NRS1100 Contemporary Nursing: Global Nursing Migration Essay Analysis

This essay critically examines the implications of global nursing migration on healthcare and nursing practice. It begins with an introduction outlining the challenges faced by countries due to the increasing recruitment of nurses to foreign countries, a phenomenon often linked to nursing crises. The essay then reviews several key articles, including studies by Wong et al. (2015), England (2015), Effendi et al. (2015), Zhou, Roscigno & Sun (2016), Benton & Francis (2017), and Mia et al. (2017), summarizing their methodologies, findings, and limitations. These articles explore various aspects of migration, such as the impact of WHO policies, cultural and ethical differences, workforce retention, and the determinants of migration. The essay evaluates the evidence presented in these articles, focusing on the role and contribution of nurses to safe and effective care within the context of global nursing migration. Furthermore, it critiques the literature in relation to the WHO Global Code of Practice on the International Recruitment of Health Personnel, discussing how the findings align with or diverge from the directives outlined in this international framework. The essay concludes by offering recommendations to enhance the efficacy of global healthcare services, promote transnational nursing migration policies, and strengthen the rights of international nurses.

RUNNING HEAD: GLOBAL NURSING MIGRATION
GLOBAL NURSING MIGRATION
Name of Student
Name of University
Author note

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Introduction
There are many social and cultural challenges faced by countries at national and state
level and these problems are diverse across nations that finally lead to a ‘flawed’ national and
global healthcare network. The incidences of nurses getting recruited to foreign countries has
drastically increased given a common scenario of ‘nursing crisis’. There is a deep and
complex interplay between immigration and emigration of registered nurses which remains
unattended in spite of robust policy formulation by World health organization.
Review of Literature
Wong et al., 2015 aims at analyzing the World health organization documents to
recognize the major issues associated with global nursing migration. The study uses a quality
content analysis as a methodology to scrutinize World health organization document
published between 2007 and 2012. A thematic analysis was done to determine the global
migration issues. The sample used a total of 32 documents. 31 subcategories were identified
from which four themes were determined. As for themes - Leadership and management
account mostly for the existent global nursing migration issues while deficient nursing
practice, lack of nursing research and incompetency in nursing education standards were the
other issues related to three other themes. The study considers a more methodical and
systemic form of organizational leadership to gain on a well ordered nursing practice globally
in spite of nursing migration but the study’s only limitation was that it uses a small sample
size of 32 documents. They implication of the research is to guide the healthcare policy
makers to value the concept of ‘ethical nursing’ to comply with the global practice guidelines
even nursing migration is coexistent in the framework. The study does well by arguing with
the ‘deficient’ areas of WHO policies – as the study uses a diverse range of country specific
documents – to explore the problem deeply.

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England (2015) aims to study the correlation of nursing migration in United States to
manage a difficult situation of ‘nursing crisis’ (Lala, Lala & Dangor, 2017) in the country.
This journal article studies various cultural and ethical differences in practices of
internationally educated registered nurses the distribution of these nurses in various parts of
United States. The study includes concepts like ‘global healthcare system’ and ‘global
healthcare economy’ (Kingma, 2018) to analyze the process and impact of transnational
nurse migration. The implication of this research focuses on the need for exploring more into
aspects of practice, process and outcomes of global nursing migration at nation- state level.
The study succeeds in exploring a vast spectrum of reasons related to global nursing
migration but the study’s only limitation was it did not use a quantitative method to
statistically determine the ‘economy gaps’ in global nursing network.
Effendi et al. (2015), aims to study the gray areas of healthcare policies and its
relation to global nursing migration. The study analyzes the work culture of Indonesia that
promotes immigration and emigration of clinical nurses – while the country suffered from
‘nursing crisis’. The problems lie in the very training, nurturing and development of national
nurses. The study concludes by finding complex ethical (Henly, 2016) and operational issues
(of nursing emigration) as it plunged into an understanding of how ‘brain waste’ and salary
differences(Oda, Tsujita & Rajan, 2018) affected the ‘issue’ between a domestic Japanese
nurse and an Indonesian nurse who has been working in the same hospital. It should be
appreciated how the study argues on the need of workforce retention to help the country’s
own healthcare framework and the conclusion is relevant as well. The implication of this
study is to equate and equalize the financial and social rights amongst foreign and local
nurses. The only limitation with this study is that it not use a ‘control’ group to measure the
differences.

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According to Zhou, Roscigno & Sun (2016) – nurses from China and other Asian
countries has shifted to European countries due to unknown reasons (World Health
Organization, 2019). The researchers of this study focused on studying and determining the
reasons, determinants and factors underlying the migration process. They conducted semi-
structured interviews with 28 Chinese nurses from different Australian healthcare facilities.
Content analysis process with majority of the clinician’s textual responses was undertaken.
However, the limitation of the study is associated to its questionnaire that used closed ended
questions for interviewing the nurses. Open ended questions would have bought out the prior
unexpressed emotions, feelings and reasoning associated with the nursing migration and
would have suited the study’s aim. Therefore, future implication of this study is to apply the
‘researched’ methods to the clinical framework so as to prevent the nurses from migrating.
Benton & Francis, (2017) aims to understand the issues related to global nursing
migration from a wide angle. The study uses a ‘bibliographic’ data analysis (Heradio et al.,
2016) to interpret the collected data into possible themes that can best describe the issues.
The study overall recognizes factors like care settings, healthcare infrastructure, career
growth, international migration and mobility in relation to workforce retention – as the main
contributors of issues. The implication of this study is that it provides a broad research
exploration into deeply coherent factors of work life balance, job satisfaction and
organizational policies leading to migration issues. The limitation of this study is that it
digresses from its aim of study at times, especially during thematic analysis.
Mia et al., 2017 aimed to scrutinize the important findings in deficient areas of global
nursing. The study uses a descriptive data synthesis method (Kraft 2017) to analyze the
nursing practice articles. The data analysis reveals certain categories that focuses on key areas
like strengthening global nursing framework, facilitating global nursing practice, creating
supportive environments, dissolving discriminations, managing class and gender issues

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amongst nursing, eliminating cross country biases. The implication of this study is to
formulate the problem solving strategies against global nursing migration issues. The only
limitation of this study is that it did not use a mixed study method to see the problem from
various perspectives.
Evaluation
A widespread disparity in nursing education across nations and continents coupled
with other grave areas of concern like non adherence to clinical guidelines, workplace
disruption and workplace discrimination, missed nursing care and discrepancies had led to
the global migration issues. The World health organization policies first need to be changed
and specified to address the ‘individual’ areas of migration problems. Both retention and
transnational nursing practice has to be encouraged within the WHO’s framework so that can
have an impact on global basis.
Discussion
The study discusses “holistically” about the combined transnational nursing migration
policy making with respect to the quality of nursing received by the patients on a global
basis. Nurses are responsible for the implementation of pharmacological interventions and
their clinic practice should be strengthened by every means. The effect of nursing emigration
has been studied and its effect on the immigrated country’s cultural nursing framework has
been highlighted. This literature review also addressed the country’s need of retaining good
domestic nurses to serve its own people.
Conclusion
The literature review can be concluded saying that – there is both a need of retaining
domestic nurses and a need to send nurses to other countries to strengthen the global nursing
network.

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Recommendations
The recommendations of this study are – 1.To enhance the efficacy of global
healthcare service. 2. To promote the transnational nursing migration policies. 3. Bettering
the international nursing policies of World health organization has to be updated. 4. To
strengthen the economic rights and 5. social rights of international nurses.

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References
Benton, D. C., & Ferguson, S. L. (2017). A wide-angle view of global nursing workforce and
migration. Nursing Economics, 35(4), 170.
Efendi, F., Mackey, T. K., Huang, M. C., & Chen, C. M. (2017). IJEPA: gray area for health
policy and international nurse migration. Nursing ethics, 24(3), 313-328.
England, K. (2015). Nurses across borders: global migration of registered nurses to the
US. Gender, Place & Culture, 22(1), 143-156.
Henly, S. J. (2016). Global migrations, ethical imperatives for care, and transcultural nursing
research.
Heradio, R., de la Torre, L., Galan, D., Cabrerizo, F. J., Herrera-Viedma, E., & Dormido, S.
(2016). Virtual and remote labs in education: A bibliometric analysis. Computers &
Education, 98, 14-38.
Kingma, M. (2018). Nurses on the move: Migration and the global health care economy.
Cornell University Press.
Kraft, M., Kästel, H., Eriksson. A & Hedman, A. M. R. (2017). Global Nursing—a literature
review in the field of education and practice. Nursing open, 4(3), 122-133.
Lala, S. G., Lala, N., & Dangor, Z. (2017). The nursing crisis in paediatrics in South African
state hospitals-an unaddressed problem. South African Journal of Child Health, 11(2),
64-65.
Oda, H., Tsujita, Y., & Rajan, S. I. (2018). An analysis of factors influencing the
international migration of Indian nurses. Journal of International Migration and
Integration, 19(3), 607-624.

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Wong, F. K. Y., Liu, H., Wang, H., Anderson, D., Seib, C., & Molasiotis, A. (2015). Global
nursing issues and development: Analysis of World Health Organization
documents. Journal of Nursing Scholarship, 47(6), 574-583.
Zhou, Y., Roscigno, C., & Sun, Q. (2016). Why do China-educated nurses emigrate? A
qualitative exploration.