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Barriers to Participation in Governance and Professional Advancement: A Comparison of Internationally Educated Nurses and Registered Nurses Educated in the United States

Wheeler, Rebecca M. RN, MA, PhD; Foster, Jennifer W. RN, CNM, PhD

doi: 10.1097/NNA.0b013e31829d6227

Objective: This study compared the perspectives of internationally educated nurses (IENs) and registered nurses (RNs) educated in the United States regarding participation in hospital governance structures and professional advancement.

Background: Nurses’ participation in hospital governance is reported to contribute to empowerment. No research has examined how IENs’ perceptions about participation in governance compared with those of US RNs.

Methods: Semistructured interviews were held with 82 nurses in 2 urban hospitals. Forty nurses were reinterviewed to follow up on themes.

Results: Internationally educated nurses and US RNs shared similar perspectives. Nurses in both samples did not value participation in governance, lacked guidance about how to advance, and preferred to at the bedside.

Conclusions: Strategies to encourage nurses to participate in and value governance and professional advancement opportunities should be explored and adopted.

Supplemental Digital Content is available in the text.

Author Affiliations: Clinical Professor (Dr Wheeler) and Assistant Professor (Dr Foster), Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia.

Funding for this research was provided by the American Nurses Foundation and Emory University’s Race and Difference Initiative.

The authors declare no conflicts of interest.

Correspondence: Dr Wheeler, 834 Dekalb Avenue, Unit B, Atlanta, GA 30307 (

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