Dr. Enweana spearheaded a program for Internationally Educated Nurses (IENs) designed to transition them to U.S. nursing practice in a healthcare system (region of 12 hospitals). In the development of the IEN Transition to Practice Program (IEN-TTP), Dr. Enweana observed six key strategies: (1) Diverse and Inclusive Selection: selecting IENs from different backgrounds and continents worldwide. (2) Equitable pre-deployment assessment and training: evaluating the IEN's skills, knowledge, and competencies in a way that considers their unique backgrounds to bridge the gap between the IEN’s previous experiences and the requirements of the new healthcare environment. (3) Belonging-based deployment process: integrate IENs into their new work environments by establishing support networks that connect onboarding IENs with experienced IEN colleagues and local staff for mentorship and support. (4) Impact-based recognition: acknowledging the specific, measurable contributions nurses make to patient care, teams, and the organization; focusing on the tangible effects and outcomes of a nurse's work in addition to tenure. (5) Fair Compensation: ensuring pay and benefits for IENs are comparable to local counterparts and addressing potential disparities due to nationality, immigration status, or other factors. (6) Access to growth opportunities: equal access to education, professional development, and career advancement. The first batch of nurses who underwent this IEN-TTP were hired in 2018. Between 2018 and 2023, 103 IENs were employed. All of them went through three phases of IEN-TTP. Phase I, pre-deployment, involved preliminary skills assessment (SA), comprehensive SA, Virtual Simulation (VS), and Educational Module (EM) 1. The EINs were asked to evaluate the VS sessions, assessing whether it helped prepare them for US nursing practice. Phase II, deployment, involved EM 2, transition to the department, department orientation and onboarding, and professional development coaching. Phase III, assimilation, involves IEN checkpoints and rounding in their assigned units. Initially, the organization worked with an international hiring agency that recommended that IENs complete a 5000-hour contract. However, since 2023, the organization has foregone IHA and hired IENs directly. The majority of the IENs were from the Philippines (64%), Korea (9%), and Nigeria (9%). The typical specialties the IENs were assigned were medical-surgical (54%) and emergency (15%) nursing. Of the 80 IENs who completed the survey after the VS sessions, 96% agreed/strongly agreed that the VS helped them prepare for their career in the US. Between 2018-2022, 53 of the 60 IENs who completed the contract stayed within the organization. Between 2018-2024, 23 of 103 IENs left the organization, reflecting 22% loss and 88% retention rate. The leading reason IENs leave the organization is family/personal matters. Other reasons include travel nursing, homesickness, and immigration issues. Several retained IENs have transitioned to charge, clinical supervisor, and managerial roles (n=6), advanced in the Clinical Nurse Credentialing Program (n=6), and obtained DAISY Awards (n=6). Dr. Enweana continues supporting the growth and success of IENs in the organization, where they are able to excel in their roles, consequently encouraging RN retention, promoting a stable and empowered diverse workforce. Dr. Enweana urges healthcare leaders to develop structures for IENs to feel they belong.

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This specific situation describes the dedication that Dr. Enweana has to the international nurses that she recruits. One of the most remarkable examples of Dr. Enweana’s exceptional dedication to international nurses occurred when she went above and beyond to support a newly arrived international nurse living in a rural area outside of Charlotte. This nurse was enrolled in Dr. Enweana’s BLS skills check-off session, a key component of the transition program she developed for international nurses. On the day of the session, the nurse encountered unexpected transportation difficulties. Unable to find Uber or taxi services to get her to Charlotte in time, she faced the prospect of missing the session altogether, a setback that could delay her transition to clinical work. Upon learning of the nurse’s predicament, Dr. Enweana immediately assessed the situation and realized it would take nearly two hours for her to reach the nurse’s location. Without hesitation, she coordinated with the other nurses attending the session and adjusted the schedule to accommodate the delay caused by her journey. Dr. Enweana then drove to the nurse’s location, taking time out of her already demanding schedule to ensure the nurse could attend the BLS session. During the drive, the nurse, clearly anxious about adjusting to life in the U.S., shared her struggles. In this moment, Dr. Enweana demonstrated her innate compassion and mentorship, offering words of encouragement and affirming the nurse's potential. By the time they arrived at the BLS session, the nurse felt a renewed sense of confidence and connected with other international nurses, forging relationships that helped her feel more integrated into her new environment. After the session, Dr. Enweana didn’t simply drop the nurse off and leave. She ensured the nurse was safely taken care of by stopping at a grocery store to help purchase essential items for her family. Dr. Enweana also offered financial assistance to ensure the nurse had everything she needed. The nurse, deeply touched by this act of kindness, expressed her gratitude for Dr. Enweana's support, “not only in navigating the logistical challenges of her first days in the U.S. but also in providing both emotional and financial assistance during such a difficult transition.” This story is just one example of Dr. Enweana’s commitment to international nurses. Her work has led to improved retention and satisfaction rates among international nursing staff, particularly through the transition-to-practice program she developed. This program, which addresses not only clinical skills but also cultural, legal, and ethical aspects of U.S. nursing practice, has empowered international nurses to succeed in their roles.