# Ethical and equity challenges in employment: Perspectives of international nursing graduates

## TL;DR

International nursing graduates in Australia face employment barriers due to policies favoring domestic graduates, raising ethical and equity concerns.

## Contribution

The study provides new insights into the systemic and ethical challenges faced by international nursing graduates in Australia’s healthcare workforce.

## Key findings

- Five key themes emerged, including economic disparity, systemic discrimination, and lack of cultural inclusion.
- Policy and regulatory barriers significantly hinder the employment prospects of international nursing graduates.
- Mental health and well-being are negatively impacted by employment inequities and exclusionary practices.

## Abstract

Australia faces a critical shortage of nurses, yet international nursing graduates (INGs) encounter significant barriers to securing employment after graduation. Current policies often prioritize domestic graduates, creating systemic disadvantages for INGs, particularly those on temporary visas. This inequity raises ethical concerns and undermines Australia’s ability to fully utilize its nursing workforce, potentially compromising the quality of healthcare services.

This study explores the lived experiences of INGs regarding employment challenges in Australia, critically examining the ethical and equity implications of existing practices.

A qualitative study employing a combined phenomenological and exploratory approach was conducted. Data were analyzed using a thematic analysis framework.

Twelve international nursing students in their final semester of the Bachelor of Nursing program at two metropolitan universities in Australia participated in semi-structured interviews.

Ethical approval was obtained from the Monash University Human Research Ethics Committee (MUHREC-44400) and the University of Technology Sydney (ETH24-10028). Informed consent was obtained from all participants, who were assured of their right to confidentiality and to withdraw from the study at any time.

Five overarching themes emerged: (1) Economic Disparity and Ethical Considerations, (2) Systemic Discrimination and Inequality, (3) Mental Health and Well-being, (4) Policy and Regulatory Barriers, and (5) Lack of Cultural Inclusion and a Sense of (Un)Belongingness.

The findings highlight urgent ethical concerns and equity challenges that demand comprehensive reforms to create a more inclusive and ethically sound environment for INGs in Australia. These reforms necessitate policy changes to address discriminatory practices and visa restrictions, enhanced institutional support to facilitate INGs’ transition into the workforce, and a commitment to cultural competence and inclusion at all levels of the healthcare system. Addressing these systemic barriers is not only a matter of fairness and justice but is also crucial for ensuring a robust and ethically sustainable healthcare workforce in Australia.