysis was conducted. Five main categories were found, including: 1) Importance and inadequacy of support; 2) Necessity of equality in education and working life; 3) Nursing competence; 4) Importance and difficulty of integration; 5) and Changes in career growth as a result of clinical practice experiences.
According to the results of the study the CALD nursing students felt that the support they received from their UAS was not sufficient, as it was concentrated mainly on the first year of studies. Educators’ support and encouragement was important. The students, who had international educators, viewed them as important role models. Some CALD nursing students experienced that the nursing degree programme in English did not offer the same variety of courses and the same options for advanced studies as the Finnish programme.
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The CALD nursing students felt that the mentor had an important role in the success of their clinical placement. The mentors also had a role in improving students’ language skills. The students felt that they learned the most when mentors let them do things. Clinical placement experiences affected students’ future job choices and preferences.
The wards often limited the number of English-speaking students to one. The limitation restricted students’ possibilities to gain experience and competence in specialties of their interest. Students were not always accepted to a placement because of their poor language skills and they hoped, that language skills could be refined during clinical placements. They experienced the workplace as a good environment for learning language and communication skills. Students considered fluency in spoken Finnish necessary for finding a clinical placement, a job, and a career. They recognised that their personal qualities, such as motivation, a correct attitude, self-evaluation skills and coping skills, can affect their careers.
The demand that CALD students should master several languages complicated integration. Most students studied in English and did their placements in Finnish. By the seashore of Finland also adequate Swedish skills were expected, at least to get a permanent vacancy. Students experienced that there were two ways to get a job: the student either needed to prove his/her skills during the placement, or a job was available because of the nurse shortage or holidays. Integration into working and civil lives affected the CALD nursing students’ decision to stay in Finland; many of the students hoped to stay in Finland if they get a job, or because they have a stable life situation in Finland.
Based on the presented research, CALD nursing students would benefit of support throughout their studies. Furthermore, the education of mentors involved in clinical environments is important to ensuring that each student achieves their learning objectives. Students who require additional support need to be better recognised and supported. Advanced studies for CALD nursing students could be organised in cooperation with other universities. Moreover, new technologies should be integrated into nursing education to ensure more effective ways of learning the Finnish language. For example, the applications of virtual reality in this context would be an interesting topic to study.
Writer: Paula Ropponen
References
Keva (2021) Kuntien työvoimaennuste 2030 – Analyysi kuntien työvoima- ja osaamistarpeista. www-dokumentti. https://www.keva.fi/contentassets/9034ce5888f14123996a6b41b9c315ea/kevan_kuntien_tyovoimaennuste_2030_esitys_180221.pdf.
Onovo, G.N., 2019. Fundamentals of Nursing Practice and the Culturally Diverse ESL Nursing Students: The Students’ Perspectives for Teaching and Learning in Nursing. Teaching and Learning in Nursing 14: 238–245.
Sairaanhoitajat (2021) Tilastoja sairaanhoitajista. www-dokumentti. https://sairaanhoitajat.fi/ammatti-ja-osaaminen/tilastoja-sairaanhoitajista-2/#
Scherer, M.L., Herrick, L.M. & Stamler, L.L., 2019. The learning experiences of immigrants who are graduates of an entry-level baccalaureate nursing program: A hermeneutic phenomenological study. Nurse Education in Practice 34: 185-191. https://doi.org/10.1016/j.nepr.2018.12.002
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