Factors associated with burnout among internationally educated nurses: A scoping review

Abstract

Background: The increasing nursing shortage in the healthcare industry has become a concern in many countries. Recruiting certified nurses from outside a country is one strategy to address this shortage. While the hiring of internationally educated nurses (IENs) fills the labor gap, a supportive work environment is necessary to retain IENs in the field.

Methods: We conducted this scoping review based on the Joanna Briggs Institute (JBI) and PRISMA-ScR guidelines. It is reported along with the PRISMA-ScR checklist. A literature search was conducted across six electronic databases (PubMed, Web of Science, CINAHL, PsycINFO, Ichushi, and CNKI) on September 8, 2023, from which 722 articles were identified. Titles and abstracts were initially screened based on inclusion and exclusion criteria, followed by a full-text review of the selected articles. Eight articles satisfied the search criteria.

Findings: From the characteristics of the factors related to nurses' burnout, all the components were categorized into organizational and individual factors. Organizational factors that contribute to higher burnout include poor professional-practice environment, high patient-to-nurse ratios, lower job satisfaction, and working in hospital wards and private hospitals. Individual factors include being younger IENs, being single (not married), being female, possessing higher educational degrees, short duration of employment, religion (Muslim), job title as a staff nurse, high stress, poor local-language capability, and first-time employment in a host country.

Discussion: Individual factors are more specific to IENs' backgrounds, whereas organizational factors are common to both internationally educated and host-country nurses. Both factors should be considered to reduce burnout among IENs.

Implications for nursing: Healthcare organizations and administrators can develop targeted strategies to prevent and address the burnout experienced by IENs. Also providing understanding and support for religious backgrounds and language proficiency is crucial for alleviating intercultural stress. Through these measures, it is essential to create a work environment where internationally educated nurses can feel secure and comfortable.

Keywords: Burnout; internationally educated nurses; nurse; nursing workforce; practice environment; scoping review.