Abstract
Background: The College of Nurses of Ontario (CNO) reported significant growth in 2025, with IENs now comprising over 53% of all new Registered Nurses (RNs) registrations. As successful IEN integration is complex and influenced by managerial actions, this study is grounded in the understanding that integration must be a two-way process, requiring adaptation from both the IEN and the receiving organization.
Purpose: The purpose of this research was to explore nurse managers' experiences in integrating IENs into acute care settings in Ontario.
Methods: This qualitative descriptive study explored the experiences of 20 nurse managers in Ontario acute care settings regarding IEN integration. Participants were recruited through CNO and the Nursing Leadership Network of Ontario. Semi-structured interviews were analyzed using content analysis to capture challenges, supports, and strategies through the lens of the two-way integration framework from nurse managers experiences.
Results: Analysis yielded five overarching categories: Pre-Entry Preparation, Entry and Early Practice, Ongoing Practice and Retention, Workplace Environment, and Managerial and Personal Insights. Managers reported barriers like inadequate orientation and communication challenges, emphasizing the need for organizational change. Concurrently, they highlighted facilitators such as mentorship and supportive cultures, representing successful organizational responsibility.
Conclusion: The findings reinforce that successful integration is a reciprocal responsibility, requiring managers to be acutely aware of and actively balance both the IEN's adaptation needs and the organization's duty to create an inclusive environment.
Implications: The knowledge generated from nurse managers' experiences provides practical guidance for applying the two-way integration framework to policy and practice, ensuring a strategic approach to strengthening IEN integration and retention in the Canadian healthcare system.
Notes
References:
College of Nurses of Ontario. (n.d.). Registration guides: Introduction (Outside Canada). Retrieved November 11, 2025, from https://www.cno.org/become-a-nurse/registration-guides/outside-canada/introduction
Haynes, K. M., Astle, B., Hawkins, M., & Reimer-Kirkham, S. (2017). Nurse Manager Perspectives about Internationally Educated Nurses (IENs) and Hiring Practices in Long-Term Care. SAGE Open Nursing, 3(3), 1–11. https://doi.org/10.1177/2377960817730999
Ramji, Z., & Etowa, J. (2015). Towards a conceptual framework for workplace integration of internationally educated nurses. Management Education: An International Journal, 15(3), 1–11. https://doi.org/10.18848/2327-8005/cgp/v15i03/50885
Sigma Membership
Lambda Pi at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Descriptive/Correlational
Research Approach
Qualitative Research
Keywords:
Acute Care, Transition to Practice or Onboarding, Workforce, Leadership Initiatives, Nurse Managers, Nursing Management, Foreign Nurses, Life Experiences, Life Experiences--Evaluation, Work Experiences, Ontario
Recommended Citation
Issani, Naseem; Bookey-Bassett, Sue; Espin, Sherry; Indar, Alyssa; and Santa Mina, Elaine, "Exploring Nurse Managers' Experiences in Integrating Internationally Educated Nurses in Ontario" (2026). International Nursing Research Congress (INRC). 238.
https://www.sigmarepository.org/inrc/2026/presentations_2026/238
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-29
Exploring Nurse Managers' Experiences in Integrating Internationally Educated Nurses in Ontario
Toronto, Ontario, Canada
Background: The College of Nurses of Ontario (CNO) reported significant growth in 2025, with IENs now comprising over 53% of all new Registered Nurses (RNs) registrations. As successful IEN integration is complex and influenced by managerial actions, this study is grounded in the understanding that integration must be a two-way process, requiring adaptation from both the IEN and the receiving organization.
Purpose: The purpose of this research was to explore nurse managers' experiences in integrating IENs into acute care settings in Ontario.
Methods: This qualitative descriptive study explored the experiences of 20 nurse managers in Ontario acute care settings regarding IEN integration. Participants were recruited through CNO and the Nursing Leadership Network of Ontario. Semi-structured interviews were analyzed using content analysis to capture challenges, supports, and strategies through the lens of the two-way integration framework from nurse managers experiences.
Results: Analysis yielded five overarching categories: Pre-Entry Preparation, Entry and Early Practice, Ongoing Practice and Retention, Workplace Environment, and Managerial and Personal Insights. Managers reported barriers like inadequate orientation and communication challenges, emphasizing the need for organizational change. Concurrently, they highlighted facilitators such as mentorship and supportive cultures, representing successful organizational responsibility.
Conclusion: The findings reinforce that successful integration is a reciprocal responsibility, requiring managers to be acutely aware of and actively balance both the IEN's adaptation needs and the organization's duty to create an inclusive environment.
Implications: The knowledge generated from nurse managers' experiences provides practical guidance for applying the two-way integration framework to policy and practice, ensuring a strategic approach to strengthening IEN integration and retention in the Canadian healthcare system.
Description
This study explores 20 Ontario nurse managers' experiences integrating IENs into acute care. Using a two-way integration framework, findings highlight key barriers (e.g., orientation gaps, communication) and facilitators (e.g., mentorship, supportive culture). Results provide actionable insights to improve managerial practices, orientation, and policy for IEN integration and retention into Canadian healthcare.