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The experiences of internationally educated nurses who joined the nursing workforce in England

02 March 2024
Volume 35 · Issue 3


The number of internationally educated nurses working in the NHS has skyrocketed over the past three decades. This study examines their experiences of working and living in England


There is limited literature on the experiences of internationally educated nurses (IENs) who have joined NHS trusts in England in the past 20 years. The objectives of this integrative review included exploring and analysing the experiences of IENs in the NHS in England and identifying the cultural, pastoral and training needs of IENs during their first 2 years working in England and providing research-informed recommendations to better support IENs.


An integrative review of primary research studies using quantitative, qualitative, and mixed methods of data collection. Data source: CINAHL, British Nursing Index and Google Scholar. Results: Nine articles met the inclusion criteria for this integrative review. All articles contributed to the findings of three main analytical themes: expectations, challenges and belongingness.


Limited research fully met the search criteria. This was concerning since IENs have been working in the NHS for decades, yet so few primary studies have been conducted into their experiences. The findings were in line with previous studies, which found that IENs faced challenges both in the workplace and in settling into an English way of life, and often reported feeling that they were not treated equally to their English counterparts. This integrative review raises issues and increases awareness of how the NHS in England can better support IENs transitioning into their new life and ways of working, to further aid recruitment and retention of the international nursing workforce.

The Department of Health and Social Care (DHSC) has stated that it has achieved the Government's manifesto pledge of increasing the number of nurses by 50 000 by 2024 (DHSC, 2023). However, the Nuffield Trust (Rolewicz, 2023) has warned that increases have not been achieved in some branches of nursing and in some English regions. Previously, The King's Fund (2022)commented that the NHS could have a shortfall of 108 000 full-time equivalent nurses by 2029. To fill the large gap in the nursing workforce meant the UK government had little choice but to increase international recruitment. For decades, the UK has been recruiting nurses from developing countries (Haves, 2021).

This integrative review of literature published between 2002 and 2022 has been conducted to better understand the experiences and needs of internationally educated nurses (IENs) working in the UK and identify researched-based recommendations to address some of the issues and challenges they experience.

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