Learning Objective #1: Utilize at least 80% of Cultural Care Theory in the orientation and training of newly-hired international nursing graduates (INGs)

Learning Objective #2: Address cultural competency into new Registered Nurses orientation manuals, integrate components of cultural care theory to newly hired international nursing graduates and evaluate outcomes as to 100% cultural care congruency in patient care

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The nursing shortage has prompted some US hospitals to hire international nursing graduates (INGs) as an employment strategy. Hiring INGs can potentially meet the diverse needs of the heterogeneously ethnic patient population. However, ING practice may not be congruent with US nursing practice. Currently, although hospitals train and orient new Registered Nurses (RNs), there are few studies that evaluate the procedures and contents of hospital orientation manuals, specifically those focused on cultural competency. The project synthesized evidence-based problems and evaluated hospital orientation programs based on cultural competency. To determine whether cultural competency were incorporated in nursing orientation, strategies and components of nursing orientation programs were evaluated based on Leininger's theory. Leininger's Theory of Cultural Care links culture and care to develop competent, knowledgeable nurses, who will care for patients from similar or different cultural backgrounds, thereby achieving a culturally congruent care (CCC). Orientation manuals and new hire policies and procedures from 15 California hospitals were collected. The contents were tabulated using a checklist of evidence-based strategies. An over-all percentage of yes/no answers represented different cultural components. The results showed that one third of hospitals evaluated have cultural competency incorporated in their orientation processes. Most are focused on technology and legal matters rather than on religion, philosophy, kinship and social relations, values and lifeways, politics, economy, and education. When hired in a new country, INGs bring their own set of cultural beliefs and values related to health care and that, in turn, may result to problems in care giving as a RN. To achieve a smooth transition into employment, orientation programs that incorporate cultural care would likely increase quality of care. By providing CCC, INGs would enhance health care delivery to meet diverse patient needs in ethnically heterogeneous regions.