Adaptation and transformation through (un)learning: lived experiences of immigrant Chinese nurses in US healthcare environment.

This phenomenological study examined the lived experiences of Chinese nurses working in the US healthcare environment. In-depth interviews with 9 self-identified Chinese nurses were conducted in English and transcribed verbatim. Using Colaizzi's (In: Valle RS, King M, eds. Existential-Phenomenological Alternatives for Psychology. New York: Oxford University Press; 1978:48-71) 7-step procedure, the narrative data were independently analyzed by a team of researchers. Five primary themes emerged from the data: (a) communication as the most daunting challenge, especially during initial transition of their first job; (b) different and even conflicting professional values and roles/expectations of the nurse between the United States and China; (c) marginalization, inequality, and discrimination; (d) transformation through clinging to hope, (un)learning, and resilience; and (e) cultural dissonance. To a large extent, this study supported the findings in the general literature on international nurses, especially those from Asia. It also documented the uniqueness of this group of Chinese nurses, namely their ingenuity to turn challenges into opportunities, their high-level job satisfaction in spite of adversity, their desire for learning and execution of strategic plans for performance and career enhancement through further education, and their proactive measures to adapt to workplace demands. In addition, this study revealed both real and potential risks to patient safety and quality of care during the transition of these Chinese nurses. In light of these findings, implications for both practice and future research are elaborated, particularly in the context of the accreditation standards of healthcare organizations and national agenda for patient safety research.