Far from home, close to purpose

A personal journey of growth, identity, and career as a nurse in the UK

By: an Internationally Educated Nurse

I still remember the day I arrived in the UK back in 2010. It was my first trip outside my home country. I felt a deep sense of trepidation stepping into this new land without a single familiar face; no friends, no family, not even a distant relative to lean on. I slowly began to understand the mix of fear and excitement of being alone in a foreign country, as it can feel daunting and exhilarating.

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Adapting and support

The first few months were incredibly intense as I worked hard to adapt to the UK’s healthcare system and ensure I passed my adaptation program to become a registered nurse. I know that many nurses seek better career opportunities and an improved quality of life through migration, often driven by financial circumstances, and these experiences are reflected in the literature (Dahl et al., 2021). During those early days, I learned to become more independent, navigating tasks like opening a bank account, managing utility bills, batch cooking meals for hectic workdays, and buying groceries on my days off, which I have never done back home.

I remember feeling overwhelmed by personal problems as I thrived here in the UK, often choosing to solve them on my own so my parents wouldn't worry. At work, I often held back on sharing my challenges with colleagues, trying to maintain a strong front and not show vulnerability. To thrive as a newly registered internationally educated nurse (IEN), I relied on myself as my own support system.

While the journey of facing life in the UK alone was intimidating, I gradually built meaningful friendships and established a supportive working environment in my first ward. These connections helped ease the heaviness of missing my family. Even with technology making family conversations more accessible, it never truly replaced the warmth of in-person interactions. Unfortunately, some IENs that I know were struggling in their first placement. As a result, they decided to move from one clinical area to the next, seeking the support and sense of belonging that they needed.

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Challenges

Over the past 15 years in the UK, I have encountered a variety of personal and professional challenges, often feeling as though I was navigating them on my own. Significant hurdles, such as language barriers, systemic and personal discrimination, and the expensive process of obtaining my nursing license. While it is affirming to see these experiences reflected in the academic literature, (Connor, 2016; Salami et al., 2018; Wheeler et al., 2014), these experiences remain as a challenging part of my journey.

I understand what it is like to receive discouraging remarks, such as “you will never be like her,” which can be profoundly hurtful. However, I transformed that pain into motivation to propel myself forward. I take great pride in having completed my Master’s in Advanced Practice in response to those experiences.

As I continue to grow, I strive to offer understanding and encouragement to those fellow IENs around me, avoiding any pushback that could cause fear. Reflecting on my journey in the UK, I feel a deep desire to support and inspire those who are embarking on their journey here. I recognise how challenging this experience can be, and I want them to feel welcomed, understood, and — most importantly — not alone in their journey.

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If you are experiencing any of the difficulties described here, or would like support for any related challenges, we have a list of resources here that you can access.

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References:

Connor, J.B. (2016) Cultural influence on coping strategies of Filipino immigrant nurses, Workplace Health & Safety, 64(5), pp.195–201. https://doi.org/10.1177/2165079916630553

Dahl, K., Bjørnnes, A.K., Lohne, V. and Nortvedt, L. (2021) Motivation, education, and expectations: experiences of Philippine immigrant nurses, SAGE open,11(2),pp.1-8. DOI:10.1177/21582440211016554

Salami, B., Meherali, S. and Covell, C. (2018) Downward occupational mobility of baccalaureate-prepared, internationally educated nurses to licensed practical nurses, International Nursing Review. 65(2), pp. 173–181. DOI: 10.1111/inr.12400

Wheeler, R.M., Foster, J.W. & Hepburn, K.W. (2014) The experience of discrimination by US and internationally educated nurses in hospital practice in the USA: a qualitative study, Journal of Advanced Nursing, 70(2), pp. 350–359. https://doi.org/10.1111/jan.12197

Celebrating and Supporting Internationally Qualified Nurses

By: Dr Gloria Likupe

For this NHS Overseas Workers Day, we focus on Internationally Qualified Nurses working in the NHS; their contributions, challenges and how our work is addressing this.

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As we celebrate this year’s NHS Overseas Workers Day, it is good to reflect on the contribution that internationally qualified nurses (IQNs) make in the UK. The UK National Health Service (NHS) estimates that around 1 in 8 nurses (12%) are trained outside the EU. In NHS hospitals and community services in England specifically, nearly one in five (18.5%) nurses are overseas nationals, this rises to 2 in 5 nurses working in social care settings (Palmer et al 2021).

This number is projected to increase further as in recent years overseas nationals have accounted for around a quarter of nurse joiners on the Nursing and Midwifery Council (NMC) register. As the largest employer, the NHS has always benefited from overseas recruitment and from nurses coming from other countries to live and work in the United Kingdom. This is in line with the NHS Long Term Plan 2021/2022 that set out the ambitions for the NHS over the next 10 years, identifying ethical international recruitment as a workforce priority.

Worldwide, internationally educated nurses make an invaluable contribution to health systems by providing diverse skills and promoting cultural sensitivity in patient care. As the demand for care and for nurses is increasing, the necessity to attract, and importantly, retain IQNs is vital.

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Challenges

However, IQNs working in the UK often face challenges related to cultural integration, communication barriers, a perceived lack of recognition for their prior experience, and potential discrimination. Many report feelings of being treated like novice nurses despite having years of experience in their home countries, leading to challenges in adapting to the professional culture and sometimes feeling undervalued (Sheeny et al. 2023). In addition, many felt they were not being used in roles that matched their prior experience and qualifications, and that integration during their initial spell of employment was often found to be challenging (Devereux 2023). These and other factors from the research show why retaining international nurses is proving to be a challenge at a time when the NHS needs nursing staff more than ever.

Dr Pamela Cipriano points out that these challenges are faced by internationally recruited nurses worldwide by stating “Nurses face numerous challenges: physical, mental, emotional and ethical, and it is imperative that we address these challenges in a way that promotes their overall health” (Church 2025) These challenges can impact their effectiveness at work as well as their personal and family lives. Nurses can fall into depression, burnout and stress which could result in suicidal ideation.

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Support

NHS trusts in England have put together a range of support for IQNs which include but are not limited to:

• Financial support to trusts for international nurse recruitment, sharing learning and best practice to ensure consistent, high-quality offers and interventions.

• A small grants scheme, offering diaspora groups the opportunity to apply for funding to strengthen their pastoral support offer for international nurses in the UK.

• Refugee nurse support pilot programme being delivered in partnership with the Department of Health and Social Care, Liverpool John Moores University (LJMU), RefuAid and Talent Beyond Boundaries (TBB), supports refugees who are qualified as nurses in their home country to resume their nursing careers in the NHS.

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Our work

Despite these challenges, many IQNs also find opportunities for professional development and positive experiences within the NHS, especially with adequate support systems in place. Pamela Cipriano has stated “By prioritising the wellbeing of nurses, we are ensuring that they can continue to provide the high-quality care that is critical to the health of our communities" (Church 2025). These opportunities can only be realised by health care systems recognising and addressing facilitators and barriers to IQNs’ success and wellbeing.

The Nurse Suicide Project is contributing to this end by conducting ground-breaking research that addresses IQNs’ experiences, some of which may lead to suicidal distress. We are using an intersectional critical feminist lens and storytelling methods to create a safe space for nurses to express these experiences. In doing this, we are supporting the recognition and utilization of IQNs' specialist skills by the world’s healthcare systems. In conducting this research, we are acknowledging that all health systems benefit from a more diverse and better-skilled healthcare workforce, ultimately leading to improved patient outcomes and a more inclusive healthcare system. The project team recognise that most research on suicidal distress is colour-blind and has overlooked the experiences of nurses from the global ethnic majority, including IQNs. The team are proactively working with nursing communities across the spectrum to ensure their views and voices are represented in their research.

In the UK, the Nurses and Midwives Council calls for health and care employers to fully support IQNs into UK practice to create the most inclusive environment possible.  We further this call by highlighting that collaboration among policymakers, healthcare organizations and regulatory bodies is crucial in developing strategies for the integration and utilization of IQNs' specialist skills.

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Study 3 will be recruiting internationally qualified and ethnically diverse nurses from spring 2026. You can find more information on the study page or get in touch using the contact form.

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References

Devereux, E (2023) NHS must recognise overseas nurses’ prior experience, urges report. Available at: NHS must recognise overseas nurses’ prior experience, urges report | Nursing Times

Church, E (2025) International Nurses day 2025 theme revealed. Available at: https://www.nursingtimes.net/nurse-wellbeing/international-nurses-day-2025-theme-revealed-10-01-2025  

Palmer, B  Leone, C and Appleby, J (2021) Return on investment of overseas nurse recruitment: lessons for the NHS. Nuffield Trust Available at: www.nuffieldtrust.org.uk/sites/default/files/2021-10/1633336126_recruitment-of-nurses-lessons-briefing-web.pdf

Sheeny, L Crawford, T and River, J (2023) The reported experiences of internationally qualified nurses in aged care: A scoping review, DOI: 10.1111/jan.15913