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Attending a bridging program to obtain a Swedish nursing license: An interview study with internationally educated nurses
University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science.ORCID iD: 0000-0002-0842-6407
University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet; Lishui universitet.ORCID iD: 0000-0002-9912-5350
Göteborgs universitet.ORCID iD: 0000-0002-0211-5077
University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Uppsala universitet.ORCID iD: 0000-0002-6869-6863
2021 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 99, article id 104744Article in journal (Refereed) Published
Abstract [en]

Background: Bridging programs have been created to facilitate internationally educated nurses’ integration process. Thus far, studies on bridging programs have been few and have only been conducted in English-speaking countries. Due to language barriers, it may be a greater challenge to attend a bridging program in a non-English-speaking country. 

Objectives: The aim was to examine internationally educated nurses’ experience of attending a one-year bridging program to obtain a Swedish nursing license. 

Design: A qualitative study with a descriptive design was applied. 

Settings: The study setting was the five universities offering the one-year, full-time Swedish bridging program.  

Participants: Purposive sampling was used. Eighteen nurses participated in the study at the end of the program. 

Methods: Semi-structured interviews were conducted and analyzed using qualitative content analysis. 

Results: Studying in a new environment and language was challenging and intensive, as were adapting to a new healthcare system and relearning some nursing practices. However, attending the bridging program was also rewarding and gave feelings of happiness and pride; the nurses developed their nursing skills as well as their language and academic skills. Moreover, they became familiar with Sweden’s nursing practices, healthcare system, and culture. Good support was important, but not always enough. 

Conclusions: By attending a bridging program, nurses can become familiar with the country’s healthcare system and nursing practices. Moreover, develop their language skills and attain skills important to lifelong learning. Although the program may not eliminate all difficulties nurses often experience in a new country, it can offer the support nurses need to handle the challenges. However, for some nurses, due to different backgrounds and prerequisites, the support offered may need to be more individualized.

Place, publisher, year, edition, pages
Elsevier , 2021. Vol. 99, article id 104744
Keywords [en]
Bridging program Competency-based education, Education nursing, Nurses international, Licensure nursing, Overseas nurse program, Qualitative research
National Category
Health Sciences
Research subject
Health-Promoting Work
Identifiers
URN: urn:nbn:se:hig:diva-35209DOI: 10.1016/j.nedt.2021.104744ISI: 000634957300008PubMedID: 33549959Scopus ID: 2-s2.0-85100388854OAI: oai:DiVA.org:hig-35209DiVA, id: diva2:1525805
Projects
IENAvailable from: 2021-02-04 Created: 2021-02-04 Last updated: 2025-10-02Bibliographically approved
In thesis
1. Internationally Educated Nurses’ Inclusion in Swedish Working Life: The Recertification Process and the First Year Working as a Nurse in Sweden
Open this publication in new window or tab >>Internationally Educated Nurses’ Inclusion in Swedish Working Life: The Recertification Process and the First Year Working as a Nurse in Sweden
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim was to examine facilitators and challenges towards and for an inclusive working life in Sweden for nurses educated in countries outside the EU/EEA and Switzerland, to examine and compare two paths to a Swedish nursing license – bridging program and validation – and to examine nurses’ perceived competence and well-being at work during the first year as nurses in Sweden. Methods: Data were collected through interviews and a longitudinal survey. This took place at three time points: the end of the licensure process, after three months, and after one year. Results: Both paths had been challenging and facilitating, albeit in different ways. The bridging program had been intensive, but also rewarding. The nurses had developed new knowledge, gained new relationships, improved their language and academic skills, and gained confidence to practice as a nurse in Sweden. The other path, through validation, had been a struggle due to uncertainty, loneliness, and considerable waiting. However, it was also facilitating because it enabled the nurses to work during the process. Support was important during recertification but was sometimes insufficient. At the end of recertification, no differences in self-rated competence, general self-efficacy, or thriving were found between those who had chosen the bridging program and those who had chosen validation. One year later, the choice of path to a nursing license was not related to the nurses’ perceived competence or well-being at work, however, current working conditions were. In addition, in interviews, previous education and working experiences were reported as facilitating factors during their first year as nurses in Sweden. Conclusions: Both paths to a Swedish nursing license were challenging but also facilitating and seemed to meet different needs. The choice of path did not determine how the nurses perceived their competence and well-being once practicing as a nurse in Sweden. Instead, previous education and working experiences and supportive working conditions were important factors.

Abstract [sv]

Syfte: Att studera vad som underlättar respektive försvårar till ett inkluderande arbetsliv i Sverige för sjuksköterskor utbildade i länder utanför EU/EES och Schweiz, studera och jämföra två vägar till svensk sjuksköterskelegitimation – kompletteringsutbildning och validering, samt studera sjuksköterskors självskattade kompetens och välbefinnande i arbetet under deras första år som sjuksköterska i Sverige. Metod: Data samlades in med intervjuer och en longitudinell enkätundersökning. Insamling skedde vid tre tillfällen; i slutet av legitimationsprocessen, efter tre månader och efter ett år. Resultat: Båda vägarna till legitimation hade varit utmanande och underlättande, om än på olika sätt. Kompletteringsutbildningen hade varit intensiv, men också givande. Sjuksköterskorna hade utvecklat ny kunskap och nya relationer, förbättrat sina språkliga och akademiska färdigheter samt fått självförtroende att utöva professionen i Sverige. Den andra vägen, genom validering, hade varit påfrestande på grund av osäkerhet, ensamhet, och mycket väntan. Dock hade denna väg också upplevts underlättande eftersom sjuksköterskorna hade möjlighet att arbeta under processen. Stödet under legitimationsprocessen hade varit viktigt, men inte alltid tillräckligt. I slutet av legitimationsprocessen var det inga skillnader i självskattad kompetens, tro på egen förmåga eller thriving (vitalitet och lärande) mellan de två olika vägarna. Ett år senare var valet av väg inte relaterat till hur sjuksköterskorna skattade sin kompetens och välbefinnande på jobbet, istället var deras nuvarande arbetsförhållanden det. I intervjuer framkom det även att tidigare utbildning och arbetserfarenheter hade varit underlättande faktorer under första året som sjuksköterska i Sverige. Slutsatser: Båda vägarna till svensk sjuksköterskelegitimation beskrevs utmanande, men också underlättande och tycks uppfylla olika behov. Valet av väg predicerade inte hur sjuksköterskorna såg på sin kompetens och välbefinnande det första året de arbetar i Sverige. Däremot framkom tidigare utbildning och arbetserfarenheter samt stödjande arbetsförhållanden som betydande faktorer.

Place, publisher, year, edition, pages
Gävle: Gävle University Press, 2024. p. 84
Series
Doctoral thesis ; 45
Keywords
Bridging program, Internationally Educated Nurses, Nursing License, Professional Competence, Recertification, Self-Efficacy, Thriving, Validation, Well-being, Working Conditions
National Category
Health Sciences Work Sciences
Research subject
Health-Promoting Work, Inkluderande arbetsliv
Identifiers
urn:nbn:se:hig:diva-43939 (URN)978-91-89593-30-5 (ISBN)978-91-89593-31-2 (ISBN)
Public defence
2024-05-31, Stora Jadwigasalen,13:111, Kungsbäcksvägen 47, Gävle, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2024-05-08 Created: 2024-03-21 Last updated: 2025-10-02

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Högstedt, DeniceEngström, MariaEriksson, Elisabet

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