Overseas Qualified Nurses’ (OQNs) perspectives and experiences of intraprofessional and nurse-patient communication through a Community of Practice lens

Background: Overseas qualified nurses enter their new workplaces as experienced newcomers, who are challenged by unfamiliar patterns of communication with patients and colleagues. Little is known of the relational dimension of these nurses’ adjustment to unfamiliar communication norms. Aim: This paper explores the barriers and enablers of clinical communication experiences of OQNs from their perspective using a Communities of Practice framework. Methods: This exploratory qualitative study involved semi-structured interviews of OQNs (males = 4, females = 17) employed in acute and semi-acute clinical settings, at a major metropolitan hospital in Melbourne, Australia, with a increased OQN presence. Verbatim transcripts were analysed using thematic analysis. Findings: Two major themes emerged from the analysis. The first theme comprised the pre-existing attributes of self, as both a barriers and enabler with sub themes of language adaptability and preparedness. The second theme was interactions with colleagues and patients with sub themes of expectations, adjustment and career progression. As seen through the CoP lens, these themes had a relational dimension, as communication with other staff and patients reportedly impacted on the nurses’ development in an unfamiliar healthcare environment. Conclusion: OQNs can find communication in Australian healthcare complex and challenging making it an important area for learning. Intercultural communication issues stand out as a crucial factor in these nurses’ transitions. ‘Newcomer’ OQNs need active and meaningful interactions with local colleagues (old timers) and patients in order to gain language and cultural understanding of the new context. Provision of an ongoing supportive learning environment with opportunities for constructive feedback will help OQNs move from peripheral participation to full participation in health care encounters.