Module 2

Work-related barriers and resources of migrant and autochthonous homecare nurses in Germany: A qualitative comparative study

Schilgen B, Handtke O, Nienhaus A, Mösko M. (2019). Work-related barriers and resources of migrant and autochthonous homecare nurses in Germany: A qualitative comparative study. Applied Nursing Research 46:57-66

Link to the article in Applied Nursing Research

Introduction: There is substantial research about the occupational health of nurses worldwide. However, empirical evidence about the psychosocial health of migrant and minority nurses in outpatient settings in Germany in comparison to that of autochthonous nurses is lacking.

Objectives: This study aims to identify work-related stressors, resources and the corresponding coping strategies of migrant and minority nurses in comparison to autochthonous nurses.

Design: 24 migrant and 24 autochthonous nurses employed in the German homecare sector were interviewed in qualitative explorative manner while a distinction was made between non-commercial and private-commercial services.

Settings: The interviews took place in the nursing services’ premises or in the nurses’ private homes.

Participants: Services were randomly chosen among all homecare providers in the second largest German federal city-state Hamburg. Nurses were invited for an interview, once their management agreed to participate in the study. Registered nurses and nursing assistants as well as those with a foreign certificate but validated or in process were eligible to participate.

Methods: Relevant literature findings formed the base for the semi-structured interview guide. Key areas in the interview guide were barriers, resources and coping strategies in the collaboration with colleagues, superiors and clients as well as in the collaboration within a linguistically and culturally diverse team and clients. The conventional approach to qualitative content analysis by Hsieh and Shannon guided the analysis.

Results: Regardless of their origin or culture, nurses perceive time pressure, lifting patients, lack of appreciation or the client’s personal fate as burdening. In the intercultural context, the divergent understanding of behavioral patterns as well as of nursing care and a non-functioning communication impede the collaboration within a diverse nursing workforce. Migrant and minority nurses suffer prejudices, verbal and sexual harassment proceeding from their clients. However they keep it to themselves and don’t broach it to their supervisors or colleagues. The interaction with humans, the verbal exchange with colleagues and supervisors at eye level as well as the sensemaking of being a nurse helps nurses to cope with occupational stressors.

Conclusions: Differences in language is a main stressor which impedes a functioning team collaboration as well as a positive nurse-client relationship. Migrant and autochthonous nurses share similar coping strategies to master occupational burdens. A good collaboration within the team and having an appreciative supervisor are resources that support migrant and minority nurses as well as autochthonous nurses to face the stressors and to cope with those. Migrant nurses of different origin perceive their status as migrants as a sense of community by sharing commonalities.