Nurse migration needs further research.

Critical global challenges facing nursing include the impact of HIV and Aids in Africa, internal and international migration and health sector reform, according to a leading nurse migration researcher James Buchan. Addressing the Nursing Workforce Research Day last month, organised by the University of Auckland's Faculty of Medicine and Health Sciences, Buchan said there were increasing concerns about nursing shortages in many Organisation of Economic Co-operation and Development (OECD) countries. In the United States, more than one million registered nurses (RNs) were needed between now and 2012; in Canada the nursing shortfall was predicted to be 78,000 by 2011; and Australia will be short of 40,000 nurses by 2010.

In his presentation to the audience of nearly 100, Buchan, a professor at Edinburgh's Queen Margaret University College, said there was little research on nurse migration. Different nurses had different motivations, objectives and career plans. New Zealanders were often backpackers, Filipino nurses were economic migrants, while Kenyans were looking for jobs and South Africans were looking for continuing professional development. Referring to the "push" and "pull" factors in nurse migration, Buchan listed low pay, poor working conditions, lack of resources, limited career and education opportunities, work and economic instability and the impact of HIV/Aids as "push" factors. "Pull" factors included higher pay and thus the opportunity for remittances, better working conditions, better resourced health systems, better career and post-basic education opportunities, political stability, aid work and travel opportunities.

The impact on source countries of nurse migration included understaffing and loss of skills, decreased capacity in health services, increased costs of recruitment and retention, compromises in quality of care and low morale for remaining nurses and patients, Buchan said.

Research revealed that close to 60 percent of nurses working outside their home countries remitted money home, with more than 70 percent of Filipino nurses and just over 20 percent of New Zealand, Australian and US nurses doing so. Around 70 percent of New Zealand, Australian and US nurses believe they are fairly paid, while just 30 percent of African nurses think so.

There were a number of national and international policy issues requiring research scrutiny, including bi- and multi-lateral agreements and ethical recruitment codes, Buchan said.

Another speaker at the research day, Auckland University associate professor Mary Finlayson said nurse migration could actually bring about a crisis in health services. The New Zealand Hospital Nurses' Survey, in 2001 and 2004, showed retention of nurses was critical. A consistent finding over the three years was that 60 percent of younger nurses and 30 percent of those over 30 were intending to leave nursing. In an update on the national cost of nursing survey turnover survey, Auckland University associate professor Nicola North said the turnover rate was higher in regional hospitals than in metropolitan hospitals.

NZNO's professional services manager Joy Bickley Asher and professional nursing adviser Angela Clark (formerly Dawbin) attended the research day.