I speak a little Arabic: Nursing communication in a cross-cultural context

Abstract

AIMS AND OBJECTIVES: This study investigated the challenges of cross-cultural communication among internationally qualified nurses, and the impact on nurse-to-nurse and nurse-to-patient relationships. BACKGROUND: Open and authentic communication between nurses and patients is required as a foundation of patient-centred practice; however, this may be a challenge in cross-cultural settings. DESIGN: An exploratory qualitative study with an inductive approach. METHODS: Semi-structured, face-to-face interviews explored the influences on communication and practice of 21 internationally qualified nurses practising in the United Arab Emirates. Manual and software-driven processes guided coding and analysis of data. Caring theory guided the analysis of themes; while COREQ criteria guided research conduct and reporting. RESULTS: Four key themes emerged; (a) Challenges in communication, (b) The science versus art of nursing; (c) The impact of ineffective communication and (d) Strategies for coping. Eleven sub-themes are reported within these themes. Overall, nurses felt they had sufficient language and nursing skills to undertake the technical or scientific aspects of their work; however, they reported experiencing restricted ability to participate in complex cross-cultural conversations, such as providing explanations and reassurance about treatment options or discussing end of life and treatment decisions. This limitation diminished the nurses' ability to engage in the art of nursing and left them unable to employ themselves therapeutically to attain a sense of true presence with patients and their families. CONCLUSION: This article highlights the need for language and communication support, and Arabic-speaking advocates as partners in care for expatriate nurses. RELEVANCE TO PRACTICE: Internationally qualified nurses in this Middle Eastern setting lack cultural orientation and language skills to fully enact the art and true presence of nursing. Findings indicate that health service employers need to increase the employment of Arabic-speaking nurses and provide additional language for other expatriate nurses.