4/30/2012. Background. Objectives. Project Site. Methods. Methods

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1 Background Internationally Educated Nurses (IENs) and English as a Second Language (ESL) nurses face substantial challenges integrating into the Canadian nursing workforce. Transition and Integration into Employment Ruth Lee, RN, MScN, PhD Andrea Baumann, PhD Jennifer Blythe, PhD Daniela Dijmarescu, RN The goal of this project is the integration of 60 IENs and ESL nurses into the workforce, by enhancing their communication, clinical and cultural competencies. Project Site Hamilton Health Sciences (HHS) is a family of 6 hospitals and a cancer centre, the largest healthcare organization in the Hamilton- Wentworth region of Southern Ontario. HHS has over 10,000 employees, 3200 of whom are nurses. Objectives Develop a suite of tools and processes for integration. Build capacity of 30 HHS experienced nurses who act as Clinical Integrators to facilitate the integration. Evaluate program components and over all project. Needs Assessment Focus groups were employed to assess needs of Clinical Integrators, HHS Clinical Managers and Participants (IEN/ESL Nurses) to facilitate the integration of the latter into the workplace Needs Clinical Integrators Meeting registration requirements Building confidence Allaying fears about accented English Providing feedback based on their own experiences 1

2 Needs Clinical Managers Creating a supportive workplace No-blame culture of patient safety (minimize the risk of hiding errors for fear of reprisal) Conflict among nurses of different origins/cultures Managers needed understanding of the cultural backgrounds and experiences of their nurses. Needs Participants Communication (cultural cues) Increased orientation time Bridging programs More resources Community Collaborative Partners/Interventions 1) Centre for Internationally Educated Nurses (CARE): Workplace Communication Course 5, (110 Registrants) 2) Mohawk College, Bridging Internationally Educated Nurses (BIEN): Learning Resource Centre/Simulation Laboratory- 127 Participants, I-CELBAN 56 Participants 3) Hamilton Centre for Civic Inclusion (HCCI): Cultural Competency Awareness Training-1 Session, 13 attendees 4) Nursing Health Services Research Unit (NHSRU): Evaluation of effectiveness of Interventions & Project Community Collaborative Partners/Interventions 4) HHS Job coaching /Mock Interviews -102 Participants 5) HHS Intranet: Share Point Website 140 Participants 6) HHS/CNO Learning Plan, HHS Policies and Procedures on the Intranet-140 Participants 7) HHS Networking Program Nurses Nurturing Nurses (N3) based on the American Academy of Medical-Surgical Nurses program -42 Dyads Additional Activities Job shadowing and attendance at nursing orientation Lunch and Learn sessions for networking Attend conferences and presentations 2

3 Internationally Educated Nurse (IEN) and English as a Second Language (ESL) Nurse Integration Project Structure Government of Ontario, Ministry of Citizenship and Immigration, Labor Market Integration Unit Signing Authority: Hamilton Health Sciences (HHS), President and Chief Executive Officer Community Collaboration Employment Model (CCEM): Bridging the Gap for IEN/ESL Nurses Project Partners Role EMPLOYER Hamilton Health Sciences (HHS) Project Role: Effectively hire and integrate IEN/ESL nurses into the workforce Project Lead: HHS Nursing HHS, Office of Nursing Recruitment and Retention Advisory Council HHS IEN/ESL Advisory Committee Members Evaluator, McMaster University Nursing Health Services Research Unit External Partners Internal Partners Co- Principal Investigators: BIEN HHS Human Resources Senior Consultant, Nursing Recruitment CARE HHS Professional Affairs and Retention NHSRU HHS Office of Human Rights Chief of Nursing Practice HCCI HHS Quality Patient Safety Associate Vice President, Faculty of Health Sciences and Clinical Resource International and Co-Director of the Nursing Health Management Services Research Unit Co- Investigator: Program Manager, BIEN Executive Director, CARE Study Coordinator: Project Manager EDUCATIONAL INSTITUTIONS Mohawk College Bridging Internationally Educated Nurses(BIEN) Program Project Role: Enhance clinical skills and language assessment EVALUATION McMaster University Nursing Health Services Research Unit (NHSRU) Project Role: Independent evaluator COMMUNITY ORGANIZATIONS Centre for Internationally Educated Nurses (CARE) Project Role: Profession specific communications in workplace course Hamilton Centre for Civic Inclusion (HCCI) Project Role: Enhance cultural competency for integration of IEN/ESL nurses Results Participants Total 140 IENs with English as a Second Language: 103 IENs with English as a First Language: 8 ESL nurses graduated from Canadian Universities /Colleges: 29 Clinical Integrators Total 40 HHS Nurses 3

4 Evaluation The partners were responsible for evaluating the interventions that they implemented. The NHSRU collated, reported the results of all evaluation components and evaluated the overall success of the Project and the Community Engagement Employment Model. Evaluation Participants exiting the Project revealed a high degree of satisfaction both with the interventions and the assistance given by project staff and partner organizations. Participants appreciated the support of the project in helping them to obtain jobs. The coaching of the Project Manager was frequently mentioned. Participants wished they had the opportunity to participate in a similar Project earlier. Participants referred other IEN/ESL nurses to join Successes and Lessons Learned All numeric targets of the project were surpassed The CCEM proved a successful framework for tapping into the expertise of major stakeholders to provide appropriate interventions. ti The Project Team received the 2012 HR Summit Award Employer Champion of Internationally Educated Professional Allowed project to evolve based on feedback from Partners, Clinical Integrators, Clinical Managers and Participants. Successes and Lessons Learned The roles of Project Partners and Researchers became better defined, throughout the course of Project implementation High rating of interventions ti by Participants. i t Share Point Website for the Participants required additional resources, including social media, beyond those currently available to the project. Project Challenges/Strategies Small research sample/increase sample size Different intake criteria amongst partners (IEN/ESL nurses)/consolidation of CCEM Current economic outlook resulting in limited hiring/project looking to community for hiring opportunities Great need for emotional support and integration for IEN/ESL nurses Increased need for workplace exposure and career progression/additional activities planned and added 4

5 Project Challenges/Strategies Lengthy registration process with College of Nurses of Ontario for IENs/Early referral to start the process Settlement and Integration Services Organization/HHS Job Coaching and Mock Interview process Some Participants faced challenges accessing some interventions due to work, personal responsibilities and travel issues/ Accommodation of Interventions around Participant schedules Next Steps Consolidate CCEM: Bridging the Gap for IEN/ESL Nurses within the next three years. New project stakeholders with new roles as project disseminators include Hamilton Region Long Term Care Network. Share lessons learned and strategies with other health care organizations. Acknowledgements We would like to acknowledge the generous funding support of the Government of Ontario, Ministry of Citizenship and Immigration. Appreciation is also extended to Participants, Clinical Integrators/HHS staff and Community Partners for their experience, knowledge and commitment to the Project. Contact Information Daniela Dijmarescu, Project Manager HHS IEN/ESL Nurse Integration Project Chedoke Site, Wilcox Building,119A Tel.: ext BB: Fax: