Intended for healthcare professionals

CCBYNC Open access
Analysis Quality Improvement

Changing how we think about healthcare improvement

BMJ 2018; 361 doi: (Published 17 May 2018) Cite this as: BMJ 2018;361:k2014

Effects of Nurse Migration on Healthcare Improvement

There is currently a worldwide nursing shortage; developed countries are facing a nursing staff shortage, with nearly all of the countries relying on nurses from abroad to ease this situation. Nurses are one of the largest sectors of the healthcare workforce, and migration has affected both source and destination countries. Many countries have difficulty achieving a stable supply and demand of nurses because of the constantly changing health care employment needs and competition for recruitment of potential workers (Sherwood, & Shaffer, 2014).

Typically, the nurse migration stream moves primarily from unindustrialized countries to developed countries. With the migration of nurses there is an increase in remittance to the source countries. Unfortunately, however, much of the money is not reinvested into the healthcare system. Although overseas nurses send large sums of funds to their home countries, it was unable to offset the loss of skilled nurses.

Nurses migrating from developing to developed countries are often leaving behind an already deprived health care system. Migration of these nurses from poorer nations causes a malicious cycle in the healthcare system. The undesirable work conditions and low compensation spur health professional immigration to more developed countries (Li, Nie, & Li, 2014).

For those nurses remaining in the public sector the workload dramatically increases, working conditions deteriorate and the level of stress nurses experiences is escalated (Kingma, 2018). With the migration of nurses there is a move of skilled nurses to developed countries leaving behind a brain drain in the country and having less skilled nurses to deliver healthcare. If the healthcare system is to be improved the governing body or policy makers need to put policies in place to address these issues to prevent the negative consequences on the healthcare system and in turn the clients being served by these facilities.

Migration has also increased the challenges associated with the recruitment and retention of health professionals. Shortages have been found to increase workload and therefore burnout among those health workers who remain in the country (Murphy et al., 2016). In developing countries there is also a shortage of supplies needed to provide appropriate healthcare to the larger public accessing care at these facilities. To improve the healthcare system there is a need for multi sectoral collaboration.


Competing interests: No competing interests

03 October 2018
Mickelle N. Emanuel-Frith
Registered Nurse, Midwife, Public Health Nurse
The UWI School of Nursing, Mona
70 Gordon Town Road Kingston 6