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Adaptation and Transformation Through (Un)Learning: Lived Experiences of Immigrant Chinese Nurses in US Healthcare Environment

Xu, Yu PhD, RN, CTN, CNE; Gutierrez, Antonio BA; Kim, Su Hyun PhD, RN

Advances in Nursing Science:
doi: 10.1097/01.ANS.0000319570.99254.e5
Article Available Online Only for the April-June Issue
Abstract

This phenomenological study examined the lived experiences of Chinese nurses working in the US healthcare environment. In-depth interviews with 9 self-identified Chinese nurses were conducted in English and transcribed verbatim. Using Colaizzi's (In: Valle RS, King M, eds. Existential-Phenomenological Alternatives for Psychology. New York: Oxford University Press; 1978:48–71) 7-step procedure, the narrative data were independently analyzed by a team of researchers. Five primary themes emerged from the data: (a) communication as the most daunting challenge, especially during initial transition of their first job; (b) different and even conflicting professional values and roles/expectations of the nurse between the United States and China; (c) marginalization, inequality, and discrimination; (d) transformation through clinging to hope, (un)learning, and resilience; and (e) cultural dissonance. To a large extent, this study supported the findings in the general literature on international nurses, especially those from Asia. It also documented the uniqueness of this group of Chinese nurses, namely their ingenuity to turn challenges into opportunities, their high-level job satisfaction in spite of adversity, their desire for learning and execution of strategic plans for performance and career enhancement through further education, and their proactive measures to adapt to workplace demands. In addition, this study revealed both real and potential risks to patient safety and quality of care during the transition of these Chinese nurses. In light of these findings, implications for both practice and future research are elaborated, particularly in the context of the accreditation standards of healthcare organizations and national agenda for patient safety research.

In Brief

Using Colaizzi's (1978) 7-step procedure, this study examined the lived experiences of Chinese nurses working in the US healthcare environment. Five primary themes emerged from the data and supported the findings in the general literature on international nurses, especially those from Asia. This study also revealed real and potential risks to patient safety and quality of care during the transition of these Chinese nurses.

Author Information

University of Nevada, Las Vegas (Dr Xu and Mr Gutierrez); and Kyungpook National University, South Korea (Dr Kim).

Corresponding Author: Yu Xu, PhD, RN, CTN, CNE, School of Nursing, University of Nevada at Las Vegas, 4505 Maryland Parkway, Las Vegas, NV 89154 (yu.xu@unlv.edu).

Funding for this study was provided by the Pauline A. Toner Fund administered by the University of Connecticut School of Nursing. Thanks go to Diane McGinnis and Kari Zizzo for their insight and assistance in this study and to Jeff Kurrus for his editorial assistance.

© 2008 Lippincott Williams & Wilkins, Inc.