A model for personal, social and professional acculturation of overseas nurses: a qualitative study in Malta

Background/Aims Hiring nurses from overseas can be a practical solution to tackling staff shortages, but these nurses often face personal and professional challenges when moving to a new country. These challenges may cause physical and psychological stress and disruption to the acculturation process, with possible negative effects on patient care. This study explored the acculturation and cultural experiences of nurses from India working in care homes for older people in Malta, with a particular focus on the potential challenges of settling and providing care to patients. Methods A total of 25 nurses who had moved from Kerala, India, to work in Malta completed online semi-structured individual interviews in July–December 2021. Interviews were transcribed verbatim and analysed using Gioia methodology, an inductive logic approach to interpretive grounded theory. Results Participants described a lengthy and demanding process to work and register as nurses in Malta. Their experiences on arrival were influenced by several interrelated factors, including settlement, workplace and acculturation challenges. Family reunification was a particularly difficult issue for participants, with many considering whether to stay in Malta or seek opportunities abroad; the latter was seen as offering better financial compensation and work, but not necessarily providing the same quality of life. Conclusions Nurses who migrate to other countries to work experience a complex process of cultural adaptation and professional integration. Initiatives are needed to support the inclusion and wellbeing of these nurses, including social and language support and measures to facilitate family reunification.