Increasing globalization of the nursing workforce and the desire for migrants to realize their full potential in their host country is an important public policy and management issue. Several studies have examined the challenges migrant nurses face as they seek licensure and access to international work. However, fewer studies examine the barriers and challenges internationally educated nurses (IEN) experience transitioning into the workforces after they achieve initial registration in their adopted country. In this article, the authors report findings from an (...) empirically grounded study that examines the experience of IENs who entered Ontario’s workforce between 2003 and 2005. We found that migrant nurses unanimously described nursing as ‘different’ from that in their country of origin. Specifically, IENs reported differences in the expectations of professional nursing practice and the role of patients and families in decision‐making. In addition, problems with English language fluency cause work‐related stress and cognitive fatigue. Finally, the experience of being the outsider is a reality for many IENs. This study provides important insights as policy and management decision‐makers balance the tension between increasing the IEN workforce and the delivery of safe patient care. (shrink)