Healthcare worker migration has been a concern for a number of years with a particular interest in nursing, since nurses represent half of the world’s healthcare workforce. Howard Catton, CEO of the International Council of Nurses, and James Buchan, professor from the University of Technology in Sydney, Australia, provide important perspective in the new report on nurse migration and the impact of the current pandemic on projections for the future nursing workforce. Their report provides grim statistics before COVID-19, and the impact as a result of the pandemic is even grimmer. Mitigating the issues of a vast under-supply of the world’s nurses and its impact on global health will take:
- A significant investment in supporting the current nursing workforce as they deal with the results of the pandemic.
- Scaling up the workforce to support an unknown proportion of persons impacted by COVID-19 who will need long-term care.
- Re-tooling some of the current nursing workforce for both the critical and long-term care of those impacted by the pandemic.
- A concomitant focus on the nursing education systems.
For the latter, the State of the World’s Nursing Report identified that a faculty shortage (also known as nursing tutors) was one of the challenges in having sufficient numbers of nurses. In some countries, the pre-COVID-19 projections for a nursing shortage are related to retirements (e.g., North America and Europe). In other places, the pre-COVID-19 shortages were due to poor salaries, little opportunity for advancement, and/or poor working conditions. As noted in the report, the pandemic has not only worsened some of these issues but added new issues like a shortage of personal protective equipment (PPE).
This is a complicated and nuanced issue. Individual nurses seek the advantages that migration may bring (e.g., higher salary, better working conditions, the opportunities for career advancement) while at the same time, countries (especially lower-resourced countries) need the nurses educated in the country to care for their citizens. More reading on this topic is available from Lisa Eckenwiler, Associate Professor in the Department of Philosophy and the Department of Health Administration and Policy, and former Director of Health Ethics at George Mason University.
Mr. Catton and Professor Buchan provide policy recommendations at the end of the report that address national and international policy needs. In addition, they note the recent World Health Organization report on recruitment of healthcare workers. At the same time, there are ethical organizations that work with nurses who are interested in migrating.
We live in a global world, not just with the ease of transmission of infectious diseases, but with a global workforce. As nurse leaders and advocates for social justice, Sigma members have a role to play in being informed of the issues in this report, advocating for fair and just recruitment practices within their organizations, working with their governments to strengthen the investment in all segments of nursing, and caring for each other as we all respond to the impact of the pandemic. These are unprecedented times, but with collaboration and coordination, the global community of nurses can continue to make the world a better place.
All my best,
Elizabeth “Liz” Madigan, PhD, RN, FAAN