Migrant Nurses: Motivation, Integration, and Contribution

Citation

LeBlanc, Y. (2008), "Migrant Nurses: Motivation, Integration, and Contribution", Equal Opportunities International, Vol. 27 No. 1, pp. 118-119. https://doi.org/10.1108/02610150810844992

Winkelmann‐Gleed's account of the motivations, contributions, and integration of migrant nurses in Britain is both timely and salient. The author begins by questioning the discriminatory “one‐sided public opinion” toward migrant workers and argues that fostering interpersonal work relationships can both ease workplace integration and further enhance the positive contributions of migrant nurses. Her arguments are supplemented with an empirical study; a self‐administered survey and in‐depth interviews conducted in 2003‐2004.

The book proceeds with a brief overview of migration and contextualises the state of nurse migration in Britain. Most nurses come from the Philippines, Africa or India and many are working below their capacity in low paying positions. Gender, race, and ethnicity are then presented as social constructs in relation to employment and integration. The point is made that while women are usually underrepresented in managerial positions, of those in senior posts, few are migrant nurses. Alternatively, migrant male nurses tend to acquire higher status positions. Generally, men are pressured into more authoritative nursing roles due to normative expectations linked to masculinity. It is further emphasised that care of the sick continues to be viewed as a “feminine” task and much of migrant nurses' work is related to “mothering and care taking roles” (p. 18). The author argues that this prejudice is further exacerbated by race and ethnicity. For instance, many black and ethnic minorities are socially excluded in Britain, and discriminatory practices are prevalent in the NHS.

A descriptive account of the NHS nursing shortage, the NHS structure, and the process of nursing registration in Britain is provided in chapter 3. This is followed by a familiar depiction of motivational factors related to migration. Based on her empirical work, overall motivations to migrate appear varied but most are related to income. In chapters 5 through 7, the issue of integration is addressed. With respect to relationships of migrant nurses with colleagues, mentors, supervisors, and other managers, there are mixed accounts illustrating both support and non‐support. The social exclusion felt by some of the respondents because of race, ethnicity, and gender is revisited and poignantly illustrated in chapter 6. For example, refugee nurses are often unable to work for several years after their arrival in the UK, either because of their immigration status or due to personal circumstances. Another major barrier is finding a supervised practice placement. These are in short supply even though this is a necessary requirement of the UK Nursing and Midwifery Council. Finally, female migrant nurses are often denied career progression while their male counterparts seem to advance with less difficulty.

The next two chapters consider the contribution of migrant nurses and how managers may enhance or constrain such propensity. It is noted that a key policy debate encompasses “capacity” or rather balancing scarce resources with performance expectations. The author argues that “capacity building” encompasses fostering interpersonal relationships by taking into account motivations and personal and group identities. She further contends that this is not without its problems because “communication skills”, “recognition of credentials”, and a “lack of both adaptation programs and mentors” are barriers to developing and sustaining this function. In chapter nine, the management of migrant and other workers is referred to as “diversity management” and the positive and negative aspects associated with this are emphasised. Finally, the last chapter nicely sums up the stages and measures of integration into employment by migrant nurses. The initial arguments are then brought full circle and Winkelmann‐Gleed leaves the reader with a quote which “challenges not only hostility but apathy towards the stranger” (p. 143).

This work provides a valuable snapshot of some of the challenges facing migrant nurses, their diverse circumstances, and experiences. One drawback is that due to inconsistencies in her research findings, there is lack of strong support for the notion of workplace discrimination. In other words, her study does little to support this notion as “most respondents perceived organisational procedures and equal opportunities policies as fairly implemented” (p. 77). Secondly, some of the proposed suggestions to enhance the integration of migrant nurses appear overly simplistic. For instance, “being sensitive to migrant nurses” personal‐ and family‐related commitments when scheduling shifts' seems like a straightforward managerial consideration. Due to union agreements, staffing issues, and policies related to hours of work, such implementation will involve the collaborative effort of both manager and a team of nurses; it is therefore not unlikely to conceive that some resistance will ensue. As she herself contends, “it is more difficult to alter practice than it is to issue policy documents” (p. 12). Finally, although beyond the author's control, some of the information presented may now be somewhat out of date, testament to the rapid and fluid changes occurring within the Home Office and the NHS. Overall, the book is thought provoking and informative and of particular interest to stakeholders involved in nurse migration, and/or nurses considering migration.