Elena Neiterman

Embodied Motherhood Women’s Feelings about Their Postpartum Bodies

Based on in-depth interviews, this article examines a sample of 48 Canadian women’s feelings about their changed postpartum bodies, their sense of self, and the factors that affect both. Our findings suggest that understanding women’s postpartum feelings requires contextualizing them in the work of infant care and women’s life circumstances, as well as ideologies about mothering and feminine appearance. Motherhood afforded the women in this study a new appreciation of their bodies, and a positive embodied sense of themselves, but only if they felt their bodies performed maternal functions well. Concerns about appearance persisted and became especially salient when women faced the return to paid work. Moreover, varied life circumstances influenced women’s overall feelings about their changed bodies as insecurities were displaced onto women’s body images.

What Do We Know and Not Know about the Professional Integration of International Medical Graduates (IMGs) in Canada

Background: The literature on international medical graduates (IMGs) in Canada is growing, but there is a lack of systematic analysis of the literature. Objectives: To examine (1) the major themes in academic and grey literature pertaining to professional integration of IMGs in Canada; and (2) the gaps in our knowledge on integration of IMGs. Methods: This paper is based on the scoping review of academic and grey literature published during 2001–2013 about IMGs in Canada. Results: The literature on IMGs focuses on (1) pre-immigration activities; (2) early-arrival activities; (3) credential recognition/professional recertification; (4) bridging and residency training; (5) workplace integration; and (6) alternative paths to integration. The gaps in the literature include pre-immigration and early-arrival activities, and alternative paths for integration for those IMGs who do not pursue medical license. Conclusion: Pre-immigration and early-arrival activities and alternative career paths for IMGs should be addressed in academic and policy research.

The shield of professional status: Comparing internationally educated nurses' and international medical graduates' experiences of discrimination.

This article examines the intersecting roles of gender, ethnicity, and professional status in shaping the experiences of internationally educated health professionals in Canada. The article is based on 140 semi-structured qualitative interviews with internationally trained nurses and physicians who came to Canada within past 10 years with the intention to practice their profession. Describing the challenging process of professional integration in Canada, our participants highlighted incidents of discrimination they experienced along the way. Although some of the participants from both professional groups experienced racial discrimination, the context of those experiences differed. Physicians rarely reported instances of discrimination in communication with patients or nurses. Instead, they were concerned with instances of discrimination within their own professional group. Nurses, on the other hand, reported discrimination at the hands of patients and their families as well as racialization by physicians, management, and other nurses. We conclude our article with a reflection on the role that gender and professional status play in shaping the experiences of ethnic discrimination of internationally educated health professionals.

Cultural competence of internationally educated nurses: assessing problems and finding solutions.

Competency to practise nursing is typically assessed by professional regulators who examine educational standards, credentials, and experience. But bureaucratic fit based on verification of documents and determination of clinical competence does not always coincide with cultural fit and ability to fulfil the role of health professional according to a countrys standards. The authors examine the challenges that lack of cultural fit can pose to the integration of internationally educated nurses (IENs) transitioning to a new health-care system. Semi-structured interviews with 71 IENs and 70 key stakeholders in Canada revealed that the cultural fitness of immigrant nurses presents a unique set of challenges for regulatory bodies, immigrant nurses, and employers. Bridging programs for IENs to upgrade their skills were found to be a means of preparing IENs to practise in the Canadian cultural context.

Converting to belong: immigration, education and nationalisation among young ‘Russian’ immigrant women

The paper examines religious conversion to Judaism among young ‘Russian’ immigrant girls in Israel. Looking into the process of conversion in religious boarding schools for girls only (Ulpana) and in the broader context of the Israeli nation‐state, we examine the strategies the educators contrive in inculcating religiosity among the girls, how they legitimise and facilitate their self‐transformation, and mobilise them to desire a religious subjectivity. At the same time, we study the experiences of the Russian girls in the Ulpana, and the meanings they assign to their conversion as depicted in the personal stories they narrated to us. The paper reveals how the Ulpana operates as a major nationalisation agent that cultivates a path for the girls to belong to the national religious camp, thus assuring their affiliation to Israeli‐Jewish society at large.

Scoping review about the professional integration of internationally educated health professionals

BackgroundOver the last decade, Canada has been one of the top destination countries for internationally educated health professionals (IEHPs). After arrival, many struggle to professionally recertify and secure employment in their field. Considerable funding has been allocated to the development of new policies and programs to facilitate IEHPs’ professional integration. Literature about the professional integration process and the available policies and programs is abundant, not synthesized and dispersed among a wide range of health professions and the academic and grey literature. This, in combination with the sustained policy relevance, contributed to the timeliness and necessity for conducting this scoping review.MethodsWe used an updated version of Arskey and O’Malley’s six-stage scoping review framework to summarize the amount, types, sources and distribution of the literature. Findings were summarized numerically and thematically. The themes included pre-immigration activities and programs, early arrival activities and programs, professional recertification and workplace integration.ResultsFour hundred and seven published sources from 2000–2012 were retained for data charting and extraction. Most focused on international medical graduates or internationally educated nurses. IEHPs from the allied health professions were underrepresented. Methodologically, about one quarter of the papers are empirical studies with the next largest category being reports from professional certification bodies and educational institutions. The overarching concern is with workplace integration, professional recognition and bridging programs. Nursing dominates the literature about pre-immigration activities and programs whereas the literature about early arrival activities and programs, professional recertification and workplace integration is dominated by medicine. Although the literature does contain some information for IEHPs in the allied health professions, the thematic analysis did not identify a clear trend. A notable increase in the number of publications was present.ConclusionsThe literature about IEHPs’ professional integration in Canada is abundant. This reflects the sustained policy relevance of the recruitment, recognition and professional integration for IEHPs in Canada. This demonstrates that Canada provides an excellent case for this review from which the findings may have international significance. Nevertheless, little information is available about the effectiveness of the policies and programs available to facilitate IEHP integration, an area that requires further consideration.

Experiences of Older Adults in Transition from Hospital to Community

Cette étude a examiné comment les patients éprouvent des transitions à la communauté des hôpitaux, y compris les problèmes de la vie quotidienne et les préoccupations médicales. Grâce à l’analyse de données qualitatives à partir d’entretiens avec 36 personnes, y compris 17 adultes âgées à haut risque avec des problèmes multiples de santé chroniques, récemment sortis de l’hôpital, et 19 membres de la famille qui ont fourni les patients avec des soins continus, nous avons demandé (1) quels sont les défis que les patients éprouvent dans la transition de l’hôpital, et (2) quelles sont les solutions de systèmes et politiques qui peuvent répondre aux défis que ces patients éprouvent? Nos résultats révèlent des défis à court et a long terme associés aux transitions à la maison. Les défis à court terme comprennent la préparation de l’habitation pour le patient et la compréhension de l’organisation des soins à la maison. Les défis à long terme sont associés à des problèmes pratiques et émotionnels. Réfléchissant sur nos résultats, nous suggérons que les besoins sociaux des patients peuvent être d’une importance égale à leurs besoins médicaux lors de la récupération post-décharge, et nous discutons les implications pour la politique. This study examined how patients experience transitions to community from hospitals, inclusive of daily living problems and medical concerns. Analysing qualitative data from interviews with 36 individuals including 17 high-risk older adults with multiple chronic health conditions recently discharged from hospital, and 19 family members who provided the patients with ongoing care, we asked (1) What are the challenges that patients experience in transitioning home from the hospital, and (2) What are the system and policy solutions that can address the challenges these patients experience? Our findings reveal both short- and long-term challenges associated with transitions back home. Short-term challenges include preparing the dwelling for the patient and understanding the organization of care at home. Long-term challenges are associated with practical and emotional concerns. Reflecting on our findings, we suggest that patients’ social needs may be equally important to their medical needs during post-discharge recovery, and we discuss implications for policy.

Integrating International Medical Graduates: The Canadian Approach to the Brain Waste Problem

The Canadian health care system has relied both historically and more recently on international medical graduates (IMGs), physicians educated in other countries, to help solve shortages in its health care system, particularly in underserviced rural and remote areas. Throughout the 1970s, roughly a third of Canada’s physicians were IMGs. Although this proportion has dropped to 23 % more recently, Canada still has a sizeable dependence on physicians trained in other countries. The profile of incoming doctors has also shifted. In the 1970s, physicians tended to come from English-speaking countries, such as Ireland and the UK. Similar educational systems and proficiency in English made the process of integration of these IMGs relatively simple since their credentials and training could be assessed according to Canadian standards and most were fast-tracked to achieve Canadian accreditation. More recent IMGs originate from a wider variety of source countries, making English language proficiency and credential equivalency key issues for medical regulators and certifying bodies. Reports of IMGs having difficulty completing the extensive licensing procedure needed to practice medicine in Canada are increasingly common. This process includes passing several costly standardized exams and often two to six more years of postgraduate medical training, to which there is limited access. This chapter draws on interviews with key policy stakeholders as well as IMGs to highlight the challenges to the integration of IMGs in Canada.

Forms of Capital as Facilitators of Internationally Educated Nurses' Integration into the Registered Nursing Workforce in Canada

Dans cet article, nous utilisons des données obtenues grâce à des interviews pour examiner comment des infirmières et des infirmiers ayant obtenu leur diplôme à l’étranger perçoivent les facteurs qui ont facilité leur intégration dans cette profession au Canada. Selon les participants, plusieurs facteurs entrent en jeu, et ces facteurs semblent refléter des formes de capital. Le capital économique (ressources financières disponibles) et le capital culturel (compétences linguistiques et connaissance du vocabulaire de la profession) leur ont permis de mettre à profit d’autres formes de capital afin de pouvoir faire officiellement partie de la profession et trouver ainsi du travail. Par conséquent, offrir aux infirmières et aux infirmiers ayant obtenu leur diplôme à l’étranger des ressources financières et des moyens de développer leurs compétences linguistiques pourrait les aider à avoir plus rapidement accès à la profession et à trouver un emploi au Canada.

The Timing of Pregnancy: Women’s Interpretations of Planned and Unplanned Pregnancy

In this paper, we apply the concept of timing to explore the meaning that women attach towards planned and unplanned pregnancy. We conducted qualitative semi-structured interviews with 42 Canadian women who were pregnant or recently gave birth to examine how they experience the transition to motherhood. We contend that the timing of pregnancy is a socially constructed norm that impacts women through a complex range of life events and circumstances. Participants’ accounts suggest a gamut of compliance, ambivalence, and defiance towards the “timing of pregnancy” standards. Situating women’s decisions on childbearing within the continuum of their life trajectories and societal expectations surrounding pregnancy allows for better understanding of the interplay between women’s personal choices and the social norms informing these decisions.