Social Processes Affecting the Workforce Integration of First-Generation Immigrant Health Care Professionals in Aging Citizens in the Netherlands.

Introduction: Within a Dutch nursing home, the prevailing workforce culture was challenged by new personnel, which caused institutional change, which in turn, affected workforce integration. The purpose of this study was to examine social processes affecting workforce integration of first-generation immigrant health care professionals in aging citizens in a Dutch health institution in the Netherlands. Method: A purposive sample of 10 immigrants and 10 established nurses was recruited. Ethnography was used to guide this study. 105 hours of participant observation, 8 semistructured interviews with 4 immigrants and 4 established nurses, and 2 focus-group discussions with 8 immigrants and 6 established nurses. Results: The study identified various processes that affect culturally congruent care in the nursing home, like the imposing professional norms, the use of "weapons of the weak," mutual suspicions of indifference, and collective images of "us" versus "them." Both groups conceived the "others" as the source of their discomfort, however, both had pain of not mattering. Discussion: When recruiting international educated nurses "all nursing staff" face difficulties when going through the precarious process of mutual integration in daily care practices. We recommend that nurse leaders facilitate positive intergroup interactions that promotes reciprocity for all groups of nurses for better health care outcomes for all.