Title : Exploring the leadership challenges and retention strategies of global nurse leaders who lead foreign-educated immigrant nurses: A phenomenological study
Abstract:
Background: The United States healthcare system increasingly relies on foreign-educated immigrant nurses to address critical workforce shortages. While recruitment strategies have expanded, less is understood about the lived experiences of nurse leaders responsible for integrating, leading, and retaining culturally diverse migrant nursing teams in acute care settings. Leadership practices that support workforce stability remain underexplored in the global nursing literature.
Purpose: This study explores the lived experiences of global nurse leaders who lead foreign-educated immigrant nurses in U.S. acute care hospitals. The research examines leadership challenges encountered and strategies implemented to promote retention and workforce stability, grounded in Job Embeddedness Theory (JET) (Mitchell et al., 2001).
Methods: Using a qualitative Interpretative Phenomenological Analysis (IPA) approach, in-depth semi-structured interviews were conducted with nurse leaders supervising culturally diverse, foreign-educated nursing staff. Participants met inclusion criteria of holding formal leadership roles within U.S. acute care settings and directly managing immigrant nurses. Data were analyzed using iterative coding, theme development, and hermeneutic interpretation to capture shared meaning-making processes (Smith et al., 2009).
Results: Preliminary findings reveal complex leadership dynamics shaped by cultural integration, communication adaptation, ethical advocacy, organizational policy constraints, and emotional labor. Leaders described strategies that enhanced nurse retention, including culturally responsive mentorship, structured onboarding, psychological safety cultivation, and intentional community-building practices aligned with the “links,” “fit,” and “sacrifice” domains of Job Embeddedness Theory.
Conclusions: Global nurse leaders serve as critical stabilizing agents within internationally recruited nursing workforces. Their leadership practices directly influence retention outcomes, workforce cohesion, and patient care continuity. Findings contribute to global nursing leadership scholarship and offer evidence-informed strategies for health systems seeking sustainable international workforce integration.
Implications for Nursing Leadership: Understanding the lived experiences of leaders managing foreign-educated nurses provides actionable insights for policy development, leadership preparation, and ethical international workforce integration. This research amplifies the often-unheard voices of global nurse leaders navigating complex cross-cultural clinical environments.
