Overseas qualified nurses’ communication with other nurses and health professionals: an observational study

Aims and objectives: To understand the interprofessional and intraprofessional communication patterns of overseas qualified nurses as they coordinate care for patients in Australian hospitals. Background: Numerous studies have informed the transitioning experiences of overseas qualified nurses with non-English-speaking backgrounds working in English-speaking workplaces. Only a few observational studies have involved examining the intercultural communication experiences of overseas qualified nurses, and none have considered their intra- and interprofessional communication patterns. Design: A qualitative design was adopted, using participant observation and discourse analysis. Methods: This study was from January 2017 to March 2017. Thirteen overseas qualified nurses working in acute, subacute and interventional cardiology settings in a Melbourne metropolitan hospital were shadowed over a period of 12 weeks to collect data that inform their communication patterns. The COREQ checklist was used. Results: This observational study informed by genre analysis revealed that intra- and interprofessional communication occurred more commonly under the clinical communication goals of coordinating care and less commonly under facilitating intervention. Communication strategies ranged from structured interactions with use of communication tools to unstructured ad hoc interactions. Analysis of the discourse patterns demonstrated that effectiveness of interactions was affected by hesitancy, lack of assertion and few strategies to manage inadequate or aggressive communication by other team members. Poor clinical communication with peers was not always caused by the nurses from non-English-speaking backgrounds. Positive interpersonal interactions with laughter, language-switching and small talk were evident in interactions with nurses from similar cultural backgrounds but were rare with local colleagues. Conclusion: The linguistic evidence from this study shows variations in communication competency between participants, which emphasises the importance of not viewing overseas qualified nurses’ communication training needs as homogenous. With the growing multicultural nature of healthcare teams, this study underscores the need for intercultural communication training for team integration and patient safety. Relevance to clinical practice: Continuous professional development should incorporate intercultural communication training to ensure team effectiveness within nursing teams as well as interprofessional teams.