This study investigates the multilingual skills of migrant nurses as a component of professional care competence. Empirical studies have shown that multilingual migrant nurses use their language skills in daily work and may receive monetary and non-monetary benefits on the labor market due to their multilingualism. (Ali & Johnson, 2017; Kalist, 2005; Patriksson, Nilsson, & Wigert, 2022). However, there is a lack of research on how multilingualism is integrated into professionalism in nursing. The current study aims to provide insights into the perspectives of migrant nurses on multilingualism as a component of professional competence in nursing. The study was conducted in Germany but the results offer implications for other European countries with high rates of immigration.

Effective communication in health care is crucial for the outcomes and success of treatment. Constant immigration into Western countries, particularly in Germany, has led to an increase in the number of people with a migration background needing care. Since access to healthcare services can be hindered by language barriers, the healthcare system faces the challenge of ensuring high-quality care for all population groups (Lebano et al., 2020).

Empirical studies revealed that multilingual migrant nurses intensively use their multilingualism at the workplace to enable multilingual communication for patients and their relatives and to assist monolingual colleagues (Meyer, 2010; Lundin, Hadziabdic & Hjelm, 2018; Chang, Hutchinson & Gullick, 2021). Since language skills enhance the productivity of migrant nurses, this study assumes that, within the framework of human capital theory, their multilingualism can represent human capital. (Becker, 1964). The current study conceptualizes multilingualism as part of professional nursing competence by drawing on two theoretical models.

First, the generic model of professional competence (Cheetham & Chivers, 1998) includes four professional key competencies (cognitive competence, functional competence, behavioral competence, and ethical competence) and considers communicative competence as a meta-competence. The impact of communicative competence as meta-competence on employees’ productivity can vary depending on the profession. Second, the specific model of professional nursing competence (Valizadeh et al., 2019) expands the key competencies to 16 profession-specific dimensions. However, both models do not consider multilingualism as a part of professional competence.

The current study addresses this gap and aims to provide a more elaborated model of nursing professional competence. It is assumed that multilingualism in nursing can act as a meta-competence that can be used across domains of professional nursing competence.

By doing so, the study focuses on the following research questions:

• To what extent does multilingualism appear in the domains of professional nursing competence?
• To what extent do multilingual nurses perceive multilingualism as a component of professional nursing competence?

Qualitative design was used in this paper to explore the experience of migrant nurses with being multilingual in the workplace. The study was conducted by using semi-structured interviews as this research method provides open scope for the interviewees and ensures that information relevant to the research question and the research object is collected (Döring & Bortz, 2016; Helfferich, 2016). The interview guide was developed according to the Helfferrichs' approach (2019) in four steps: collecting, checking, sorting, and subsuming. The holistic model of professional competence according to Cheetham & Chivers (1998) and the theory-driven domain of professional nursing competence according to Valizadeh et al. (2019) serve as the theoretical basis for the conception of the interview guide. In the first step collecting, all possible questions were generated that could be relevant to the investigation of the research subject. In the next step checking, the collected questions were checked to determine whether they were suitable for the interview guide. During sorting, the remaining questions were sorted according to content aspects and grouped thematically. This process resulted in sets of questions addressing the following themes: communication with multilingual patients, communication in everyday working life, linguistic challenges, problem-solving, behavioral competence, and functional competence. In the last step subsuming, the questions were classified into a guide. The finalized version of the guide was pilot-tested to check the clarity and understandability of the questions and to ensure their suitability for investigating the research questions. The sample for the semi-structured interviews was selected by the top-down method which means the selection criteria are deductively determined in advance. The interview partners were selected according to the following criteria: work in inpatient care for at least one year, have their own migration experience, and have a native language other than German. 10 semi-structured interviews were conducted and analyzed by using qualitative content analysis (Kuckartz, 2022). The analysis was performed with MAXQDA 2024, to enable the detailed processing of all analysis steps, the results’ representation, and comprehensive documentation of the working process. According to Kuckartz (2022), the category system for qualitative content analysis was developed using a deductive-inductive method. Categories were initially derived deductively from theoretical models of professional competence. After pilot coding, the system was enriched with inductively generated categories. This finalized category system was then used to code the ten interviews sequentially.

The preliminary findings have shown that multilingualism occurs in 12 out of 16 domains of professional nursing competence. The domains where multilingualism is most frequently used include communication with patients, teamwork and cooperation, and the ability to work in difficult and complex situations. Since several studies have already proven that multilingual nurses use their multilingualism to communicate with multilingual patients and assist their monolingual colleagues, it was expected that multilingualism would be present in these domains. Furthermore, multilingualism enables nurses to handle complex situations where linguistic precision is essential. Remarkably, multilingualism is also utilized in situations that do not involve direct communication. Nurses reported using their multilingual skills for professional education and accessing sources in different languages. Additionally, multilingualism supports the development of management and leadership skills. It was notable that the nurses assigned different values to their multilingualism. Differences were observed in the assessment of the role of the majority language, German, and the heritage languages. Although all respondents intensively use their multilingualism for professional purposes in their daily nursing practice, some emphasized that only German plays a role in their professional activities. This may point to a power relationship in the language market of nursing and could be explored in further studies. Multilingualism plays a significant role in everyday nursing practice and appears in multiple domains of professional nursing competence. It is relevant not only in domains related to communication skills but also as a medium for acquiring knowledge. In future research, the use of multilingualism in selected domains that have shown potential for its application can be investigated in greater detail. It is also important to include other stakeholders, such as nursing station management and multilingual patients, to gain a more comprehensive understanding of the role of multilingualism as part of professional competence.

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