Grassroots support: how diverse nursing associations are making a difference

Rohit Sagoo, senior lecturer at Anglia Ruskin University and founder of British Sikh Nurses

This week’s blog is by Rohit Sagoo (@RohitSagoo) – Children’s nurse and academic, founder and director of British Sikh Nurses (@NursesSikh).

For many years, the NHS has benefited from recruiting overseas nurses. Reliance on overseas nurses is ever-growing not only in the UK but across the globe. The pandemic has put unprecedented pressure on the nursing workforce. The demand for overseas nursing staff has also increased by approximately 15%. In 2021, The Nursing and Midwifery Council (NMC) reported a growth of 15,311 registrants. Of which over 9,000 registrants were overseas nurses outside of the European Union. Over half of the overseas registrants were from the Philippines and India. Reliance on overseas nurses in the United Kingdom is at an all-time high. It will continue as the government has a recruitment target of delivering 50,000 more nurses by 2024. Currently, there are approximately 92,000 nurses and midwives serving in the NHS. Most nurses are from outside the European Economic Area (EEA), which does not account for the number of overseas staff working in the social care sector.

International recruitment of nurses and midwives in the United Kingdom (UK) is growing. There are many international nursing associations representing peers in the NHS workforce. They are the driving force behind the support, including the development, adaptation, and transition of overseas nurses here in the UK. Nursing associations centre their work on supporting nurses’ adaptation to the NHS. Studies have highlighted the need for smoother transitions for international nurses and midwives. Working in foreign healthcare systems can be challenging. There is a need to understand cultural integration and communication.

Furthermore, acknowledging the differences in working practices. International nursing associations step in to help the needs of their peers, educating foreign nurses about cultural differences and language barriers.

Diaspora nursing associations support the challenges overseas nurses face in the healthcare system. Studies show that overseas nurses are often deskilled or undervalued. Especially with the wealth of experience and expertise they bring to the profession. At times this can be overlooked. International nursing associations also voice the challenges of their peers. Thus, nursing leaders must listen and act.

Diverse nursing associations are the heart and soul of support for foreign nurses. Foreign nurses are the beating heart of the National Health Service (NHS). Nevertheless, overseas nurses face many challenges when moving to the UK. Many studies have reported experiences of marginalisation, discrimination and bullying in the workplace. Therefore, diverse nursing associations play an essential role when advocating for and supporting colleagues. They use an array of activities that strengthen their well-being. Types of activities include social engagements with their fellow native peers. They also help improve their communication skills in the workplace and support transition. They also assist with developing nursing competencies and skills, which is in line with the policies and protocols of nursing in the UK.

Studies have shown that there are inconsistencies with managerial support for overseas nurses. Subsequently, this has hindered their confidence. Significantly, some overseas nurses felt that their ethnicity contributed to receiving a lack of support, skills and training from their work environments. The challenge is to carefully understand the cultural and professional adaptation to a new place of work, especially for those adapting to new practices, policies, guidelines and ways of working. More importantly, pastoral support is provided by the diverse nursing associations, which offers a sense of belonging and connectedness for overseas nurses.

Diverse nursing associations also provide education programmes that develop fundamental principles of nursing. Programmes vary in teaching and learning. Structured clinical examinations (OSCE) develop communication and nursing skills, especially for those with ESOL needs (English to Speakers of Other Languages). Interview techniques develop for nurses applying for jobs or promotions. What is notable is that the NHS does not fund the programmes that are on offer. All international nursing associations are self-funded. Their vital work bridges the gap between the NHS and their international recruits and supports their personal and professional development needs.


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Gerrish, K. & Griffith, V. (2004) Integration of overseas Registered Nurses: evaluation of an adaptation programme. Journal of Advanced Nursing. 45 (6), 579–587. doi:10.1046/j.1365-2648.2003.02949.x.

Nichols, J. & Campbell, J. (2010) The experiences of internationally recruited nurses in the UK (1995-2007): an integrative review: Experiences of internationally recruited nurses in the UK. Journal of Clinical Nursing. 19 (19–20), 2814–2823. doi:10.1111/j.1365-2702.2009.03119.x.

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