Communication & Medicine, Vol 13, No 3 (2016)

‘Are we on the same wavelength?’ International nurses and the process of confronting and adjusting to clinical communication in Australia

Tonia Crawford, Peter Roger, Sally Candlin
Issued Date: 16 Jun 2017


Effective communication skills are important in the health care setting in order to develop rapport and trust with patients, provide reassurance, assess patients effectively and provide education in a way that patients easily understand (Candlin and Candlin, 2003). However with many nurses from culturally and linguistically diverse (CALD) backgrounds being recruited to fill the workforce shortfall in Australia, communication across cultures with the potential for miscommunication and ensuing risks to patient safety has gained increasing focus in recent years (Shakya and Horsefall, 2000; Chiang and Crickmore, 2009). This paper reports on the first phase of a study that examines intercultural nurse patient communication from the perspective of four Registered Nurses from CALD backgrounds working in Australia. Five interrelating themes that were derived from thematic analysis of semi-structured interviews are discussed. The central theme of ‘adjustment’ was identified as fundamental to the experiences of the RNs and this theme interrelated with each of the other themes that emerged: professional experiences with communication, ways of showing respect, displaying empathy, and vulnerability.

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DOI: 10.1558/cam.28953


Australian Bureau of Statistics (2013) Doctors and nurses. 4102.0 - Australian Social Trends (April). Retrieved from

Australian Health Practitioner Regulation Agency (2015) Registration process. Retrieved from

Burns, R. B. (2000) Introduction to Research Methods. Fourth edition. Frenchs Forest, NSW: Longman/Pearson Education.

Candlin, C. N. and Candlin, S. (2003) Health care communication: A problematic site for applied linguistics research. Annual Review of Applied Linguistics 23: 134–154.

Candlin, S. (2002) Making meaning out of experience: The nursing perspective. Paper presented at the BAAL conference: Colloquium on health communication.

Chiang, V. and Crickmore, B. L. (2009) Improving English proficiency of post-graduate international nursing students seeking further qualifications and continuing education in foreign countries. Journal of Continuing Education in Nursing 40 (7): 329–336.

Cordella, M. and Musgrave, S. (2009) Oral communication skills of international medical graduates: Assessing empathy in discourse. Communication and Medicine 6 (2): 129–142.

Couser, G. (2007) Twelve tips for developing training programs for international medical graduates. Medical Teacher 29 (5): 427–430.

Deegan, J. and Simkin, K. (2010) Expert to novice: Experiences of professional adaptation reported by non-English speaking nurses in Australia. Australian Journal of Advanced Nursing 27 (3): 31–37.

Dörnyei, Z. (2007) Research Methods in Applied Linguistics. Oxford: Oxford University Press.

Gibbs, G. (2007) Analyzing Qualitative Data. London: Sage.

Grant, J. and Luxford, Y. (2011) ‘Culture is a big term isn’t it?’: An analysis of child and family health nurses’ understanding of culture and intercultural understanding. Health Sociology Review 20 (1): 16–27.

Hamilton, J. and Woodward-Kron, R. (2010) Developing cultural awareness and intercultural communication through multimedia: A case study from medicine and the health sciences. System 38 (4): 560–568.

Hearnden, M. (2008) Coping with differences in culture and communication in health care. Nursing Standard 23 (11): 49–58.

Hoekje, B. J. (2007) Medical discourse and ESP courses for international medical graduates (IMGS). English for Specific Purposes 26 (3): 327–343.

Howard, T. C. (2003) Culturally relevant pedagogy: Ingredients for critical teacher reflection. Theory into Practice 42 (3): 195–202.

Kingma, M. (2008) Nurses on the move: Diversity and the work environment. Contemporary Nurse: A Journal for the Australian Nursing Profession 28 (1–2): 198–206.

Major, G. and Holmes, J. (2008) How do nurses describe health care procedures?: Analysing nurse-patient interaction in a hospital ward. Australian Journal of Advanced Nursing 25 (4): 58–70.

O’Grady, C. (2011) Teaching the communication of empathy in patient-centred medicine. In B. H. S. Tipton (ed.) English Language and the Medical Profession: Instructing and Assessing the Communication Skills of International Physicians. Bingley, UK: Emerald.

O’Neill, F. (2011) From language classroom to clinical context: The role of language and culture in communication for nurses using English as a second language. International Journal of Nursing Studies 48 (9): 1120–1128.

Omeri, A. and Atkins, K. (2002) Lived experience of immigrant nurses in New South Wales, Australia: Searching for meaning. International Journal of Nursing Studies 39 (5): 495–505.

Popay, J., Rogers, A. and Williams, G. (1998) Rationale and standards for the systematic review of qualitative literature in health services research. Qualitative Health Research 8 (3): 341–351.

Roberts, C., Moss, B., Wass, V., Sarangi, S. and Jones, R. (2005) Misunderstanding: A qualitative study of primary care consultations in multilingual settings, and educational implications. Medical Education 39 (5): 465–475.

Roper, J. M. and Shapira, J. (2000) Ethnography in Nursing Research. Thousand Oaks, CA: Sage.

Sarangi, S. (2017) Mind the gap: ‘Communicative vulnerability’ and the mediation of linguistic/cultural diversity in healthcare settings. In H. Coleman (ed.) Multilingualisms and Development, 239–258. London: British Council.

Shakya, A. and Horsefall, J. M. (2000) ESL undergraduate nursing students in Australia: Some experiences. Nursing and Health Sciences 2 (3): 163–171.

Shen, J. J., Xu, Y., Bolstad, A. L., Covelli, M., Torpey, M. and Colosimo, R. (2012) Effects of a short-term linguistic class on communication competence of international nurses: Implications for practice, policy, and research. Nursing Economic$ 30 (1): 21–28.

Strauss, A. L. and Corbin, J. (1998). Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Second edition.Thousand Oaks, CA: Sage.

Turner, D. S. and Beddoes, L. (2007) Using reflective models to enhance learning: Experiences of staff and students. Nurse Education in Practice 7 (3): 135–140.

Ulrey, K. L. and Amason, P. (2001) Intercultural Communication between patients and health care providers: An exploration of intercultural communication effectiveness, cultural sensitivity, stress, and anxiety. Health Communication 13 (4): 449–463.

Walters, H. (2008) The experiences, challenges and rewards of nurses from South Asia in the process of entering the Australian nursing system. Australian Journal of Advanced Nursing 25 (3): 95–105.

Xu, Y., Shen, J., Bolstad, A. L., Covelli, M. and Torpey, M. (2010) Evaluation of an intervention on socio-cultural communication skills of international nurses. Nursing Economic$ 28 (6): 386–392, 408.


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