Nurse migration: Challenge for the provision of health care

Cycles of shortage and surplus of registered nurses were experienced in many countries during the past decades, and in times of demand nurses were recruited from abroad. The trends and effects of nurse migration that we observe today, however, have changed tremendously. Driven by growing and ageing populations, demand for health care and for nurses continues to grow, whilst projections point to actual reductions in the supply of available nurses in some developed and developing countries. Moreover, today, nurse migration follows the logic and rules associated with the liberalisation of markets and the global circulation of goods and services. Within this framework some countries rely heavily on foreign nurses instead of building up a sufficient training capacity at home. In many cases the source countries loose a high percentage of the nurses they trained to other countries. The supply of health and nursing care in these countries is often inadequate to meet even the basic needs of the population. As projections show, in future, the global shortage of nurses will have a deep impact on the provision of health care, and on sociocultural developments in many countries.

In a first step the presentation outlines the global context and international influences of nurse migration (1). Facts and figures concerning nurse migration are highlighted in a second section (2). The third part (3) explores the impact on professional standards and quality issues in health care provision drawing on a systematic review of the few studies done in this field. The paper concludes with a summary and some statements addressing possible research objectives and interests; national and supranational policies are presented for discussion (4).