Aug 2026· International Journal of Nursing Studies Advances· Vol 11, pp. 100645· 0 citations· 27 references
Medicine
TL;DR
The findings highlight the intersecting factors such as unsafe working conditions, professional role conflicts, limited support for career advancement, and racial discrimination collectively impact the retention, well-being, and professional growth of Black RPNs.
Abstract
Background Nurses form the backbone of the Canadian healthcare system, with the largest workforce representation across various care settings (Health Canada, 2024). The purpose of this narrative review is to critically examine from the literature the structural and systemic challenges experienced by Black Registered Practical Nurses (RPNs), within the broader context of the ongoing national nursing crisis. While RPNs form a significant portion of the nursing workforce, Black RPNs encounter unique and compounding barriers due to anti-Black racism (ABR) and systemic inequities. RPNs, who are invaluable healthcare providers that work in various disciplines such as education, informatics, policy and leadership, are increasingly impacted by workforce shortages, burnout, and structural challenges issues especially intensified for Black RPNs (RNAO, n.d.; Registered Practical Nurses of Ontario (WeRPN), 2024). Methods Between January and March 2025, a literature search was conducted on the following databases: Emcare, Embase, Scopus, Medline (Ovid), CINAHL Complete, and APAPsychNET. Key search words such as “Black Canadians”, “Black Persons”, “Registered Practical Nurses”, “Social Discrimination”, “Prejudice”, “Job Satisfaction", “Professional Development” were used. Out of 795 papers reviewed, a narrative review of eight qualitative and quantitative studies was conducted to explore the experiences of Black nurses in Canada. Thematic analysis identified four core themes: (1) navigating racism and discrimination in the workforce, (2) leadership and career progression in nursing, (3) diversity and inclusion in the workforce, (4) and strain on personhood. Results and discussion Racism emerged as a key barrier at multiple levels. For example, historical exclusion limited early access to nursing education, while career progression remained hindered by structural inequities and lack of mentorship. Studies have also shown a pattern of internationally educated Black nurses facing systemic obstacles through immigration and credentialing processing, contributing to underemployment, and deskilling. Diversity initiatives also were often seen as symbolic rather than transformative. Conclusion This review’s findings highlight the intersecting factors such as unsafe working conditions, professional role conflicts, limited support for career advancement, and racial discrimination collectively impact the retention, well-being, and professional growth of Black RPNs. By highlighting these overlooked experiences, this review will contribute to further inform equity-oriented policies, education, and organizational change to promote the professional well being of Black RPNs.
Background: Gender-based violence (GBV) is a significant public health crisis in South
Africa. Nurses in health clinics at higher education institutions (HEIs) are often first
responders for survivors. However, their preparedness to manage GBV cases remains
unclear, and nursing curricula may not adequately equip them for this role. Purpose: To
investigate the preparedness of professional nurses at HEI health clinics in managing GBV
and to identify related educational gaps for undergraduate nursing curriculum
enhancement. Methods: A qualitative, descriptive case study was conducted at two HEIs
in Cape Town, South Africa, between January and February 2025. Purposive sampling was
used to recruit five professional nurses. Data was collected through semi-structured online
interviews and analyzed using thematic analysis. The study adhered to the Consolidated
Criteria for Reporting Qualitative Research (COREQ) guidelines. Results: Key findings
revealed significant gaps in formal education, with nurses relying heavily on informal, onthe-job learning to develop competence in GBV management. Three themes emerged: (1)
Educational and Systemic Barriers to GBV Competence; (2) Development of Competence
through Experiential Learning; and (3) Skills and Ethical Foundations in Managing GBV
and OBV. Barriers included a lack of structured GBV content in nursing curricula, leading
to inconsistent care. Core competencies, such as empathy and communication, were
developed experientially. Stigma and challenges with survivor disclosure further
complicated case management. Conclusion: The findings suggest that the professional
nurses interviewed in this study feel underprepared to manage GBV due to deficiencies in
their formal nursing education. An apparent disparity exists between the practical demands
of their role and the training that they receive, highlighting the need for urgent curriculum
reform. Implications for Nursing: There is an imperative need to integrate dedicated,
practical GBV modules into undergraduate nursing curricula. Continuous professional
development and standardized institutional protocols are essential to enhancing the
competence and confidence of practicing nurses in providing effective, survivor-centered
care.
Keywords: Gender-based violence, Nursing education, Professional competence,
Preparedness, Qualitative research, South Africa.
Siphesihle Delani Hlophe· Jordan Journal of Nursing Re...· 0 citations
INTRODUCTION
Recruiting international registered nurses (RNs) is one solution health care systems employ to address nursing shortages; however, these nurses often encounter challenges. The purpose of this study was to explore international RNs' experiences at a large health system in the United States and identify strategies to effectively integrate these RNs into U.S. health care systems.
METHODS
A mixed-methods study design was used. Nurses involved in the health system's International RN Program, all of whom were from the Philippines, were invited to participate in a survey and interviews.
RESULTS
A total of 114 Filipino RNs completed the survey, and nine participated in interviews. Findings highlighted supportive workplace relationships, but challenges remained in community integration, orientation, and adapting to new clinical practices and communication styles.
DISCUSSION
Recommended strategies to support international RNs include extending orientation programs, providing refresher sessions, offering structured mentorship programs, and providing cultural adaptation programs.
Y. Wen, Qing Yang, Deborah H Allen et al.· Journal of Transcultural Nur...· 0 citations
The GEP is a 5-day immersive educational program that provides structured exposure to APRN education, curricular frameworks, and clinical practice in the United States while fostering sustained dialogue on contextually appropriate pathways for APRN development in Brazil.
M. Diamante, Andrea P Rangel, A. B. S. Hercules et al.· Journal of the American Asso...· 0 citations
ABSTRACT Background Structural racism remains a pervasive and deeply embedded determinant of healthcare inequity globally. Despite strengthened professional standards and policy commitments to equity, racialised populations continue to experience substantial disparities in healthcare access, quality, safety and outcomes. These inequities are sustained not only through interpersonal encounters but also through structural conditions embedded within healthcare systems, workforce arrangements, governance processes and organisational cultures. Structural racism additionally affects nurses' wellbeing, workforce sustainability, psychological safety and professional progression, creating implications for both patient outcomes and healthcare system functioning. Aim To articulate an evidence‐informed position that addressing structural racism in healthcare is a moral, ethical and professional responsibility of nurses, and to propose a conceptual framework positioning nurses as leaders of structural reform, governance accountability and equity‐driven healthcare transformation. Design Position paper drawing on interdisciplinary empirical evidence, ethical frameworks, workforce literature and contemporary nursing scholarship. Discussion This paper introduces the NSERF, which conceptualises structural racism as a multidimensional patient safety, workforce sustainability and governance accountability issue requiring coordinated nurse‐led structural advocacy and institutional reform. Structural racism is shown to operate through interconnected systems including healthcare policy, workforce structures, organisational governance, clinical practice and professional hierarchies, contributing to inequitable access to care, workforce exclusion, reduced psychological safety, burnout and poorer health outcomes. While nursing advocacy has historically focused on individual patient protection, this paper argues that structural advocacy is necessary to address systemic inequities embedded within institutional systems. Strategic reform directions include governance accountability, equity‐integrated clinical governance, workforce equity, structural competency education and policy engagement. Conclusion Structural racism compromises healthcare equity, patient safety, workforce sustainability and organisational trust. Nurses possess an ethical mandate, professional authority and practice‐informed insight to lead structural reform. Moving beyond interpersonal advocacy towards sustained structural advocacy is essential for developing equitable, culturally safe, accountable and sustainable healthcare systems.
ABSTRACT Aim To map the available evidence on the assessment of migrant nurse and midwife workplace integration in global healthcare settings. Background Globally, migrant nurses and midwives are important resources in mitigating workforce shortages. Existing evidence focuses on the orientation stages of migrant nurse and midwife transition into the healthcare setting rather than their long‐term workplace integration. Design/Methods The nine databases searched were CINAHL, Medline, Web of Science, Embase, PsycINFO, ASSIA, SicELO, Maternity & Infant Care and Global Index Medicus. An initial search was performed in December 2021 and updated in December 2025. Results A total of 91 articles were included, comprising qualitative (n = 48), quantitative (n = 13), mixed‐methods (n = 6), others (n = 23) and one book chapter. Multiple definitions of workplace integration were found, and 23 tools were identified. Conclusions Workplace integration, a multidimensional, time‐dependent process, requires collaboration among stakeholders. A standard definition will help to clarify their responsibilities. Key factors ensuring successful integration include promoting effective communication, supporting knowledge advancement, facilitating career development and skill utilisation. The development of standardised interventions with flexibility for local adaptation will support successful workplace integration. Implications for nursing/health policy Findings highlight the need for policy developers to support migrant nurses and midwives with interventions focused on linguistic challenges, cultural competence and differing care models, that are key to successful integration. Future research must include host stakeholders’ perspectives to fully understand the dynamics of workplace integration.
Barry McBrien, F. O. Brien, S. Shetty et al.· International Nursing Review· 0 citations
OBJECTIVE(S)
To explore how healthcare workers, managers, and policymakers understand, perceive, and operate preconception care (PCC).
DESIGN
An interpretive descriptive qualitative study was conducted (April-September 2025) in two government hospitals. Data from interviews, focus groups, document review, and observations were analyzed using constant-comparative methods to generate an explanatory account of PCC practice.
SAMPLE
Thirty-six participants were purposively recruited, including healthcare workers, hospital managers, policymakers, health bureau staff, and NGO stakeholders. Data were collected in Amharic, transcribed, translated, and analyzed inductively, focusing on patterns, tensions, and system-level influences.
RESULTS
Preconception care emerged as structurally unsupported yet sustained through individual effort, shaped differently across system levels. Frontline providers delivered it through moral commitment and improvisation within routine services, rendering it invisible and inconsistent. Fragmented knowledge, shaped by a biomedical focus, limited training, and confusion with antenatal care, further undermined consistent delivery. Managers described the absence of training, supervision, and performance indicators, limiting accountability and integration into service delivery. Policymakers emphasized it as a strategic priority but highlighted gaps in operationalization, coordination, and resource allocation. Across levels, gendered norms and reliance on community trust networks shaped access and reinforced inequities, revealing a persistent misalignment between policy intent and practice.
CONCLUSIONS
PCC functions as an informal practice sustained by individual agency within weakly institutionalized systems. Strengthening implementation requires bridging policy and practice through system integration, managerial accountability, and gender-responsive, community-engaged care models.
Y. Aynalem, Pauline Paul, Z. Lassi et al.· Public Health Nursing· 0 citations
