Author Affiliations: School of Nursing & Human Sciences, Dublin City University

Option 1- Scientific / Empirical Research Findings Presented as - Oral Presentation

Aims:

To explore hospital factors that account for the variation in rates of non-EU qualified nurses in general hospitals in Ireland. Working hypotheses were that: large, teaching, urban hospitals would have higher levels of non-EU qualified nurses, given their higher turnover rates; hospitals with more negative work environments would have higher levels of non-EU qualified nurses as they would have relied more heavily on active overseas recruitment.

Methods:

Secondary analysis of data gathered during the FP7 RN4CAST project, was carried out. Data were collected in 30 acute general hospitals in Ireland in 2009/10, focusing on 112 medical and surgical wards. Nurses (n=1,406) completed a survey about their working environment and their own characteristics. An organisational profile was completed for all hospitals.

Results:

Organisational data on nurses with non-EU qualifications were only provided for 12 of the 30 hospitals and showed that up to half of the nurses employed in some large teaching hospitals have non-EU qualifications. However no characteristics such as size, voluntary/HSE status, geographical region were clearly associated with higher levels of non-EU qualified nurses. Also, hospital level nurse-reported factors such as high burnout level and a negative practice environment were not associated with higher hospital levels of non-EU qualified nurses.

The data gathered in 2009/10 do not tell the story of the trends across time of overseas trained nurses who were actively recruited and subsequently left the hospital before data collection. Therefore it is plausible to suggest that hospitals with better work environments have retained non-EU qualified nurses to a greater extent. Retaining nurses who were actively recruited to Ireland is even more important in the current health service context. There was limited organisational-level data available for many hospitals, though this was supplemented by nurse-reported survey data on place of qualification for this analysis.

Author Affiliations:Royal College of Surgeons in Ireland

Option 1- Scientific / Empirical Research Findings Presented as - Oral Presentation

Aims:

Ireland began actively recruiting nurses internationally in 2000 and is now the OECD country most heavily reliant upon international nurse recruitment. This paper reflects on a decade of international nurse recruitment in the Irish context.

Methods:

The paper analyses secondary data from An Board Altranais and the Department of Jobs, Enterprise & Innovation. It also draws on a 2009 survey of non-EU migrant nurses (N=337) working in Ireland and interviews with key stakeholders (N= 12) in 2009/2010.

Results:

• 
  Non-EU migrant nurses accounted for 35% (N=14,546) of newly registered nurses 2000-2010 with 11,481 non-EU migrant nurses obtaining visas 2000-2009.


• 
  The numbers recruited internationally almost matched the numbers trained locally 2000 -2010 - 14,546 non-EU and EU nurses joined the Irish nursing workforce alongside 17,264 Irish-trained nurses.


• 
  A fresh challenge for nurse workforce planning is the slowing of immigration and a possible increase in emigration by non-EU nurses. Between 2008 and 2010, verification requests were processed on behalf of 4202 non-EU migrant nurses, equating to 29% of those recruited since 2000.


• 
  Our 2009 survey of non-EU migrant nurses asked about future plans; 19% (65) of respondents intended to stay in Ireland, 49% (166) intended to return home and 23% (79) planned to migrate another country.

Discussion/conclusions/ implications: 


International nurse recruitment became a major contributor to the nursing workforce by default - ‘I believe the State doesn’t really know . . . before they hire us they don’t have a plan or policy in place’ (Migrant Nurse Survey 260). Successful international nurse recruitment campaigns obviated the need for health workforce planning in the short-term, but did not solve the nursing shortage. The current assumption that nurse migration (emigration and immigration) will always work for Ireland over-plays the reliability of international recruitment as a health workforce planning tool. 

Authors:Fitzgerald J.


Author Affiliations:London School of Hygiene & Tropical Medicine

Option 1- Scientific / Empirical Research Findings Presented as – Oral Presentation

Aims:

This study was an analysis of individual global careers. It explored the careers of UK-based African nurses including the pre and post migration context of career and career narratives

Methods:

This qualitative study analysed data from two interviews given by 17 UK-based migrant African nurses.

Drawing on Bordieu’s notion of research being composed of “two minutes", a life history approach first identified the social space and structures creating the ‘field’ of the observed/ objective career.
A second analysis of ‘habitus’ involving a narrative study incorporated participants’ subjective experience and evaluation.

Results:


Analysis of life histories identified:

Pre and post migration context
Participants’ career stage
Resources, enablers and barriers at each stage of career

Organisations’ human resource architecture and the employment relationship were also determined indicating the types of careers experienced.

Four narratives provide an overarching story about nursing and being a migrant nurse in the context of a global labour market. Participants drew on canonical narratives to reveal what nursing means in relation to the wider concept of career and its role in migration. This included choosing the UK as the destination for migration and its subsequent contribution to career.

Discussion/conclusions/ implications:

The analysis identifies cohort differences in career prior to migration, specifically careers are increasingly self- managed entities that involved working in multi-agency services, involving private and third sector international organisations.

The narratives identified the cultural capital individuals drew upon to articulate their past, present and future careers incorporating migration decisions, recent experiences and future plans
Complimenting macro-analytic approaches this study offers new insights by utilising a micro-analytic approach demonstrating individual migration decisions occur not in the context of a wider enabling context but also within a range of socio-historic influences and personal factors. The narration of career integrates a range of motivations that sustain identity and self esteem

Author Affiliations:1University Hospital Galway, National University of Ireland Galway, 2Jabir AbuEliz Diabetes Centre, University of Khartoum, Sudan

Option 2- Lessons from the field; project and programme evaluations; and syntheses or analyses

Presented as – Oral Poster

Issues:

This abstract highlights an initiative by an expatriate doctor to strengthen the role of Sudanese Specialist nurses through skills-focused training in Ireland.

Description:

This collaboration began in November 2010 between the Diabetes Day Centre (DDC), University Hospital Galway, Ireland and Jabir AbuEliz Diabetes Centre (JADC) Khartoum, Sudan, the leading multi-disciplinary diabetes centre in Sudan with over 40,000 diabetes patients registered. Two diabetes nurses from JADC joined the DDC for a four-week attachment. The training involved education on a wide range of services available to diabetes patients in Galway. A preset educational curriculum, accompanied by appropriate references, protocols and study material was supplied to both nurses. As well as general outpatient clinics, the visiting nurses had opportunities to attend specialist clinics such as antenatal/pre-pregnancy diabetes clinics and paediatric clinics. They had exposure to innovative services such as structured group education programmes, the retinal screening service, multidisciplinary foot service, cardiovascular prevention programmes, in-patient diabetes services and patient/parent support initiatives.

Lessons learned:

The feedback from both nurses has been very positive, both in terms of learning and the applicability of concepts such as multi-disciplinary case discussion, diabetes patient education programs and computer-based patient databases. Following this attachment the two nurses have been able to advise on the implementation of best practice guidelines for patients with diabetes attending their centre in Sudan. They continue to examine ways to reduce the high incidence of diabetes-related foot amputation and other complications of diabetes.

Next steps:

To expand the initiative to include other areas of patient care such as stroke service, oncology and maternity and to organise visits for resource individuals to Sudan to provide a larger capacity built short-term skills-focused training courses. A systematic collaboration between specialized centres in North and South will facilitate sustainability and enhance the impact.