SATU The update education for immigrant nurses to be registered as a nurse in Finland

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SATU The update education for immigrant nurses to be registered as a nurse in Finland Raija Sairanen COHEHRE conference 19.4.2013 Kuopio, Finland

IN FINLAND 5,4 Million inhabitants 4% are foreigners 220 000 health care professionals immigration background 2,2 % of registered nurses 3,7 % of primary nurses 7,2 % of medical doctors

THE CURRENT SITUATION High educated immigrants ( medical doctors, dentists, nurses etc.) without corresponding work Shortage of health care workers, specially nurses, at the same time No possibilities to work as a nurse without legalization and qualification > Registered Nurse in Finland They have to work as helping staff in the health care or in other areas (kitchen, cleaning, shops) The immigrants live in Finland with their families They are integrated in Finnish society, many have already Finnish nationality

WHY THE SATU-EDUCATION? This update education is a necessity and ethically right They are not extra transported to Finland for to work as nurses, they are not second hand help Education for immigrant citizenship provides right to live and work in their new homeland It is a gesture of the humanity to recognize and acknowledge their earlier education and professional competence as a part for the update education

JOBSEEKER IDENTITIES & COMPETENCE by Rintala-Rasmus A., 2007 Competent departure status Neo competent status Non competent entry status

WHAT IS THE SATU-EDUCATION? Labor market training education HEI-level ( University of Applied Sciences) update education Financing by The Employment and Economic Centre in Southwestern Finland ( first group by ESF) Carried through by Turku University of Applied Sciences, Health Care, Unit of the Adult Education In cooperation with Turku Employment Office, The Union of Health and Social Services TEHY, Turku University Hospital and Turku Health and Social Services ( = the counsel group)

TO WHOM? Registered Nurse or other comparable health care profession, e.g. public health nurse, barbersurgeon With the certificate, diploma etc. from the home country > Nurse in the educational system in the home country Outside EU/EEC Living already in Finland

CRITERIA OF ADMISSION Certificates are ok Good Finnish language skills for to study at University of Applied Sciences-level > to talk, to read, to write and to understand in Finnish, B1-B2 level Motivation to work as a nurse and live further in Finland Good health Passed entrance examination ( interview and essay)

THE GOAL OF THE SATU-EDUCATION To get the Registered Nurse legalization in Finland To find the workplace within the health care To be a good educational model

SATU- GROUPS SATU 1: 18.8.2003-18.2.2005 SATU 2: 27.2.2006-2.11.2007 SATU 3: 18.8.2008-26.3.2010 SATU 4: 29.9.2010-29.4.2012 SATU 5: 17.9.2012-25.4.2014 SATU 6 etc. Intake to the first group 20, later 16 into the groups, altogether 84 participants Earlier only 1-2 male persons in each group, now 5! Age mainly between 30 and 40 years One hearing impaired person is now also in the group

THE BACKGROUND OF THE SATU STUDENTS Most are from Russia, but also from Iran, Iraq, Ukraine, Kazakhstan, Columbia, Lithuania, Poland, Kosovo, Bosnia, Estonia, China, Thailand, Philippines, Jordan, Kenya, Guinea Most are nurses, some are barber-surgeons, midwifes Some had other professions besides: medical doctors, one was biologist, one lawyer as well Work experiences in homeland: emergency & accident, ambulance, intensive care pediatric, medical and surgical nursing Work experiences in Finland: mainly in the elderly care

SATU CURRICULUM Regular nurse education is 210 ECTS, 3½ years From the earlier nurse education is approved 90 ECTS SATU updating is 120 ECTS > 80 ECTS theoretical studies > 40 ECTS practical training SATU-education is in Finnish The update education takes 1½ years

WHAT THEORETICAL STUDIES MUST BE UPDATED? Finnish social and health care system and how to work there Management and entrepreneurship Health problems among Finnish people and how to treat them > nursing interventions Evidence based nursing and research methodology, nursing development Bachelor's thesis ( ordered by the care sector) ICT license Medication certificate

ICT is funny

Bachelor's thesis seminar on the ferry boat

EXPERIENCES FROM THE THEORETICAL STUDIES Earlier knowledge and skills very heterogeneous Mainly easy to work independently Endless need and interest for knowledge

SIMULATION PEDAGOGY AS ONE OF THE LEARNING METHODS First Aid Patient Safety Medication skills Job advertisement Mentoring Challenging situations in the psychiatric care Carried out multiprofessionally with students from different degrees

First Aid

Baby is born

Immigrants teach other immigrants

Stereotypes and prejudices

Operation can start, we are ready

WHAT CLINICAL PRACTICE MUST BE UPDATED? 40 ECTS = 27 weeks Supervised practical training According to EU-directives Basic nursing, nursing interventions 4 weeks Medical-surgical nursing, somatic nursing 5 weeks Mental health and substance abuse 5 weeks Advanced nursing 5 weeks Own career 8 weeks Important in nursing: Nursing process, documentation Client centered nursing Evidence based nursing Multiprofessional teamwork Nurse identity

EXPERIENCES FROM THE CLINICAL PRACTICE Immigrants are very friendly, polite and ethically working Mental health and substance abuse area is new for most Some special nursing placements are too demanding, challenging Independent nursing is too demanding for some immigrants Many clinical placements wait for 100% Finnish language skills

SWOT ANALYSIS by SATU students Strengths Motivation to study Patience Weaknesses Finnish language Time management Opportunities To get the Finnish nurse certificate To get work as a nurse To get the possibility to study more Threats Cultural difficulties in workplaces Illness or stress (cannot come to school) Cannot graduate

SWOT ANALYSIS by SATU teachers Strengths Motivated students and teachers Innovated teacher team Well working SATU model Weaknesses Learning methods(e-learning, independent, group working) not easy to immigrants Cultural encounters Opportunities Internationalization at home Employment of immigrant nurses Threats No funding in the future Not more necessary to get legalization and registration as a nurse, every nurse from everywhere can work wherever

BIGGEST CHALLENGES Heterogeneous groups Heterogeneous nursing knowledge and skills Finnish language Multicultural group > cultural backgrounds and experiences Group work Assessment of learning Electronic systems, intranet, social media etc. Time management of SATU students Preconceptions of the working life

RESEARCHES AND DEVELOPMENT WORKS RELATED TO SATU PROJECT Soinne L., 2005, SATU project, Nurses to the city of Turku from immigrants, Issues which encourage and which prevent the learning process of immigrant Nurses, Master s thesis, Tampere University Nieminen S., 2011, Politics of inclusion: Immigrant nurses, entrance into profession and agency in the making, Dissertation, Tampere University Vilen P., 2011, Immigrant nurse students and learning assessment, Professional teacher education thesis, HAMK Eronen R., 2012, Simulation pedagogy with immigrant nurses education, Professional teacher education thesis, HAMK Koivuniemi S., 2012, Health care professionals with immigration background, TEHY Kurvinen H., The follow up study about SATU graduated immigrant nurses working history, Master s thesis, Turku University of Applied Sciences is in the process!

BEHIND THE SUCCESS OF SATU UPDATE EDUCATION The high motivation of the immigrant nurses The good management of the education The well-working collaboration with the educators and the working life The Red Cross in South Western Finland gave this year 2013 to SATU education The unprejudiced visionary - award and acknowledgement

AFTER GRADUATION Everyone graduated They are Registered Nurse in Finland They have also earlier nurse certificate > double nurses They have ICT-license Medication certificate Official Finnish language certificate All SATU nurses have found a workplace in the primary or special nursing Many of them have already a permanent post, even in the special nursing area

I promise..

We are now Registered Nurses in Finland

CONCLUSIONS SATU immigrant nurses are highly qualified manpower in the health care They disseminate multiculturalism and cultural sensitivity, enrich the workplaces SATU project is a well tried model how to support the education of immigrant citizenship And how to secure the safety in the health care

BUT WHAT WE COULD DO BETTER? For immigrant nurses: prepare how to study at the university level and how to work in the health care sector For teachers: prepare how to teach people with other cultures than their own For staff at hospitals and other health care organizations: prepare how to meet immigrant nurses and how to work with them as colleagues

AND QUESTIONS FOREVER Where to get the funding in the future? Where and how to find right applicants? How to be sure that all documents, certificates from home countries are ok? When the Finnish language skills are enough good?

Now we can celebrate

THANK YOU! KIITOS!