Navigating Cultural Differences: Enhancing Orientation for Diverse Nursing Workforces in Finland : a scoping review
LI, YIJIAN (2025)
Tiivistelmä
Finland’s increasing reliance on culturally and linguistically diverse (CALD) nurses amidst workforce shortages necessitates enhanced orientation practices. This scoping review aimed to explore how culturally competent approaches to orientation could better help the integration of CALD nurses into the Finnish health system.
Adhering to PRISMA-ScR guidelines, a literature search (January 2015–May 2025) across six major databases (CINAHL, PubMed, ProQuest, Google Scholar, MEDIC) and manual screening initially yielded 26 eligible studies. A subsequent relevance scoring process (0-10 scale, where a score >6 indicated high direct relevance based on criteria including directness to topic, population focus, Finnish contextual relevance, and methodological characteristics) identified 16 core studies for thematic analysis.
Thematic analysis of these 16 studies revealed persistent barriers to CALD nurse integration, including linguistic difficulties, cultural misunderstandings, and experiences of discrimination. Essential components identified for effective orientation models include: tailored and staged onboarding, comprehensive cultural competence training for all staff, integrated professional language support, and robust, culturally informed mentorship. The critical roles of inclusive leadership and supportive organizational cultures were consistently emphasized. However, systemic deficiencies such as a lack of standardized national frameworks, insufficient integration of cultural competence into current programs, unprepared mentors and leaders, and absent evaluation mechanisms were prominent findings.
This review concludes that current orientation practices in Finland are often fragmented and inadequately responsive to the needs of CALD nurses. A national shift towards developing and implementing standardized, flexible, and culturally responsive orientation models is vital. This requires a system-wide approach, reconceptualizing orientation as a sustained integration strategy to support CALD nurse retention, ensure quality patient care, and bolster the sustainability of Finland's healthcare workforce.
Adhering to PRISMA-ScR guidelines, a literature search (January 2015–May 2025) across six major databases (CINAHL, PubMed, ProQuest, Google Scholar, MEDIC) and manual screening initially yielded 26 eligible studies. A subsequent relevance scoring process (0-10 scale, where a score >6 indicated high direct relevance based on criteria including directness to topic, population focus, Finnish contextual relevance, and methodological characteristics) identified 16 core studies for thematic analysis.
Thematic analysis of these 16 studies revealed persistent barriers to CALD nurse integration, including linguistic difficulties, cultural misunderstandings, and experiences of discrimination. Essential components identified for effective orientation models include: tailored and staged onboarding, comprehensive cultural competence training for all staff, integrated professional language support, and robust, culturally informed mentorship. The critical roles of inclusive leadership and supportive organizational cultures were consistently emphasized. However, systemic deficiencies such as a lack of standardized national frameworks, insufficient integration of cultural competence into current programs, unprepared mentors and leaders, and absent evaluation mechanisms were prominent findings.
This review concludes that current orientation practices in Finland are often fragmented and inadequately responsive to the needs of CALD nurses. A national shift towards developing and implementing standardized, flexible, and culturally responsive orientation models is vital. This requires a system-wide approach, reconceptualizing orientation as a sustained integration strategy to support CALD nurse retention, ensure quality patient care, and bolster the sustainability of Finland's healthcare workforce.