Blog post

Does nurse migration lead to deskilling?

Young serious nurse in uniform and protective workwear looking at you through transparent screen

Marta Bivand Erdal and Lubomiła Korzeniewska reflect on the effects of the pandemic on migrant nurses and deskilling.

By Marta Bivand Erdal and Lubomiła Korzeniewska

The pandemic has brought attention to the value and salience of health care workers in new ways. This has been reflected in symbolic gestures of gratitude and recognition of the life-saving work of front-line doctors and nurses combating COVID-19. Our interviews with migrant nurses took place well before the onset of this pandemic, in 2017-2018. In this blog post, we reflect on the ways in which the experience of the pandemic sheds new light on our previous analysis of deskilling in the context of nurse migration.

Deskilling unpacked

In our article, published in Migration Studies (academic.oup.com), we draw on our research on Filipino and Polish nurses’ migration to Norway, which is critically shaped by two different regimes of immigration and authorization, to unpack what deskilling means to nurse migrants.

As EU citizens, Polish nurses can easily access the Norwegian labor market and quickly gain appropriate authorization based on their nursing qualifications obtained in Poland. Filipino nurses, by contrast, find themselves working hard to overcome first, the immigration regime third country nationals face entering the EU/EEA area, and subsequently struggling with the often unclear requirements of the Norwegian nurse authorization system. Based on this radical structural difference, one might anticipate contrasting, rather than similar, experiences between Filipino and Polish nurse migrants (onlinelibrary.wiley.com). Indeed, the structural context matters!

Nevertheless, we also find significant similarities in the experiences of migrant nurses (journals.sagepub.com), namely, that their professional identity as nurses comes under threat. Arguably, professional identities (onlinelibrary.wiley.com), much as identities more generally, are malleable, because identities are dynamic, relational, and processual.

For nurses who leave jobs in Poland as specialized nurses in a hospital to work as nurses in a nursing home in Norway, their sense of professional identity might be affected. Or, when a Filipino nurse migrates to Norway, first as an au pair for few years and later as an auxiliary nurse, due to the lengthy and demanding nurse authorization process, her professional identity as a female skilled worker of color is likely to be affected.

Who defines a nurse?

These examples are drawn from our data with 30 interviews with nurse migrants, defined as migrants who arrived in Norway with a nursing degree from their country of origin, and often with years if not decades of work experience. Our approach to ‘deskilling’ goes beyond the typical examples, whereby a lawyer is washing dishes, a doctor is cleaning floors, or a high school teacher is serving coffee. For the very term ‘deskilling’ is arguably quite crude.

To start with, we might ask who defines what the skill level is? One might assume that’s straightforward, your formal credentials and experience as a professional is unequivocal: so, either you are a nurse, or you are not a nurse. However, the context of international migration – and different national authorization regimes – reveals that this is not so simple at the systemic level.

For the individual, if you are a trained nurse, you are a nurse. But these two views of your skills may not align, although both views are legitimate. Yet, within nation-states, certain professions are defined by labor laws, with clear parameters for qualifications and authorization. This includes modes of translating qualifications between contexts to assess needs for additional, tailored training. In this context, deskilling needs unpacking in order to reveal the underlying processes and to shine a light on opportunities and constraints for re-skilling or up-skilling.

The opportunities of migrants’ skills

Given the demand for health care workers globally, better understanding how we can globally make the best possible use of trained health care workers is of critical concern. National authorization regimes need to be critically scrutinized. Training and qualifications for key professions need to be transparent about their modes of teaching, assessment, and verification of graduates’ competence. We also need to better understand how the individuals who are subjected to these systems think and act – recognizing their agency and resilience in doing so.

The question of deskilling in the context of international migration is broadly related to the ways in which human capital is put to use. Too often, migrants who have skills, education, and professional experience, may not have the knowledge, networks, time, or resources to invest in gaining work commensurate with their skills in the country of settlement. The reasons might be understandable. Migrants work hard to send remittances to ensure decent livelihoods, education, or adequate health care for their loved ones in places of origin.

Simultaneously, countries with significant immigrant populations rarely have a systematic understanding of the skill sets newly arrived migrants possess, unless their entry visas and residence permits are tied to particular jobs. Over time, migrants may work their way to re-skilling and re-entering the professions for which they trained.

However, it seems likely that many may not, and that even those who might want to, may be challenged not just by financial responsibilities both in the country of settlement and transnationally, but also by the very real experience of discrimination in recruitment processes in the labor market. An uphill struggle toward re-skilling or up-skilling may not be the path migrants want to pursue. This is a loss from the best use of human capital perspective that impacts the labor market and the economy, as well as the well-being of individual migrants.

You can also listen to a podcast where Marta Bivand Erdal & Lubomiła Korzeniewska discuss nurse migration in the context of the pandemic, here (open.spotify.com).