Research - Personal Safety of Migrant Nurses - Zimbabwe Practising in Melbourne - Assessment Answer

Introduction:

Over the year, the healthcare sector in Australia is facing lots of challenges and high pressure as it has to render the care services as per the expectations and demand of the patient. These pressures are concentrated on the nursing workforce nature and structure. The pressure is how the nursing workforce is effectively managed and organizes to face the upcoming challenges (Ohr et al., 2009). The major reason for mobility of the nurses is due to the chronic shortage of the registered nurses globally. Overseas Qualified Nurses (QQN) immigration reasons are many and can be associated with their family and personal issues. As per the data, in 2020 shortfall will be up to 808,500. After the evaluation this figure, the foreign recruitment and migration of the nurses are not the permanent solution (Bieski, 2007). As per the data gathered by the Australian Bureau of Statistics, there is high need of the nursing practitioner as the 14% of the population is older than 64 years. Chronic disease along with high life expectancy and the aging, is formulating the demand of the patient for effective health care. Moreover, to fulfill the expectation of the patient, it creates pressure for the comprehensive involvement of doctors and health professionals, mainly nurses. This research is to study the experiences of the immigrant nurses from Zimbabwe working in Australia. Using open-ended questionnaires approach the aim of the research was to describe, explore and evaluate

the live experiences about the personal safety of the three migrant nurses, practicing in adult acute mental health settings in Melbourne metropolitan areas. The research highlights the still existing cultural and social gap between nurses of diverse background and the nurses with the dominant culture.

Future recommendations for research:

The method chosen for the research was the primary qualitative method.There was three participant from the specific aura. The data was collected in the interview, and recorded form followed by the analyses by dividing the data as per the theme and then the results were presented in the narrative form. Bias is one of the issues of concern while conducting a primary research as the researcher assumes that they already know the answer. Three areas are there where bias can creep into the research, include how the researcher asks the question, how the researcher takes the note, and the way the researcher concluded. It is recommended to formulate the survey and interview questions of high quality. Always take the objective notes while performing the research observation. It is recommended to interpret the data objectively and only draw the conclusion from the data only.

It is recommended that the researcher for the further research can use the method that is less time-consuming. The interview method is the effective method of conducting research but required lots of time to conduct a research. Moreover, the participant can prove fake answers also that leads to bias in the study. It is recommended that the researcher should work in association with the govern concern body in the hospital or outside the hospital to get appropriate evidence related to the claim of nurses. It is recommended that reflection method can be used to perform the research in that the nurses can reflect upon the experiences they had while start working in the Australian hospital. In this research, the questions were in English only. It can be evaluated that the participant will be comfortable to answer in their native language so it can be recommended that the interview can be formulated as per the native language also.

This was the pilot study. This study can be extended for the future research as the topic of an issue is paramount to discover, and the governing body should take effective steps. It is recommended to take at least 80 nurses from different healthcare sectors of different areas of Australia. The inclusion criteria should also be extended. The nurses from different countries can be included not only the nurses from Zimbabwe. To avoid any error, initially, the data should be collected from the NMBA organization and then approach the nurses. This method will eliminate the error associated with the inclusion of the participant. The increase participation number, different nurses of different countries and hospitals, will increase the possibility to acquire accurate results. The topic was only included the personal safety of the nurses, after conducting this research. It is acknowledged that the nurses are facing many other problems also related to diverse culture. It is recommended to include the other factors also in future studies. The issues include cultural issues, language issues, improper behavior of recruiters, improper agreements between the countries, and mistrust by the other nurses. It is recommended to perform research on these issues also, as these issues are interlinked to each other and can help to formulate the policies for the beneficence of the QNN.

Future recommendations and implications for practice :

The immigrated nurses from Zimbabwe to Australia manifest that, they came to this country as in their country opportunities were less and they were underpaid and had few possibility for the personal and professional development. These reasons compel them to decide the migration. The QQN also reported that the decision was determined by various domains to include support of the family, peer support and high packages promises from Australian recruiters. The nurses stated that their professional and employability performances were affected due to adaptation to new environment and culture. Moreover, the main difficulty zone was the divergent culture and in that these nurses have to demonstrate nursing skill and build the relationship with physicians and colleagues (Seima et al., 2011). Besides the requirement of adaptation to the environment, Introduction:

Over the year, the healthcare sector in Australia is facing lots of challenges and high pressure as it has to render the care services as per the expectations and demand of the patient. These pressures are concentrated on the nursing workforce nature and structure. The pressure is how the nursing workforce is effectively managed and organizes to face the upcoming challenges (Ohr et al., 2009). The major reason for mobility of the nurses is due to the chronic shortage of the registered nurses globally. Overseas Qualified Nurses (QQN) immigration reasons are many and can be associated with their family and personal issues. As per the data, in 2020 shortfall will be up to 808,500. After the evaluation this figure, the foreign recruitment and migration of the nurses are not the permanent solution (Bieski, 2007). As per the data gathered by the Australian Bureau of Statistics, there is high need of the nursing practitioner as the 14% of the population is older than 64 years. Chronic disease along with high life expectancy and the aging, is formulating the demand of the patient for effective health care. Moreover, to fulfill the expectation of the patient, it creates pressure for the comprehensive involvement of doctors and health professionals, mainly nurses. This research is to study the experiences of the immigrant nurses from Zimbabwe working in Australia. Using open-ended questionnaires approach the aim of the research was to describe, explore and evaluate the live experiences about the personal safety of the three migrant nurses, practicing in adult acute mental health settings in Melbourne metropolitan areas. The research highlights the still existing cultural and social gap between nurses of diverse background and the nurses with the dominant culture.

Future recommendations for research:

The method chosen for the research was the primary qualitative method.There was three participant from the specific aura. The data was collected in the interview, and recorded form followed by the analyses by dividing the data as per the theme and then the results were presented in the narrative form. Bias is one of the issues of concern while conducting a primary research as the researcher assumes that they already know the answer. Three areas are there where bias can creep into the research, include how the researcher asks the question, how the researcher takes the note, and the way the researcher concluded. It is recommended to formulate the survey and interview questions of high quality. Always take the objective notes while performing the research observation. It is recommended to interpret the data objectively and only draw the conclusion from the data only.

It is recommended that the researcher for the further research can use the method that is less time-consuming. The interview method is the effective method of conducting research but required lots of time to conduct a research. Moreover, the participant can prove fake answers also that leads to bias in the study. It is recommended that the researcher should work in association with the govern concern body in the hospital or outside the hospital to get appropriate evidence related to the claim of nurses. It is recommended that reflection method can be used to perform the research in that the nurses can reflect upon the experiences they had while start working in the Australian hospital. In this research, the questions were in English only. It can be evaluated that the participant will be comfortable to answer in their native language so it can be recommended that the interview can be formulated as per the native language also.

This was the pilot study. This study can be extended for the future research as the topic of an issue is paramount to discover, and the governing body should take effective steps. It is recommended to take at least 80 nurses from different healthcare sectors of different areas of Australia. The inclusion criteria should also be extended. The nurses from different countries can be included not only the nurses from Zimbabwe. To avoid any error, initially, the data should be collected from the NMBA organization and then approach the nurses. This method will eliminate the error associated with the inclusion of the participant. The increase participation number, different nurses of different countries and hospitals, will increase the possibility to acquire accurate results. The topic was only included the personal safety of the nurses, after conducting this research. It is acknowledged that the nurses are facing many other problems also related to diverse culture. It is recommended to include the other factors also in future studies. The issues include cultural issues, language issues, improper behavior of recruiters, improper agreements between the countries, and mistrust by the other nurses. It is recommended to perform research on these issues also, as these issues are interlinked to each other and can help to formulate the policies for the beneficence of the QNN.

Future recommendations and implications for practice :

The immigrated nurses from Zimbabwe to Australia manifest that, they came to this country as in their country opportunities were less and they were underpaid and had few possibility for the personal and professional development. These reasons compel them to decide the migration. The QQN also reported that the decision was determined by various domains to include support of the family, peer support and high packages promises from Australian recruiters. The nurses stated that their professional and employability performances were affected due to adaptation to new environment and culture. Moreover, the main difficulty zone was the divergent culture and in that these nurses have to demonstrate nursing skill and build the relationship with physicians and colleagues (Seima et al., 2011). Besides the requirement of adaptation to the environment, some QQN felt discrimination and mistrust from their department, as per the research results from Australia, Canada, and USA (Omeri, A., & Atkins, 2002; Hancock, 2008).

Kingma in 2001 stated that there are several reasons for the worldwide migration of the nurses include pull and push factors. As per this research, The first came to Australia for the educational and professional opportunities, as such opportunities were not available in her country. The nurses faced the challenges while forming the working relationship with the colleague's nurses of the hospital. She reported the isolation, loss of self-esteem and confidence, loneliness and frustration. The conditions were not appropriate and affected her work also.

This finding was the finding of Stankiewicz, G., & O'Connor, M. in 2014. The authors opined that the nurses from different culture background feel isolation from the colleague nurses. As the nurses from the different country, and culture have the issue of languages also make them uncomfortable to adjust to the new environment. Isolation from the department leads to decreased self-confidence and ultimately decrease the work performance.

It is recommended to keep an eye on the immigrant nurses and allow the eligible nurses for the immigration, as the registration is not only the criteria for the migration. The Australian Nursing and Midwifery Accreditation Council should have the department and members to deal with the immigration nurses and their citizenship to evaluate the eligibility of the nurses (Australian Nursing and Midwifery Council(ANMC),2008). Smith et al. in 2011 stated that the Nursing and Midwifery Board of Australia (NMBA) is the authorized body to process the applicant's registration application and the QQN should register themselves for the documentation purpose.

As per the NMBA, it is mandatory to go through the five criteria. It is recommended for the QQN to follow the five principles to reduce the risk of feeling isolated in working place. They have to meet the current English proficiency standard. It is recommended for QQN that they should have a good command of English language so that they can work effectively in Australia hospital and can interact with a patient, concern doctors, and colleagues nurses. It is recommended to Australia government that they should have the proper check for this to avoid the risk of isolation among the QQN. As per the NMBA, it is mandatory to provide the evidence associated with the practice and fitness certificate also so that the QQN can meet the recent Australian education standard. It is recommended to follow this criterion appropriately to insure quality treatment of the patient. Moreover, the colleagues will not mistrust the QQN, if they are coming after the channelized organization (ANMC, 2013; ANMC, 2009a).

The second nurse seeks good money and wages, and better living condition than the exist at Zimbabwe. She reported that the act of discrimination by the recruiter due to her nationality and race. The recruiter had promised to pay high but did not pay the same amount. The pay scale of the nurses was lower than the nurses of the same level of the native country. This discrimination made her uncomfortable to work in the hospital environment. It is recommended to formulate the governing body that can deal with the recruiter disparity against the QQN. There should be check with the recruiters. The nurses should comfortable to contact the concerned authority. The government should have the organizing body that deals with the appointment and salary detail of the QQN in written form not just in the verbal form. There should be some transition programmes for the QQN before the registration. The same was opined by Xu and He in 2012. There should be the check on the collection of data, and the governing authority should keep the check on the number of QQN so that further they can contact the nurses for recording purpose includes the experiences of the nurses. Such step by the government will encourage these nurses to work without fear and discrimination.

The third nurse seeks the work in Australia because she wanted to work in an environment with less risk of infection include HIV/AIDS. Kline in 2003, stated that the nurses from the African countries shifted to a developed country to get personal safety from the contagious infection as in African countries the rate of HIV/AIDS are very high, and nurses don't feel safe to work in such environment. The third nurse reported about the incidence of bullying included laughing on her by the other nurses and other nurses were called her by different names. The above-stated findings were opined by the author U. Choudhry in 2001. The nursing workplace had been identified as one of the most prone areas for bullying. This place is associated with the relational aggression that includes intimidation and gossiping. Various forms of bullying can be seen in the healthcare services center include management bullying, doctors bullying, nurse bullying another of the different culture, patients bullying the nurse and other health professional bullying the nurse ( Hutchinson et al., 2008).

The bullying act can hurt the person emotionally and decrease the working efficiency of the person. The act can include the verbal as well as the physical abuse and hamper the personal safety of the target. The isolating the person and interfere with work practice can impact the physical safety of the person. The bullies are unaware of the fact that what kind of damage they are rendering to the person. Guerrettaz, in 2012 stated that the 76% of the nurses had experienced bullying act from their colleague nurses. Rude remarks and bad names from co-workers can make them do mistakes in the healthcare sector. It is mandatory to take effective action against the bullies. It is recommended that the health organization educate the healthcare team and whole staff about the expected behavior from the colleagues and all staff. Some workshops should be there to discuss the various culture and their importance so that the QQN can talk about their culture, language, and feeling while working in the different country of different culture and language.

The government should make the framework as per that in every hospital one governing body should be there to conduct workshops on culture discussion with the aim of the improvement of the social interactions and foster positivity. The strict action can be taken against the bullies, include monetary compensation and fired from the workstation. Moreover, the collaboration and communication are the prime step for the improvement of the environment of the working place and help the nursing staff to initiate the professional relationship with both the patients and the colleagues. Open forum, mentoring, counseling and workshops are the possible options for the management of the bullying act in nursing profession (Martin,2008).

It is recommended that always treat the new nurses as you want to be treat as. It should be looked after by the governing body in the hospital that there should be welcome of the new nurses to encourage her to work efficiently and this act will help the nurses to think that she is the part of the nursing staff. Encourage the new nurse to address the misbehave and bullying act immediately to concern authority. Use the conflict-management laws and strategies. The concern authority should identify the issue and the cause of the problem and raise the point during staff meetings. To end this horizontal violence, a hospital should implement the Zero- tolerance policies. The message should be delivered clearly and loudly from the management or governing body that this culture should not be followed in the working place (Johnson, S. L., & Rea, 2009). It is paramount to break the bullying cycle to render the active treatment to the patient and ensure the safety of the patient also.

Table1 is showing the financial expenditure while conducting the pilot study with three participants of the same hospital. The monetary expenditure is divided into three [phases. The phase 1 consist of the expenditure prior the conduction of study that includes arrangements of a consent form, Interview formant forms, pen, pencils, Eraser, Sharpener, pebblepad, Voice recorder, and Observation sheet. For the phase 1, the calculated expenditure is $500. Phase 2 consists of expenditure while approaching the participant and reaching the hospital. The cost required was the $600 for approaching the nurses and traveling to the hospital. Phase 3 consist of the expenditure associated with the analysis of the data and interpretation of the results that required total $900 expenditure. So the total expenditure was $2000.

Table 2: Estimation of the cost for expanded study with total 50 participants of different zone and hospital of Australia.

After the evaluation of the table2, the following expenditures can be expected

For the conduction of the future study by pilot study, the the financial expenditures are evaluated. For the phase 1, there will be the requirement of approximately $8000, while for phase 2 there will be the requirement of $ 15,000 and then for phase 3 the expected expenditure will be $15, 000 so the total expenditure will be approximately $38,000.

Task: 4

Research portfolio

The healthcare sector in the whole world is facing the tremendous pressures as it has to handle the new expectations and demands. Most of the time, these pressures had concentrated on the nature and structure of the workforce associated with the nursing practice. It is important to evaluate the effectiveness of the nursing practice to meet the challenges and handle the pressure (Xu and He 2012; Smith et al. 2011). There are many driving forces related to the migration of the nurses to Australia. By looking into the present scenario, the aim of the present research was to evaluate the personal safety issues associated with the migrant nurses from Zimbabwe working in the adult acute mental health settings in Melbourne metropolitan areas, looking at the physical mental, psychological and social well being. This research is based on the primary research with the qualitative approach to evaluate the desired results. For the same, three nurses were selected as per the inclusion criteria. Only migrant nurses from Zimbabwe and working in the acute mental health settings in Melbourne metropolitan areas were included in the study group. The consent forms were provided to the participant with details explanation of the study. The structures interview was the method of data collection. The interview Performa was in English and participant from the study group were asked to answer the open-ended questions so to evaluate the data accurately. The interviews were systematically recorded in the voice recorder also to ensure that the data would be secure and permanent. The data was collected then transcribed into the word file for the analysis of the data. An analysis was performed as per the thematic method. After the analysis, the results were formulated and compared with the other researcher's results too.

As per the finding, the nurses were shifted to Australia for the betterment of their living conditions and standards. They had both positive as well negative experiences associated with the working place. One of the nurses stated that she faced the challenges while forming the working relationship with the other nurses of the hospital. She reported the isolation, loss of self-esteem and confidence, loneliness and frustration. The conditions were not appropriate and affected her work also. This finding is by the finding of B. Stilwell et al., (2004). The second nurse reported the act of discrimination by the recruiter due to her race and nationality. The recruiter had offered the low salary as was promised originally. The third nurse reported about the incidence of bullying included laughing on her by the other nurses and other nurses were called her by different names. The above-stated findings were opined by the author U. Choudhry in 2001.

It is recommended to formulate the governing body which can deal with the discrimination and bullying issues. The nurses should feel free to contact the concerned authority. There should be check point over the recruiters too. When there is any discrimination and bullying is reported and identify than the concerned authority should take strict action by evaluating the whole act in the parameters of legislation.

As per the findings of the pilot study, it is paramount to expand this study for further research for the evaluation of the experiences of various migrant nurses on a large scale. For the same, the total 50 nurses will be included in the study group as per the inclusion criteria from the various hospital in Melbourne, Australia. The required time frame will be of one year. This study will help to evaluate the issues and challenges faced by the migrant nurses. The evaluation is important for the eradication of the challenges especially discrimination and bullying. So that the immigrant nurses can feel free, safe and comfortable to work in Australian hospitals.

Research artifact required:

For the conduction of interview

• Pebble pad
• Pen/ pencil
• Consent form
• Interview question
• Interview guides
• Observation sheet
• Information sheet
• Voice recorder
• Eraser
• Sharpener

For the analysis of data

• Laptop/computer system
• Printer
• A4 paper sheets