Chaired by Prof Nancy Fontaine, Chair, Cavell, the meeting focused on the challenges and support mechanisms for internationally educated nurses and midwives (IENM) in the UK healthcare system.
Summary
Support for Internationally Educated Nurses
Nancy discussed Cavell's support for internationally educated nurses and midwives, highlighting financial assistance, emotional support, and career development programs. She emphasized the need for better recognition and support for these professionals, who often face economic and social challenges in the UK. Nancy introduced Professor Paula Holt Senior Nursing Adviser, Professional Practice Directorate, NMC, who provided an overview of the Nursing and Midwifery Council's (NMC) work with internationally educated nurses, including their commitment to reviewing the NMC code and revalidation process. Professor Holt also touched on the NMC's involvement with the Florence Nightingale Foundation's Wind Rush program.
UK Nursing Workforce Challenges
Paula presented data on the UK nursing workforce, highlighting a slowdown in international nurse recruitment and increased departures of internationally educated nurses. She emphasized the importance of supporting international nurses and addressing systemic issues such as racism and bullying in the workplace. Paula also discussed the NMC's efforts to improve diversity and inclusion, including changes to regulatory processes and support programs for international nurses.
Supporting International Nurses in the UK
Jeni Caguioa MBE, Senior Clinical Manager, NHS England, and Dr Agimol Pradeep, Chair, Alliance of Senior Kerala Nurses (ASKeN) Forum, shared their experiences as international nurses, highlighting the challenges faced by international nurses in the UK, including language barriers, immigration issues, and lack of confidence. They emphasized the importance of support from line managers and organizations to help international nurses integrate and progress in their careers. Agimol discussed her journey from being an adaptation nurse to earning a PhD, and her advocacy efforts to change NMC policies to allow international nurses who were taught and examined in English to practice without taking additional English language tests. The session concluded with a call for further support for international nurses, including access to professional mentors and appropriate induction programs.
International Nurse Induction Programmes
Zoe Rothwell, International Nurse Recruitment Lead, Central London Community Healthcare NHS Trust discussed their induction program for international nurses, which includes pre-arrival webinars, welcome packs, airport meet-and-greets, and two weeks of comprehensive orientation covering practical matters like banking and benefits, as well as cultural adaptation to UK healthcare. Lisa Smith, Lead for Nursing and Midwifery Recruitment and Retention, Guys and St Thomas NHS Foundation Trust shared their induction programme which emphasizes psychological support through narrative therapy and includes a six-week OSCE training programme, followed by a shortened 6-month preceptorship focused on safeguarding and professional development. Both presentations highlighted the importance of acknowledging international nurses' existing skills, providing proper orientation, and ensuring retention through career progression opportunities.
Supporting International Nurses in the NHS: Discussion points
Nancy highlighted the importance of career progression for Black and ethnic minority colleagues, noting that current efforts may not be sufficient. The group discussed challenges faced by international nurses, including driving license issues in rural areas and housing affordability in expensive locations like Brighton. Robert from Cavell emphasized the need for a single, strong voice for diaspora associations. The meeting included a presentation of a Cavell Star Award winner, Ryza, who was recognized for her exceptional support of international nurses at Imperial College Healthcare NHS Trust.
Enhancing Communication Through Drama
The afternoon session began with Dr. Karl Tizard-Kleister, Co-founder and Director, Health Action Training Ltd and Hazel Vera D. Tan, Deputy Ward Manager, Priory Hospital, focusing on applied drama facilitation and actor training approaches to enhance communication skills and create a safe space for participants. Karl and Hazel introduced breathing exercises, including the psychological sigh and box breathing, to help manage stress and prepare participants for interactive activities. They emphasized the importance of responding rather than reacting in challenging situations and introduced exercises to practice different communication actions, such as acceptance, rejection, and respect. The session concluded with a role-play scenario to demonstrate how to navigate conversations involving sensitive topics, encouraging participants to support each other in breakout rooms.
Wellbeing Support for International Nurses
Lisa Dennis, Practice Development Nurse, International Recruitment Programme & Healthcare Support Workers Interim Lead, and Sally Porter, Recruitment and Retention Lead, Norfolk and Norwich University Hospitals NHS Foundation Trust, who lead the international recruitment programme, described the comprehensive pastoral care and ongoing professional development offered to these nurses. The support includes pre-arrival preparation, welcome events, clinical training, and ongoing assistance with accommodation, financial concerns, and cultural integration. The hospital celebrates diversity and provides opportunities for professional growth, including leadership courses and various support networks. The session highlighted the importance of cultural sensitivity, personal-centred practice, and the challenges faced by international recruits, emphasizing the hospital's commitment to their wellbeing and success.
International Nurse Recruitment Consortium Success
The panel discussed the collaborative approach to international nurse recruitment in London, highlighting the success of the Capital Nurse consortium model. The consortium, established in 2020, brought 10,000 international nurses to London by standardizing recruitment processes and support across 10 initial participating trusts. The panellists shared their experiences of how the consortium provided consistent support and ethical recruitment practices, noting particularly low attrition rates among their mental health nurses. The discussion concluded with questions about the model's potential national replication and future focus, suggesting that while international recruitment has paused, the collaborative networks and support structures should continue to help retain and develop international nurses.
Compassionate support for International Nurses in the UK
Sally Nyinza, Foundation Director/President, KENMA-UK, and Christianah Morakinyo, Midlands Regional Lead and Senior Lecturer, NNCAUK, shared insights on cultural integration, trauma, and support systems for international nurses. They emphasized the importance of preparation for both international and UK-trained nurses, reverse mentorship, and the role of community associations in supporting internationally educated professionals. The panel discussed strategies to address challenges around immigration status and safeguarding measures, including better organizational preparation and support networks.
Supporting Nurses in Difficulty: RCN Immigration Advice Service Update
Sophia Barrett-Mlangeni, Senior Immigration Adviser and Solicitor, RCN presented on the RCN Immigration Advice Service's support for members and discussed new government proposals for indefinite leave to remain. She explained how the service assists members with visa applications, appeals, and administrative reviews, particularly for health and care workers. Sophia outlined the proposed changes to the 5-year route to settlement, including increased requirements for English language proficiency and financial contributions. She emphasized the importance of participating in the consultation process and contacting Members of Parliament to oppose these changes. The discussion also covered recent changes to visa rules affecting nurses and care workers, including salary thresholds and restrictions on employers recruiting from outside the UK.
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