Rusette Tesani discussed best practices for ensuring international nurses thrive in their new hospitals.
Around the globe, emergency nurses work tirelessly to care for their patients, yet practices often differ across countries, cultures and geographies. The global sessions at Emergency Nursing 2026 shed light on how local cultures and customs shape the specialty and how nurses can adapt these best practices for their local patient populations and communities.
During the session, “Global Emergency Care, Beyond Hospital Walls: Extending Care Into the Community to Reduce ED Attendance and Boarding,” members of the ENA Global Advisory Committee presented case studies about community-based care models in the United States, England and the Philippines. For example, a program in the Philippines taps trained community responders and health workers, often on a volunteer basis, to check on patients at home.
“Because we’re approaching it in a different way, we may come up with a different solution that maybe you haven’t considered,” said session co-presenter Colin Fleming, MSc, RN, CEDE, clinical director of emergency services and nursing clinical operations at Cleveland Clinic Abu Dhabi in the United Arab Emirates.
Another session, “Empowering Practice: Protocols That Improve International ED Outcomes,” covered the benefits of nurse-driven protocols for initiatives such as decreasing ED crowding and boosting staff and patient satisfaction.
To make the case for their adoption, nurses must communicate how these protocols can save time and money, according to session co-presenter Sarah K. Wells, MSN, RN, CEN, CNL, consultant and founder of NTN Consults and New Thing Nurse.
International Insights
During the session “Trauma Around the World,” panelists shared their experiences treating patients in the United States, Japan, the Middle East, Ghana, the Philippines, Australia, Canada, and South Africa, revealing differences in heritage, traditions, education, infrastructure and even patient presentation.
For instance, the panelist from Australia had never treated a gunshot wound. The speaker who’d worked in the Middle East highlighted cultural preferences for same-sex patient care. And the nurse from South Africa described relying on backup generators during rolling blackouts.
The panelists also discussed what they considered best practices and key areas for improvement in each of their respective countries.
In the United States, prehospital blood administration is among the strengths, said panelist Jamla Rizek, DNP, MBA, RN, CEN, CPEN, NHDP-BC, NRP, FAAN, FAEN, founder of Adventures with Nurse Jamla. Tailoring trauma care by facility, instead of using standardized processes like the ENA Trauma Nursing Core Course, is a key weakness of the U.S. health care system, she said.
Abena Agyekum Poku, BSN, of Ghana, said her country’s strengths include its culture of hospitality, excellent interpersonal relationships and clinicians’ improvisational abilities. When it comes to weaknesses, she noted Ghana’s lack of a pediatric nursing specialty.
Panelists at the session “Trauma Around the World” shared their experiences treating patients in the United States, Japan, the Middle East, Ghana, the Philippines, Australia, Canada, and South Africa,
Despite regional contrasts, the panelists shared more commonalities than differences.
“Patients bleed the same around the world,” said session co-presenter Rene Ackermann, RN, fANSA, clinical and technical expert for Lenmed Group (South Africa & International). “It’s how we manage it that makes it different.”
What happens if a patient gets sick or injured abroad? The session “Across the Continuum: What Emergency Clinicians Must Know About Caring for International Travelers” attempted to answer that question. Debbie McCrea, EdD, MSN, RN, FNP-BC, CNS, CNE, CEN, CFRN, EMT-P, assistant professor at the University of Texas Health Science Center Cizik School of Nursing in Houston, outlined how a medically complex traveler might get care and eventually arrive home, like ensuring they receive care abroad and coordinating transportation, often from remote regions.
McCrea also covered caring for patients before and after international travel. Before their trips, patients should receive necessary vaccinations, secure insurance, and consider how chronic health conditions might impact activities like hiking at high altitudes or scuba diving. They should also register their travel with the Smart Traveler program, which allows the U.S. Department of State to quickly contact travelers in case of emergency. Post-travel care includes determining where a sick patient has recently traveled in case their complaint is related.
The Foundation to Excel
Finally, during the session, “Through the Eyes of Migrant Nurses in the ED: A Global Perspective,” Rusette Tesani, BSN, RN, director of nursing at Jacobson Memorial Hospital Care Center in Elgin, North Dakota, shared best practices for ensuring international nurses thrive in their new hospitals.
Drawing on her own experience leaving the Philippines to work in the Middle East and the United States, Tesani noted migrant nurses not only have to adapt to working in new hospitals but also to new languages, people, customs, cultures and even weather.
For instance, she advised hospitals to provide dedicated onboarding programs for migrant nurses and resources to help them connect with other migrant nurses in their communities. She also pointed out kindness and empathy ensure these nurses build resiliency, confidence and long-term success.
“You have to be mindful that transitioning here is really difficult, not just mentally, psychologically, ethnically, but everything,” she said.