The long-term experiences and career progression of international nurses working in the health sector in England

Abstract

Objective: To compare career development trends and understand enablers and barriers to career progression of international nurses working in the National Health Service in England, United Kingdom (UK).Background: International nurse recruitment is happening at size and scale across the globe due to nursing workforce shortages worldwide. The UK is one of many healthcare systems competing for international nurses. Demonstrating how international nurses are supported with career progression can validate a healthcare systems employment offer.Methods: A mixed methods approach, comprising a quantitative analysis of career progression rates comparing domestic nurses and international nurses working in England between the dates 2014-2021; and qualitative interviews, exploring career progression of international nurses that have worked in the NHS for 5 years or more.Results: Data were collected on 611,912 nurses, including 496,741 domestic nurses (81.2%) and 115,171 international nurses (18.8% of all nurses). Progression from a Band 5 registered nurse happens less frequently and more slowly for international than for domestic nurses (median time to progress 5.8 years for domestic and 6.8 years for international); with less marked differences in frequency of progression from higher nurse bands. From 21 interviews, three themes emerged from the pre progression stage: (1) See me and know I can thrive; (2) Don’t overlook me; (3) Embrace Me as I learn; and three from the post-progression stage: (1) I have power to influence; (2) I can break down barriers; (3) I lead and inspire others. International nurses described characteristics of mettle, resilience and determination; with many demonstrating successes influencing change.Conclusions: The presence of international nurses in leadership and as role models can benefit career progression. Through empowerment and representation, following succession, international nurses are inspiring role models to enable opportunities for career progression for future generations.