The First Winter. Its an interesting time for us expats and I know I was ill-prepared for it when I first arrived in the UK in the early December of 2018 having come from a hot, humid Australian summer. We flew into Heathrow and went straight to London to then catch a train to our destination, unfortunately it was late, a crisp low of 4 degrees, and the train we needed was cancelled. We really weren’t dressed for the occasion and with no luck finding a hotel nearby we made the bold decision to pay £300 for a London Cab to take us on the long journey. Skip to the Christmas season and a little outing to a village outdoor event and I soon regretted my decision to wear ballet flats as the temperatures plummeted leading to me having to put my gloves on my toes until I could get my socks from the house.

The lack of experience living in a cold climate has caught us out a few times in the past 4 years and we have needed help with issues like working the radiator and boiler, deciding travelling routes when it is icy or snowing, and finding clever ways to walk without falling on the ice. We were blessed to have family here to ask advice from, however not everyone that moves here has someone to lean on, so it is important for us to be kind and show compassion and support to those Internationally Educated Nurses (IEN) that may be joining your Trust or hospital service.

This also applies to those who are weathering their first winter anywhere in the world where cold weather might not be their home country norm. The support you provide will differ dependent on the country you are in of course.

Donate

Donating what you have capacity to donate is a commendable act, and accepting offers of support/donations if you are an IEN helps others to feel useful and is designed to help you in those challenging early times. Donations that are helpful for new IENs entering their first winter are coats, warm clothes (including beanies, scarves, gloves, new thick socks) and warm bedding. Donations can be new but can also be used but in great condition, including items for different sizes and gender.

Check-In

Winter can be a really lonely time for so many people and our IENs are no exception. Winter is that time where everyone stays indoors more reducing the opportunity for socialising, along with the plans everyone has already made with their families for the holidays. This is a great time to check-in with your international colleagues to see that they are coping okay with the transition, ask if they have everything they need, explore what challenges they may be facing, and be that kind and compassionate voice to them. This is not to say that you are responsible for solving everyones problems, but you may be in a position to signpost them to support for the simple things like signing up for a GP in case they get sick, where and how to access emergency medical help, how the pharmacy system works, and where local and late night pharmacies are located.

Mental health can suffer during the winter season and can be impacted during that time of transition to a new country, new work environment, and new communities. It is helpful to lend people a listening ear and share where and how mental health support can be accessed both publicly in emergencies and via the wellbeing support system in the organisation they work in.

Educate

There are so many unknown variables for people newly arrived in this country, and unfortunately many assumptions are made about what we expats do or should know. I had never before considered that there would be knowledge gaps in day to day life when moving abroad, that is until we came here. Some of the many things I needed to learn included:

1. How to use and adjust a radiator (we didn’t know we had to “bleed” a radiator that wasn’t heating well.

2. How to prevent or treat mould and damp and the impact heating had on this.

3. What my rights as a tennant are in reality – can you put pictures up, what repairs are you liable for, what is the landlord responsible for.

4. When, how and to who should you escalate and report issues to – housing/heating, crime, safety, workplace, schooling.

5. What unexpected or unknown costs are going to be your repsonsibility – council tax, TV license, energy costs.

Engage

Connection is at the heart of every home, workplace and community in one way or another, and the loss of this in a physical sense can be difficult to overcome. Growing up to build a life and family in Australia was delightfully seasoned with strong networks of friends and family who spent holidays, weekends and afternoons together. Friendships were mostly made and maintained with ease there, but we found it difficult to create the same here in England for whatever reason.

Helping others to build connection and social support structures for long term happiness and belonging, can mean the difference of someone staying and thriving instead of questioning their decision to come.

1. Consider if there are any social, cultural or spiritual networks they can tap into.

2. Offer to have lunch at work together – breaks can be the loneliest time for people new to the organisation.

3. If you feel moved to open your home to a colleague at special times of the year, or any time.

4. Get to know them personally – their likes, dislikes, hobbies, challenges, and aspirations.

5. Include them in your chit-chat and small talk the same way you would someone you know well.

Quality connection can only happen when we are transparent and behave with integrity, so also consider how your own way of communicating and engaging might impact others. If someone were to look in and observe you in public and in secret, are you being kind, compassionate, welcoming, respectful, inclusive?

Nursing

Nursing across the world embraces the same central theme:

“And what nursing has to do in either case, is to put the patient in the best condition for nature to act upon him.”

Florence Nightingale

I can only imagine that Florence had conerned herself with the best interests of the patient, and the provision of good and appropriate nursing care that upheld this person-centredness. Whilst we hold this central focus collectively as a profession, every country will have its differences in some aspects. Keeping in mind the varied roles nursing hold across the world, it is important to both understand that we each travel through our careers with unique sets of skills that differ from each other, and that for this reason we must never assume the knowledge or understanding of others.

Supporting our IENs in a positive way is essential to being inclusive and building a strong team. There are a few things you can commit to doing to demonstrate your professional and compassionate approach to supporting colleagues:

1. Never assume knowledge or skill: ask and explore because what is normal in one location or setting may not be in another.

2. Be generous with your assumptions: assume that people are doing their best and want to be successful.

3. Share your valuable knowledge, skills and expertise in an inclusive and respectful way.

4. Support them to learn the local cultures, communication styles, and historical factors that may impact care.

5. Teach them the skills, systems, and processes that they may not have strengths in.

6. Celebrate their successes and build on their strengths: many IENs arrive with years of expereince in areas you may not know.

7. Be approachable and offer help: remember we are all one team working towards the same goal.

8. Be brave – if you see your new colleagues being treated disrespectfully or unfairly it is your responsiblity not to be a bystander but rather be an upstander that speaks up.

I sincerely hope that his has given you good insight to the challenges that IENs face along with ways to be the supportive person our colleagues need to succeed and feel welcome. Our colleagues from abroad bring such a wealth of knowledge that can support our patients, and they are an essential and valued addition to our workplaces and communities.

Do you have an idea on how to support IENs both in day to day life and in practice?