A Qualitative Study Exploring Perceptions of Pakistani Nurses about Nursing Workforce Migration: Analysis and Policy Implications

Abstract

Background: The interaction of numerous factors leads to nurse migration. The poor national nurse production rate and the high incidence of migration of Pakistani-Educated nurses are the two main causes of Pakistan's extremely low nurse-to-patient ratio. Objective: This study intends to explore the perceptions of Pakistani nurses about the migration of the nursing workforce. Methods: This qualitative descriptive exploratory study used purposive sampling to conduct semi-structured interviews with three groups of Pakistani-educated nurses: those who have migrated, those who are working professionally and have established their careers in Pakistan, and those who are student nurses pursuing nursing education in Pakistan from January to April 2019. The interviews explored the nurses' perceptions of migration as a nursing workforce. Six analytical methodologies were used to analyse the forty-one IDIs that were performed. Results: Inductive analysis of qualitative data resulted in three main themes and nine sub-themes i.e. motivation for migration, contextual transition, and adaptation to the new environment. These themes were constructed from the image of nursing, work environment, scope of nursing, quality of life, beginning again, obscured individual identity, contrasting healthcare system, capacity building, acclimatization, and settling. Conclusion: We found that Pakistani-educated nurses are highly motivated to migrate. The most frequent causes of nurses' intention to migrate were wage disparities, political upheaval in Pakistan, working circumstances, lack of opportunities for professional development, active recruitment, and personal safety. The findings can inform the policy of professional organizations and government agencies to decrease the brain drain.