Transnational nurse migration has evoked a growing interest in the phenomenon of professional integration of expatriate nurses into their host societies. Despite research connecting employee and organizational outcomes such as job satisfaction and organizational citizenship behavior to the quality of leadership styles, there remains a lack of research linking professional integration of expatriate nurses to nurse leadership styles in the United Arab Emirates (UAE). The purpose of this grounded theory study was to develop a theory that would explain how nurse leadership styles and behaviors impacted the professional integration of expatriate nurses into the multicultural work environment of the UAE. The research questions addressed the perceptions of the expatriate nurses on effective leadership styles and behaviors of nurse leaders in a culturally diverse work environment, the lived experiences of the expatriate nurses, and the impact of the organizational culture on the process of integration. Data were collected through in-depth semi-structured interviews with 10 expatriate nurses, demographic surveys, documents review, and researcher memos. Data were analyzed using the constant comparative method and initial, focused, axial, and theoretical coding. Results indicated that nurse leadership styles and the conditions surrounding the integration process influenced the success of the expatriate nurses' adaptation, integration, and assimilation into the host society. Implications for social change include the preparation of nurses while in their home country on what to expect in the host country, and development of leadership training programs to prepare nurse leaders for leading in a culturally diverse work environment.

This study addressed three research objectives related to non-Muslim nurses’ experiences providing health care to Muslim patients in Saudi Arabian hospitals. These objectives included: first, understanding what it is like to care for Muslim patients considering both religion and culture; secondly, exploring what it is like being cared for by non-Muslim nurses. In order to address these objectives, the study has employed a qualitative approach, represented in hermeneutic phenomenology. The target groups in this study were Muslim patients and non-Muslim nurses who were interviewed using interviews and focus group discussions. The study found that religious, cultural and linguistic factors have a negative effect on non-Muslim nurses’ experience of care in Saudi Arabia, which included a personal impact, and a practical impact resulting from working practices. However, the results indicated that nurses had some problems with family members who interfered in decisions related to patients, and that they also encountered disrespect from patients’ relatives and friends. The study results indicated that non-Muslim nurses, to some extent, have an understanding of the different aspects and practices of Islam, such as praying, fasting and spirituality. The study results also revealed a significant relationship between spirituality (Islamic faith) and the provision of health care. Nurses believe that religious and spiritual practices have an effect on care. However, they failed to understand the importance of religion and spirituality to Muslims in general and patients in particular. The lack of training and orientation concerning specific issues of religion and culture negatively affected not only the communication between nurses and patients, but also the provision of health care. It was envisaged that this study would have a positive impact on the delivery of nursing training and education, because it highlights the need to tailor this to specific contexts. The study distinguishes itself from other studies conducted in the same field by investigating non-Muslim nurses’ and Muslim patients’ confusion between religion and culture. The study stressed an overlap between religion and culture in Saudi society, which consequently affected nurses’ provision of health care. It was essential in this study to investigate the differences between religion and culture, to see of non-Muslim nurses would understand religion and culture are not the same; while in some cases they complement one another, in other cases they contradict. Furthermore, the study addressed the issue of professionalism when caring for Muslim patients’ and non-Muslim nurses’ point of view. Although nurses claimed to provide healthcare in professional way, they were not fully aware of Saudi local culture or the impact of religion on patient’s daily life It can be concluded, in general, that non-Muslim nurses are facing challenges to providing healthcare to Saudi Muslim patients, due to a lack of understanding of the importance of cultural values and religious practices, and the lack of training and alignment on such issues.

Nursing Muslim patients in the Kingdom of Saudi Arabia (KSA) poses challenges for expatriate non-Muslim nurses. Caring for Muslim patients in a cardiac intensive care unit, catering for patients who underwent open heart surgery, poses unique challenges to non-Muslim nurses. Semi-structured interviews were conducted with 63 non-Muslim nurses who cared for Muslim patients who had undergone cardiac surgery. Factors that influenced non Muslim nurses’ experiences of working with Muslim patients in the KSA, included culture shock, language barriers and a lack of understanding of Islam as a religion. In-service education sessions, addressing these issues, could enhance non-Muslim nurses' abilities to render culture competent care to Muslim patients in a cardiac intensive care unit in the KSA. Arabic-English translators could facilitate communication between the expatriate nurses and the Muslim patients. / Health Studies / M.A. (Health Studies)

Nursing Muslim patients in the Kingdom of Saudi Arabia (KSA) poses challenges for expatriate non-Muslim nurses. Caring for Muslim patients in a cardiac intensive care unit, catering for patients who underwent open heart surgery, poses unique challenges to non-Muslim nurses. Semi-structured interviews were conducted with 63 non-Muslim nurses who cared for Muslim patients who had undergone cardiac surgery. Factors that influenced non Muslim nurses’ experiences of working with Muslim patients in the KSA, included culture shock, language barriers and a lack of understanding of Islam as a religion. In-service education sessions, addressing these issues, could enhance non-Muslim nurses' abilities to render culture competent care to Muslim patients in a cardiac intensive care unit in the KSA. Arabic-English translators could facilitate communication between the expatriate nurses and the Muslim patients. / Health Studies / M.A. (Health Studies)