Redefining Resilience & belonging in a shifting landscape

By: Angela Kumah

Friday 6th March 2026 marks Overseas NHS Workers' Day, a celebration of the extraordinary contributions migrant health workers make to the NHS and to the United Kingdom and to honour the deep commitment, expertise, strength and diversity they bring to the health and social care workforce.

Many accounts of immigration and migration are underpinned by stories of sacrifice, strength and resilience, many holding home and memories close while searching for belonging in a new land. Quotes from immigrants and migrants across the world highlight the complexity of negotiating identity, as we work out the nuance between holding on to national and cultural roots while adapting to a new society and attempting to redefine home (Watson, 2025). For many overseas health workers, the resilience required to make this transition is not simply a personal strength or badge of honour. It becomes an expectation and, over time, an identity rather than a choice.

Resilience is commonly understood as the capacity to recover and manage effectively during stressful circumstances without psychological collapse, often described as a dynamic interaction between environmental conditions and internal protective mechanisms that buffer responses to adversity (Rutter, 1985). It is often associated with strength, endurance, optimism, aspiration, faith and spirituality, and social support from family/friends. Ungar (2014) & Dahl et al (2022) remind us that the resilience of individuals and families is inseparable from the resilience of the society in which they are situated.

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Navigating belonging and resilience in the current political climate

If resilience is shaped by environment as much as by individual values and traits, then we must examine the environments migrant health workers are navigating. The current political climate surrounding immigration has become a significant national conversation, with direct implications for healthcare workers, particularly those who’s right to remain is tied to employment sponsorship. This creates uncertainty, affects the everyday workplace experience and shapes how security, a sense of belonging and value are perceived within the NHS.

Belonging, therefore, is no longer simply an emotional attachment to a place of safety but becomes conditional, negotiated by politically mediated definitions of what it means to earn the right to be a part of this society. This shifting goalpost for what constitutes belonging is bound to contribute to internal tensions that affect not only individuals, but their professional identity and practice.

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Bending without breaking

Within this context, resilience may often be framed as bending without breaking, a narrative of endurance, survival and innate toughness. It is portrayed as an inherent trait, something one is born with and must rely upon to survive and while resilience does function as a protective factor, it can simultaneously discourage help-seeking. When resilience becomes internalised as identity, vulnerability may feel like an afront to identity and the ability to shape narratives about self. In the case of minoritised groups (such as overseas nurses) these feelings are further amplified in the face of adversity.

The Workforce Race Equality Standard Report (NHS England, 2024) states that domestically and internationally recruited nurses and nursing assistants from Black and Minority Ethnic backgrounds, alongside white nurses recruited internationally report less favourable workplace experiences within the NHS. In the case of overseas health workers, particularly those navigating migration-related tensions, many may feel pressure to and stay resilient without complaint. In the context of ongoing work on suicidality in nursing, it becomes increasingly clear that resilience narratives, especially those embodied by overseas nurses, can unintentionally silence distress.  What this highlights, is that two realities can coexist: while overseas NHS workers are deeply resilient, they face systemic barriers that impact mental wellbeing and consequently necessitate the embodying of resilience as an identity. Holding space for both truths is imperative, if we truly want to foster a culturally humble and safe environment that truly celebrates their contributions to our health and social care system.

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Cultural Safety

Contextual and structural protective mechanisms shape how cultural safety is practiced, and organisational culture, inclusive leadership and equitable policy frameworks play a key role in determining whether resilience is supported collectively or demanded individually. Ungar (2014) identifies protective factors including meaningful relationships, strong identity, personal agency, social justice, access to resources, cohesion and cultural continuity as key to supporting resilience. These are not simply personal attributes; they are socially constructed and need to be sustained in a context that appreciates not only the contributions overseas NHS workers make to the very systems that sustain this nation, but wholly embrace the individuals, who make up this workforce.

Recognising the influence of political discourse on the health and wellbeing of overseas workers and ensuring safe environments, not only in conversation, but for policies that protect these essential service providers, is the first step towards truly acknowledging their value. Secondly, supporting culturally safe environments where overseas workers can navigate the delicate balance between affirming resilience and intentionally seeking support should underpin efforts to strengthen belonging. While family networks, community structures and national diasporic associations continue to sustain the health and wellbeing of many overseas healthcare workers, they often end up sharing the burden of distress caused when navigating the current hostile political climate, in an already emotionally tasking profession. This is counterproductive to any efforts towards fostering a resilient society.

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Creating ‘fully belonging’ environments

As such, in a multicultural society like the United Kingdom where identity, hope and expectations shape meaning, it is imperative that we adopt a culturally humble approach that recognises, respects and safeguards the value our culturally diverse workforce contribute to the success of our nation. Resilience should, therefore, not be demanded as individual toughness within complex political and organisational landscapes, but it must be supported collectively, so that bending toward help happens before breaking becomes the only option.

Supporting overseas workers must be grounded in an appreciation of how resilience, empowerment and social and cultural capital intersect to promote wellbeing while acknowledging the unintended barriers resilience narratives can create in relation to help-seeking. It also calls for thoughtful reflection on the wider political landscape that shapes feelings of belonging and security, recognising that the environments in which people live and work inevitably influence how safe they feel to be fully human, to fully belong.

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References

Dahl, K., Nortvedt, L., Schrøder, J., & Bjørnnes, A. K. (2022).
Internationally educated nurses and resilience: A systematic literature review. International Nursing Review, 69(3), 405–415. https://doi.org/10.1111/inr.12787

NHS England. (2024).
NHS workforce race equality standard (WRES) 2023: Data analysis report for NHS trusts. https://www.england.nhs.uk/publication/nhs-workforce-race-equality-standard-2023-data-analysis-report-for-nhs-trusts/

Rutter, M. (1985).
Resilience in the face of adversity: Protective factors and resistance to psychiatric disorder. British Journal of Psychiatry, 147(6), 598–611. https://doi.org/10.1192/bjp.147.6.598

Ungar, M. (2014).
Resilience and culture: The diversity of protective processes and positive adaptation. In M. Ungar (Ed.), Youth resilience and culture (pp. 37–48). Springer. https://doi.org/10.1007/978-94-017-9415-2_3

Watson, S. (2025).
Quotes from immigrants. Burning for Success. https://burningforsuccess.com/quotes-from-immigrants/

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We are grateful for the support of the Wellcome Trust who have funded this project.

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