Nurses on the Move: Historical Perspective and Current Issues

Mireille Kingma, PhD, RN

Disclosures

Online J Issues Nurs. 2008;13(2) 

In This Article

Abstract and Introduction

The number of international migrants on the move each year continues to increase. Women migrants are becoming agents of economic change as they enter the international labor market and participate in a new distribution of global wealth. Professionally active nurses are important players in an increasingly competitive, global labor market. Thousands of nurses migrate each year in search of better pay and working conditions, career mobility, professional development, a better quality of life, personal safety, or sometimes just novelty and adventure. In this article, the author looks at the characteristics and the effects of nurse migration, addresses the factors driving international nurse mobility, and discusses current issues regarding nurse migration. The author advises that rather than focusing on national and international recruitment, serious attention be given to retention strategies to successfully address the critical shortage of health professionals willing to remain in active practice.

The number of international migrants on the move each year continues to increase. While they represent a steady three percent of the world's population, their numbers have doubled in the last four decades, now reaching a total of 191 million international migrants (International Organization for Migration [IOM], 2005; United Nations [UN], 2006). There has been a particularly marked growth in labor migration flows to industrialized countries (Zlotnik, 2003). In the Organization for Economic Co-operation and Development (OECD) countries, whose 20 member States tend to be the industrialized countries, including the United States (US), United Kingdom (UK), Australia, Japan, and Switzerland, among others, people with tertiary educations accounted for nearly half the increase in migrants older than 25 years during the 1990s (UN, 2006). There is an increasing feminization of migration flows, with women representing almost half of today's international migrants. Patterns of migration are evolving with many more women migrating independently of partners or families (Timur, 2000), thus changing family dynamics and community networks in both source and destination countries. Women migrants are becoming agents of economic change as they enter the international labor market and participate in a new distribution of global wealth (IOM, 2003).

The eight Millennium Development Goals, which range from halving extreme poverty to halting the spread of HIV/AIDS and providing universal primary education, all by the target date of 2015, form a blueprint agreed to by all the world's countries and all the world's leading development institutions. They have galvanized unprecedented efforts to meet the needs of the world's poorest. Countries having the greatest difficulty in meeting these UN Millennium Development Goals (MDGs) tend to be faced with absolute shortfalls in their health workforce, seriously limiting their potential to respond equitably to even basic health needs (World Health Organization, 2006). The international recruitment efforts and subsequent migration of health professionals from these areas affects the national workforce supply in these countries. Increasingly, these recruitment efforts appear on the political agenda as a possible major factor contributing to the shortage of healthcare professionals in these countries (Stilwell et al., 2003; International Council of Nurses [ICN]/Florence Nightingale International Foundation [FNIF], 2006; World Health Organization [WHO], 2006).

Migration in the context of a supply surplus would not be an issue. In such situations, it may even be considered a positive strategy to reduce unemployment, improve the national economy through the transfer of funds between migrant workers and their families left behind (estimated to be US$ 232 billion in 2005) (UN 2006), and advance healthcare through the global exchange of knowledge and skills. However, within a context of critical staff shortages affecting access to healthcare, international migration becomes a challenge that needs to be urgently addressed. Migration is increasingly recognized as a symptom of our failing health systems and not the primary disease.

This article will look at the characteristics and the effects of nurse migration, address the factors driving international nurse mobility, and discuss current issues in nurse migration. The author will argue that rather than focusing on national and international recruitment, serious attention be given to retention strategies to successfully address the critical shortage of health professionals willing to remain in active practice.

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