— Photo supplied by Dr. Monique Sedgwick
Community and workplace support play a critical role in the success of Internationally Educated Nurses (IENs) working in rural Alberta, according to a research project funded in part by the Rural Health Professions Action Plan (RhPAP).
The study, Internationally Educated Nurses’ Experience of Rural Alberta Nursing Practice: A Mixed Methods Study, examined the experiences of registered nurses (RNs) who recently relocated to rural Alberta through an initiative sponsored by Alberta Health Services (AHS).
The researchers found that IENs are most successful when they receive what they describe as “wrap-around support” — a mix of professional, organizational, and community-based assistance tailored to individual needs.
“It’s support that is holistic, it’s individualized to that person’s needs, and it brings together a variety of resources from community, the professional bodies, the employers, and all of those people that they work with,” explains Dr. Monique Sedgwick, a registered nurse and professor with the Faculty of Health Sciences at the University of Lethbridge (U of L).
Beyond formal workplace support, informal community connections are just as important. These supports often came from community members, other immigrant families or employees, faith leaders, childcare providers, local businesses, and others.
Dr. Sedgwick conducted the study between 2023 and 2025 alongside colleague Dr. Helen Kelley, associate dean emeritus and associate professor emeritus from the U of L’s Dhillon School of Business.
In the second phase of the study, 127 rural registered nurses completed an online survey. Many participants showed strong determination to succeed, even when faced with an expanded scope of practice not available in their home countries.
“They did a lot of independent self-learning in their own time as they strive to provide high quality nursing practice care to patients,” says Dr. Kelley.
That level of commitment was expected under the circumstances.
“That makes sense, because would you come from halfway around the world to sort of go, ‘If it works, it works. If it doesn’t, it doesn’t?’ You know you’re probably going to be committed and do everything within your power to make sure that it works for you and your family,” adds Dr. Sedgwick.
“Overall, the participants spoke very positively about their experience. They love the wide-open spaces; they love the geography. One participant described how when she had just arrived in the community, she opened her door one day, and there’s a box, a care package for her and her family. She doesn’t know who it’s from, but it’s things that they need.”
Most participants reported feeling welcomed, but some identified challenges beyond their professional roles, including spouses being unable to find work, limited childcare options, difficulty securing appropriate housing, and the emotional strain of being away from family overseas.
Some nurses were unaware of the cost of living in rural Alberta. Others cited the lack of amenities such as public transportation or nearby international airports as barriers.
Many of these issues could likely be addressed through improved employer communication and stronger community connections prior to IENs arriving in rural communities, so they were better versed in rural living, they noted.
The researchers hope the findings of the study will be valuable to stakeholders such as AHS and Covenant Health, both major employers of IENs.
The results have been published, featured in a webinar, and shared with the Alberta Association of Nurses, AHS, and other stakeholders. They hope that AHS and Covenant Health leadership, and the College of Registered Nurses of Alberta, the regulatory body, can use these findings to help them develop a standardized assessment for IENs.
“Maybe IENs can be evaluated when they first start, at six months and at 12 months post hiring to make sure that they’re developing the knowledge, the skills, the confidence that’s required to work in rural and to address any learning gaps that they may have,” says Dr. Sedgwick.
“It’s really hard to know what you need to learn if you don’t know those things right off the bat.”
They also expect rural communities — many of which have worked closely with RhPAP on healthcare attraction and retention initiatives — will find the research useful for recruitment, training, and long-term retention.