Workplace Integration Programs for Nurses


Patient satisfaction and timely access to healthcare services remain the key priorities in healthcare. Given the existing shortage of qualified nurses in the United States, healthcare providers in the country can be interested in using the fruits of globalization to deal with this problem. This position paper proposes a policy change related to the mandatory implementation of workplace integration programs for immigrant nurses and discusses it with special attention to agenda-setting and design issues.

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Healthcare Globalization and Nursing Issues

The globalization of healthcare can be listed among the most important trends in the field related to a broad range of new nursing issues. The impact of the mentioned tendency on priority setting in nursing is evident since globalization in any field can never produce positive results without service quality control (Lim-Saco, Kilat, & Locsin, 2018). The most discussed nursing issue that is caused by the trend is presented by unfair exchanges between developed and developing countries in terms of healthcare resources and their quality.

With the help of globalization, more progressive states exploit the economies of their less developed partners, helping the latter to manage the timely provision of high-quality care. At the same time, with the growing impact of globalization, more countries that are economically vulnerable become the suppliers of poorly qualified workers. This tendency can manifest itself in various fields, including nursing, and it is critically important to turn it into an advantage.

The Proposed Policy Change

To provide care, adult-gerontology nurses should be versatile specialists who understand both psychological and physiological differences related to age, and the latter may vary depending on the culture. The policy change discussed in the section is aimed at deriving benefits from healthcare globalization in order to reduce the problem of nursing shortage widely discussed today (Abhicharttibutra, Kunaviktikul, Turale, Wichaikhum, & Srisuphan, 2017).

According to modern researchers, the key factors contributing to the nursing shortage in the United States include the adoption of the ACA that has increased the demand for professional nurses, population greying, and higher chronic disease prevalence rates (Snavely, 2016; Fischer, 2016). The policy change that can be implemented is focused on the use of the foreign workforce to deal with the shortage of adult-gerontology nurses and other nursing professionals.

To approach the problem, it can be beneficial to improve the existing strategies that help to attract foreign nurses and prepare them for work in different socio-cultural conditions. In particular, to increase the number of employment opportunities and provide more patients with access to timely care, it is proposed to require all large hospitals to implement standardized workplace integration programs for foreign specialists (Eriksson & Engström, 2018).

The aforementioned change will require substantial funding, but its expected positive consequences are numerous. Among the potential benefits are reductions in the nursing shortage and burnout rates and new opportunities for experience exchange and workforce diversification. Moreover, it is expected that the proposed change will help native nurses to broaden their experience in educating others.

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Agenda Setting Strategies and the Use of Models/Theories

Being among the key components of policymaking, agenda-setting is the process that involves attracting public attention to important problems and their potential solutions. In the case being analyzed, it is possible to increase the awareness of the problem by working with various groups of stakeholders and mass media. For example, it will be pivotal to gain the support of international nursing organizations and collaborate with their representatives to study the position of foreign nurses in different states and common barriers to education and professional practice.

At this point, it will be possible to use the research results to justify the need for the proposed change. There will be numerous opportunities to present the results to the national scientific community and common citizens with the help of open lectures, conference papers, and research papers. With the lapse of time, the idea will attract the attention of various media sources, and the society will be able to form an opinion about the change in question.

There are many groups of stakeholders apart from nurses, and collaboration with all of them can increase the chances of being heard. In order to attract more attention to the need for training programs for the foreign workforce, it will be possible to collaborate with the Department of Labor and immigration agencies. Apart from that, it will be beneficial to make the problem a popular discussion topic among social media users. In the end, having gained the support of different organizations, it will be necessary to eliminate any logical inconsistencies and present the proposal to legislators.

The strategies listed above focus on interprofessional collaboration and parallel work with different stakeholder groups. Therefore, there is an opportunity to bring about the change with the help of Kingdon’s theory of agenda-setting. According to it, to open the so-called policy window and make some change justified and attractive, interested parties are to emphasize three focus areas such as problems, policies, and political streams (Howlett, McConnell, & Perl, 2017; Cairney & Jones, 2016).

To work with the first stream, the stakeholders will problematize the shortage of nurses with the help of media sources. The actions related to the second stream will be focused on collaboration with scientific communities and research activities. In the end, the use of the final stream can involve working relationships with specialists from governmental agencies and the creation of interest groups.

Design, Implementation, and Evaluation

The policy design strategy that will be implemented will include a range of essential steps. First, the interested parties will define the set of goals related to the proposed change (the diversification of the workforce, international reciprocal learning, higher patient satisfaction rates, etc.). Moreover, the importance of financial support should not be underestimated – the interested parties will have to calculate the costs of the nationwide implementation of the project and outline all hospital funding changes (Palmer et al., 2018). Next, to design the initiative, it is pivotal to conduct research and systematically present the educational needs of foreign nurses. This information can be used to propose a standardized workplace integration program for immigrant specialists.

To implement the change being discussed, it will be essential to analyze the situation of hospitals in terms of the immigrant workforce and define the facilities attractive to foreign healthcare workers. The successful implementation of the change will require the dissemination of information materials related to workforce integration and the provision of necessary tools and resources. Three and six months after the implementation of the change, it will be possible to conduct mid-term evaluations.

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To define the success of the change, evaluators will study a set of measurable objectives (patient satisfaction, staffing ratios, nurses’ job satisfaction, etc.) before and after the start of the project. The data for all healthcare facilities participating in the project will be summarized and statistically analyzed to identify improvement areas.


In the end, the proposed change is expected to benefit both native and foreign nursing specialists, including adult-gerontology nurses. For native nurses, the positive consequences will include the lack of heavy workloads, increases in patient safety, and improved intercultural competencies. As for immigrant nurses, they will have more employment opportunities and avoid numerous acculturation issues related to professional experience. Therefore, the proposed initiative will help to increase the national healthcare workforce and reduce the number of underserved patients.


Abhicharttibutra, K., Kunaviktikul, W., Turale, S., Wichaikhum, O. A., & Srisuphan, W. (2017). Analysis of a government policy to address nursing shortage and nursing education quality. International Nursing Review, 64(1), 22-32.

Cairney, P., & Jones, M. D. (2016). Kingdon’s multiple streams approach: What is the empirical impact of this universal theory? Policy Studies Journal, 44(1), 37-58.

Eriksson, E., & Engström, M. (2018). Internationally educated nurses’ descriptions of their access to structural empowerment while working in another country’s health care context. Journal of Nursing Management, 26, 866-873.

Fischer, K. M. (2016). How the educational funding provisions of the Patient Protection and Affordable Care Act will affect the nursing shortage in the United States. Northwestern Journal of Law and Social Policy, 11(1), 54-77.

Howlett, M., McConnell, A., & Perl, A. (2017). Moving policy theory forward: Connecting multiple stream and advocacy coalition frameworks to policy cycle models of analysis. Australian Journal of Public Administration, 76(1), 65-79.

Lim-Saco, F., Kilat, C. M., & Locsin, R. (2018). Synchronicity in human-space-time: A theory of nursing engagement in a global community. International Journal for Human Caring, 22(1), 29-38.

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Palmer, K. S., Brown, A. D., Evans, J. M., Marani, H., Russell, K. K., Martin, D., & Ivers, N. M. (2018). Qualitative analysis of the dynamics of policy design and implementation in hospital funding reform. PloS One, 13(1), e0191996. Web.

Snavely, T. M. (2016). A brief economic analysis of the looming nursing shortage in the United States. Nursing Economics, 34(2), 98-100.

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