BAME Nurses’ Experiences in Western Healthcare: A Qualitative Evidence Synthesis

Introduction
The shortage of nurses in Western countries has led to an increased reliance on internationally trained Black, Asian, and Minority Ethnic (BAME) nurses, who now constitute an essential component of the healthcare workforce. However, their working environment is often marked by unique challenges and complexities distinct from those faced by native nurses. Understanding these experiences is crucial for creating a positive work environment, thus underscoring the necessity for diversity and inclusivity in the nursing workforce.
Aims and objectives
To synthesise evidence from qualitative research on the work experiences of internationally trained BAME nurses in Western healthcare settings.
Methods
A qualitative evidence synthesis was conducted by electronically searching databases, including Medline, Embase, CINHAL, Web of Science Core Collection (incorporating the Social Science Citation Index), and grey literature sources. After screening, 36 studies were included in the review. The methodological quality of these studies was evaluated using the CASP tool, and data were
synthesised using Thomas and Harden’s thematic synthesis approach.
Outcomes
The thematic analysis revealed three main themes: “Initial Adaptation Hurdles”, “Professional Adversities”, and “Strategies for Coping”, each encompassing several sub-themes. Internationally trained BAME nurses experience diverse challenges adapting to Western healthcare settings due to cultural, communication, and workplace differences. Differences in nursing practices, workplace culture, employer expectations, and unfamiliarity with policies and guidelines in the host country make their experience more complex and challenging. In addition, a lack of understanding of the family functioning in caregiving and workplace racism and discrimination further complicate their experiences.
Conclusion
Internationally trained BAME nurses face unique challenges in Western healthcare settings stemming from cultural, communicative, and workplace differences and experiences of discrimination. Culturally tailored orientation programmes, peer mentorship, and equitable career and educational
opportunities are essential to improving their integration, job satisfaction, and retention, ultimately increasing organisational safety and performance.