Building a professional Mexican nursing workforce: A case study

    Nursing workforce development is the constant challenge of balancing the entry-level educational needs, opportunities for career advancement, and retention measures.  In most countries, nursing workforce development occurs through a professionalization model that produces nursing human resources to staff a healthcare system.  The purpose of this study was to examine the professionalization of Mexican nursing between 1980 and 2005 in order to understand the longitudinal development process of nurses as a profession in a pre-migration state.  By understanding the professionalization process, events and policies that facilitated or detracted from the development process and subsequently, the production of nursing human resources, can be better understood and improve policymaking.

   A case study approach structured data collection, which included 48 interviews with Mexican nurses from 4 sites around the country and 410 documents that served as primary and secondary sources.  Documents were selected for their themes about nursing human resources, workforce development, and professionalization.  A combination of general thematic and directed content analysis guided the coding process for all data sources.  Aspects of complexity theory and institutional analysis informed the analytic process.

   Eight major themes shaping nursing workforce development emerged from the data: intraprofessional development dynamics, the workplace, sociocultural, economic, political, unions, international influences, and historical foundations.  Each theme had multiple categories, revealing that professionalization is a complex process that does not occur in isolation of its context.  The relationships between the themes suggest that nursing develops under its own social system that is outside of, yet complements, the healthcare system.  The Nursing System creates products that benefit both society and affects health outcomes.  The strength of the institutions shaping the system play a significant role in the quality of these outcomes.  Policy implications for public health infrastructure development specific to nursing human resources are described.