Academic journal article Canadian Journal of Public Health

Caring beyond Borders: Comparing the Relationship between Work and Migration Patterns in Canada and Finland

Academic journal article Canadian Journal of Public Health

Caring beyond Borders: Comparing the Relationship between Work and Migration Patterns in Canada and Finland

Article excerpt


Objectives: We discuss from an explicit gender lens the key contextual factors that shape nurse migration patterns through the cases of Canada and Finland.

Methods: We employ a context-sensitive, comparative case study approach drawing upon documentary data from primary and secondary sources analyzed according to key themes that were both emergent and based on a systematic review of the nurse migration literature.

Results: Despite the recruitment of foreign care workers being frequently raised in public debate as a solution to the care shortage in both Canada and Finland, there is still little evidence to show that this is happening to any great extent. This is particularly the case for Finland. Our analysis does, however, confirm how the migration process is linked to the devaluing of care (in terms of wages and working conditions), which is in turn connected to recent neo-liberal reforms, pushing some nurses from the country in which they were trained to better remuneration and working conditions somewhere else.

Conclusions: We shed light on how the impending nursing shortage can be addressed in Canada and more generally.

Key words: Nursing; migration; Canada; Finland

Mots clés : soins infirmiers; migration; Canada; Finlande

Despite the complexity of modern nursing and its position as an important health profession, the work that nurses do remains devalued in many countries, resulting in comparatively low salaries and poor working conditions. This situation is worsened by neo-liberal, efficiency-driven policies that increasingly commodify health care and allow nurses to be treated as an easily replaceable workforce. Immigration and automation are the key strategies of workforce management arising from this line of thinking.1 Celia Davies2 argues that the high turnover of nurses, the vast majority of whom are female in virtually all high-income countries, is one of the key areas in which the "gender question" in nursing is visible. Nursing work has constituted a key target of governments that have explicitly created and reinforced the redistribution and internationalization of care work.3 At the height of these neo-liberal reforms aiming to make public management more efficient many nurses have either been laid off or made to "multi-task". This has resulted in an overall increase in workload for those who remain, leading to burnout and exit from the profession altogether for a substantial minority.4 At the same time, fewer and fewer women in high-income countries are choosing nursing as a career.5 This has proven to be especially challenging in the case of long-term nursing care, in that the aging population has given rise to consumer pressure to improve the quality and quantity of publicly funded nursing services.

In short, at a time when the need for nurses is rapidly increasing, many highincome countries are experiencing difficulties in finding sufficient numbers of new recruits and in retaining nurses already in the workforce.6 The vacancies create a space for international migrants. Indeed, some argue that nursing work/life issues (in particular, adequate remuneration and dignity in work) have not been as effectively addressed because governments have the option to recruit foreign health workers, thus avoiding the need to meet the demands of their domestic labour forces.7 The result is what some scholars have called "global care chains",8,9 whereby (largely female) workers in low-income countries are recruited to help solve the care deficit in high-income countries.

These gendered international labour practices come with a price, however: when high-income countries recruit nurses from low-income countries, they tap human resources that those countries can ill afford to lose. Because of this, the recruitment of internationally trained nurses has rapidly become one of the key issues in a global crisis of health care labour. Furthermore, research suggests that nurses migrating from low- to high-income countries commonly face poorer working conditions and downgraded work as compared with domestic nurses. …

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