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Nursing students intention to work abroad - a public health policy issue in Serbia: Milena Santric-Milicevic

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M Santric-Milicevic, B Matejic, Z Terzic, V Vasic, U Babic, Nursing students intention to work abroad - a public health policy issue in Serbia: Milena Santric-Milicevic, European Journal of Public Health , Volume 24, Issue suppl_2, October 2014, cku161–147, https://doi.org/10.1093/eurpub/cku161.147

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Out-migration of nurses from less developed countries continues to exacerbate. In a country with poor economy and limited job opportunities students’ out-migration is not commonly understood as a problem rather is perceived as a solution for high unemployment of young health professionals. Attainment of a health care system intermediate objectives and goals may be challenged by lasting nurse shortages and inequity in distribution of nursing care. Study objectives were to identify the prevalence of intention to work abroad, to point to the predictors of intention to work abroad and predictors of having a firm plan to leave and work in a foreign country. Total of 719 nurse students attending the final years of state college and specialist studies in school year 2012/2013 voluntarily completed the questionnaire designed with regard to similar surveys carried out in pre EU accession period in Poland. Data were analysed with descriptive and multivariate regression analyses. 69.7% (501) respondents have considered working abroad. Among them majority was college nurses (70%), average age 22 years, females (80%), single (93%), from urban residence, unemployed (80%), with no foreign country’ professional experience, but with a relative or friend abroad. Most respondents speak one foreign language and prefer to work abroad right upon graduation permanently or temporarily. A firm plan to work abroad already had 13% nurses. Single nurses and those friend or relative abroad were more likely to consider working abroad than their counterparts (Odds Ratios were 2.3 and 1.7 respectively). The likelihood to consider working abroad was decreasing by 29% with the improvement in financial situation. Having someone abroad was associated with 4.8 fold higher likelihood for having a firm plan to go. Also associated were previous professional experience in foreign country, and financial improvement (5.4- fold and 2-fold higher likelihood). Serbia has no explicit policy to address nurse out-migration nor nurse student’ intention to leave. The high prevalence of intention to work abroad suggests putting the issue of student’ out-migration on policy agenda. Factors associated to work abroad instead in country are relevant to be understood, analyzed and effectively addressed in a short- and long-term multidimensional approach (labor, education, socioeconomic and health policy).

Key messages

Students consider work abroad in need for better quality of life, better work conditions, and higher salaries. They are ready to leave alone and overcome language and administrative barriers.

Serbian managers’ myopia posees difficulties to plan and maintain “the right number of nurses with the right skills, in the right place at the right time, doing right things … at right costs”.

  • students, nursing
  • public health medicine

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Foreign educated nurses' work experiences and patient safety-A systematic review of qualitative studies

Affiliation.

  • 1 Centre for Women's, Family and Child Health Faculty of Health and Social Sciences University College of Southeast Norway Kongsberg Norway.
  • PMID: 30338091
  • PMCID: PMC6177550
  • DOI: 10.1002/nop2.146

Aim: The aim of this systematic review was to identify the evidence contributed by qualitative research studies of foreign educated nurses' work experiences in a new country and to link the results to patient safety competencies.

Design: A systematic literature review of qualitative studies.

Methods: Electronic searches in the Ovid MEDLINE, Embase, PsycINFO, Cochrane Library and Cinahl databases and additional manual searches in five scientific journals. A content analysis of 17 qualitative articles was conducted.

Results: The analysis revealed one main theme: "Being an outsider at work" and two themes: "Cultural dissonance and Unfamiliar nursing practice. Two sub-themes emerged from the first theme; Loneliness and discrimination" and "Communication barriers". The second theme was based on the following two sub-themes: "Handling work-related stress" and "Role uncertainty and difficulties in decision-making". A better prepared and longer orientation period with continual clinical supervision including systematic reflection on practice experiences is needed to support foreign educated nurses in the transition period and strengthen their Patient Safety Competencies. Nurse Managers have an important role in ensuring the inclusion of foreign educated nurses and providing desirable working conditions.

Keywords: foreign educated nurse; patient safety; transition; work experience.

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In college, I dreamed of having an international career. Several years after my sister ventured off to foreign lands to teach English, I pursued the same route — not as an English teacher but as a nurse. Now it's my sister who is visiting me in a foreign land!

Since the skills and knowledge that U.S.-educated nurses possess are highly regarded internationally, the profession can open doors to a wide array of possibilities for working abroad. The call for nurses is a cry heard from all corners of the globe, from developed nations to the developing world. According to the World Health Organization (WHO), " Nurses are the largest category of health workers. Nursing personnel make up over 50 percent of the health workforce in every country of the world. In many countries in the developing world, more than 80 percent of health workers are nurses .” There is a shortage of millions of healthcare workers, and the demand is projected to double in the next generation. The vast majority of nursing schools are in the U.S. and other Western countries, so there will be a dire need for at least 13 million trained nurses abroad to provide healthcare (with the increase in some countries partly due to the COVID-19 pandemic).

Because of a global nursing shortage and a higher demand for nursing services, healthcare organizations are facing staffing dilemmas that are reaching crisis levels in certain places. Sigma Theta Tau International, the Honor Society of Nursing , a great resource that offers a job board, reports that "countries around the world are facing critical nursing shortages. From North America to Africa and Europe, communities are challenged with growing health care needs and diminishing numbers of nurses.”

Faced with the spiraling labor shortages, healthcare organizations worldwide are scrambling to recruit nurses to fill positions through enticing advertisements in top nursing journals and on nursing websites. Just as the range of opportunities varies from place to place, so do salaries.

In some countries, benefits may outweigh salary. The seven weeks of annual leave provided by many hospitals in England means the chance to travel. It may be more important than salary to determine the most desirable job.

How to Land International Nursing Jobs

The decision to work abroad as a nurse requires intense consideration. While motivation is essential, the more informed you are, your experience will likely be more rewarding.

A review of your reasons for wanting to work abroad will help you narrow your focus and determine which nursing job will meet your objectives. Here are some other considerations when pursuing an overseas nursing job. • Your Nursing Experience You will likely receive a job offer based on your previous career history. Later, once you work in an organization for a while, you can expand your nursing skills and knowledge by pursuing another nursing job. A Canadian nurse who has worked in the U.S. and, most recently, in Saudi Arabia was hired to work on a renal transplant unit in a Riyadh hospital. She soon landed a job as a private-duty nurse, providing care to a member of the Saudi royal family at home and even traveling with the family abroad. • Your Knowledge of the Language Communication plays a vital role in the provision of healthcare. To effectively care for patients and practice safely, you should acquire a basic knowledge of the language of the country where you will be working. As native speakers of English, American nurses may restrict their search for jobs in countries where English is the primary language. However, please consider other locations where healthcare organizations may use English as their official language. Certain hospitals in the Middle East require that the staff speak English and all documentation is in English. Basic knowledge of the country's language is helpful when providing care to non-English speaking patients and interacting with local staff. At least learn conversational expressions and a list of standard medical terms. While the hospital may offer language classes and provide translators to aid communication, you should understand the language before and during your time overseas to fully appreciate the experience personally and professionally. Also, remember that while many speak English in other countries, terminology may vary. For example, in the U.K., head nurses are referred to as “sisters,” the operating room is called “the theater,” and the emergency room is known as “the accident and casualty department.” • Using Healthcare Recruiters Intermediaries, generally known as healthcare recruiters, specialize in recruiting healthcare professionals on behalf of employers. They advertise in nursing journals and on the Web. Recruiters can assist you with all the details that will enable you to work abroad as a nurse and advise you regarding banking, housing, and other important issues in preparation for your move overseas. You can also answer advertisements and approach potential employers directly once you have obtained the necessary documentation regarding nursing registration from the country where you would like to work (see Nursing Registration below). While recruiters play a vital part in certain situations, such as finding jobs in developing nations or major cities, remember that many healthcare facilities in smaller locations outside metropolitan areas may only sometimes utilize their services. Whatever route you take in your job search, doing homework is the best policy. • Registration You will need an appropriate work visa for the country where you plan to work. In most cases, the hiring organization obtains visas for nurses. The issuance of such work permits can take days to months, depending on the country, so plan to wait in some cases. Nurses also must provide proof of licensure to practice their profession. Where you are planning to work will determine whether you need to register your nursing qualifications before you can look for a job. To practice nursing in the U.K., for example, an overseas nurse must apply to the Nursing and Midwifery Council (NMC) for a British nursing license (see below). Depending on the licensing board, the process may take weeks to several months from the initial request to the final outcome. In countries where a system of nurse registration still needs to be established, you will need to provide proof of your nursing licensure from the U.S. The code of professional conduct you follow in the state where you are licensed must continue while working overseas.

If you want to work abroad as a nurse, there is no better time than now. With thorough research, an open mind, and a sense of adventure, you can easily achieve your international career goals.

CAROLINE A. POLT, RN , whose home is in Philadelphia, PA, currently works as a nurse in England.

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Working overseas

This is a guide for RCN members considering working overseas - whether in paid employment or as a volunteer. It covers topics such as research, language, qualification and registration requirements, attending interviews and what to consider before accepting a job offer. 

Do your research 

Check with the  International Council for Nurses  (ICN) and the specific nurses' association in the country where you intend to work for information on the minimum requirements and regulatory framework in place.

Obtain background information on nursing and health care in overseas countries. Learn about the culture, religious beliefs and laws of the country that you are travelling to. This will help prepare you for differences of culture and legislation, minimising the risk of you running into difficulties during your stay.

If you're interested in working within the European Union or European Economic Area, go to  www.europa.eu  where you'll find information on living and working in the EU/EEA.  

Country profiles can also be found at the  Foreign, Commonwealth & Development Office  (FCDO) and the  World Health Organisation

Carry out a 'working overseas'  literature search  of the RCN's Library of eBooks and eJournals.

Communication plays a key role in the provision of health care. To effectively care for patients and practice safely, you should check if you need a basic knowledge of the language of the country where you will be working or if there will be an interpretation service available to you.

Some 'British' and 'American' hospitals abroad welcome applications for employment from UK-trained nurses and midwives. However, the working language of these hospitals is generally the language of the country in which they are located (except in the case of British Military hospitals which have their own nursing staff).

Qualifications and experience

The UK nursing qualification which is generally transferable in every other country is the 'Registered Nurse: Adult'. Not all countries have equivalents to the UK qualifications in mental health, learning disability, children’s nursing, health visiting and the enrolled nurse. If there is no equivalent to your nursing qualification in the country you would like to visit then you will not be able to work there as a qualified nurse. Please check the full qualification requirements for your chosen country with that country's regulatory body (see useful information below).

There is no formal mechanism for recognising UK post-registration qualifications such as, for example, intensive care nursing but employers may take them into account.

Overseas employers and recruitment companies will be specific about the experience and qualifications required for a particular role (whether paid employment or voluntary work).

The Nursing and Midwifery Council (NMC) has some really useful information on the portability of qualifications overseas, both inside the EU and outside the EU.

Many countries/employers have specific requirements around previous experience. For example, employers in the Middle East usually require at least two years’ post-registration experience for nursing roles. Voluntary Service Overseas (VSO) outline different experience requirements for a range of voluntary opportunities in health care - not all of which require NMC registration.

It is in your own best interests to gain at least six months to one year's experience in the UK after registration before working abroad as a nurse. It will be an opportunity to consolidate your pre-registration education, access preceptorship and make the transition from being a student to being a registered accountable practitioner. A prospective overseas employer will be able to request a reference relating to your ability as a qualified nurse. It will also be easier for you to provide references to overseas employers if you already have experience.

Professional registration

Most countries have their own nurse registration or licensing authorities. The NMC advises that you should always register with the appropriate regulator in the country in which you are practising.

European Union

Information about the impact of Brexit can be found on the NMC website .

Outside the EU

Nurse registration processes vary enormously from country to country and can be lengthy and time-consuming. The process may involve passing an examination or assessment, i.e. submitting an application including records of your nursing education and qualifications. For example, you will have to pass the English language proficiency test to register to work in Australia.

You may find that your nursing education does not fully meet the requirements of the nurse registration authority in the country where you wish to work. Making up this shortfall requires negotiation by an individual nurse with a UK university. These programmes are not universally available in all universities and courses may incur a fee. You would also normally be expected to complete the course in your own time, so use annual leave or negotiate unpaid leave for this.

Nurse registration authorities in other countries may require transcripts of your training and proof ('verification') of current NMC registration. Please contact the registering body directly for more information about their registration process. 

The NMC can provide verification of registration via NMC Online . If the verification requires translation you will be responsible for arranging this.  

In addition to your verification of registration, you may also need a transcript of your training. Please contact the organisation where you completed your training for this.

Finding a job

You can find vacancies through advertisements in nursing journals such as Nursing Standard and Nursing Times. These vacancies are placed by overseas employers or their recruiting agencies. Some countries regularly run recruitment events in the UK. To subscribe to the Nursing Standard log on to  www.nursing-standard.co.uk . 

Overseas employers or recruitment agents often have detailed procedures for processing your application, interviewing you and making arrangements for you to take up your post. It is still your responsibility to:

  • find out all you need to know in order to decide whether you want the job
  • assess whether you are competent to do it
  • confirm that you meet the legal requirements involved such as work permits and registration as a nurse in the host country.

If you decide to send speculative letters enquiring about work overseas you will need to prepare a detailed  curriculum vitae (CV)  that can easily be understood by someone unfamiliar with UK nursing qualifications, scope of practice and abbreviations. Our careers service can only offer personalised feedback on CVs if you are planning on working in the UK.

Your covering letter will need to make it clear whether you need the employer to obtain a work permit on your behalf.

An interview for work abroad may be very different to interviews for work in your own country. A thorough interviewer will look for evidence that you have the personal qualities needed to cope with and successfully complete work in a foreign country, perhaps working in a foreign language. If the interview is successful, an informal job offer may be made to you. Responsible employers and recruiters will give you time to consider before making a definite commitment. The employment contract checklist below in this guide will help you to evaluate job offers and contracts of employment.

Take at least 24 hours to reflect on the offer before you accept it - take your time to research the country, check your contract and ensure that you are happy with the details.

Taxation and salary deductions

As taxation is a complicated matter you should seek professional advice about your obligations at home and abroad. Contact  Her Majesty's Revenue and Customs  for further information.

Please note: if you are not paying UK tax whilst abroad you cannot claim tax relief on your RCN subscription during this time.

Visas and work permits

You should always check visa requirements when planning to undertake work abroad. This is a complicated issue which varies from country to country. Further information can be found at  www.gov.uk/foreign-travel-advice .

Work permits are usually obtained by the employer from the immigration authorities of the host country. Where work permits are a requirement, you will be unable to take up paid employment in that country if you cannot find an employer who is able to obtain a work permit for you.

Employment contracts: a checklist

This checklist may help you evaluate the contents of any contract of employment (or contract for voluntary work) before committing yourself. You must also ensure that any agreements made between you and the prospective employer/recruiter are confirmed in writing.

  • Never sign a contract until all the blank spaces have been completed.
  • Never sign a contract that is in a foreign language that you do not understand.
  • Never place any reliance on verbal promises. How would you be able to prove the commitment later?
  • Always ask for copies of any documents referred to within the contract and ensure that you understand these before agreeing.

1. Pre-employment agreement

You may be asked to sign a document which covers the period between accepting the job offer in the UK and taking up employment in the host country. It may commit the employer or recruiter to providing a language or examination revision course, facilitating your application to take an examination, or even paying for you to fly abroad to take the examination. In addition, it usually includes details of any financial penalty you would incur if you withdrew your application.

Think carefully before you commit yourself, as it may be expensive to change your mind later. Be clear about the kind of post you would be willing to accept and the length of time you are willing to wait for a placement. Please ensure that all of this information is contained within the pre-employment agreement.

2. Job description

The job description should be detailed enough to give you a good idea of what the job involves.

Your nursing education and experience to date should have provided you with the necessary knowledge to undertake the role. If not, will this be covered in any orientation/induction programme?

3. Orientation/induction programme

This is a crucial part of any overseas post and should include information about the new workplace, the whole health care system and nursing practices within the country.

You should ask for written confirmation of the following:

  • How long will the induction last?
  • Does it include training in tasks which you may not have done before?
  • Will you be on full pay during the programme and is the programme included in the time period of your contract.

4. Probationary period

  • Is there a probationary period?
  • What support will you get?
  • How do the termination of contract arrangements differ during this period?
  • Does the employer have the right to terminate the contract without any reason and with immediate effect during this time? If so, would you still be entitled to benefits such as a paid flight home?

5. Premature termination of the contract

  • If you terminate your contract early then you may face a penalty such as having to pay for your own flight home or having to reimburse the employer/recruiter for your outward airfare. Under these circumstances, would your employer give you a reference and would you be given a copy of the reference for your records?
  • Does the contract state the nursing specialty and site you will be working in?
  • Does the contract allow the employer to change this without your agreement? Could you be required to work for the employer in any part of the host country?

7. Salaries (if applicable)

  • Will you be paid the same salary as a nurse originating from the host country?
  • Is the salary you have been offered on a scale or is it a fixed salary?
  • What will your net salary be?
  • Where will the salary be paid - in the UK, host country or part in both? If you intend to send money back to the UK on a regular basis e.g. to meet mortgage repayments, remember that currency fluctuations could affect the amount of sterling you receive.

8. Hours of work and overtime

  • The exact hours of work should be written into your contract. The working week is longer than 37.5 hours in many countries.
  • Does the contract state that you may be asked to do overtime?
  • What shift pattern will you work and does it include breaks?

9. Annual leave and time off

  • Annual leave entitlement varies widely from country to country and may be much less than you have been used to. Public holidays may or may not be included
  • Will you be allowed to take your annual leave when you want, or do you have to take it after a waiting period (common in Australia) or at the end of your contract? Are you entitled to emergency or compassionate leave?

10. Length of contract

  • The commencement and termination date should be clearly stated on the contract. If you are signing a standard contract for permanent employment used by the host country employer, there may be no termination date. In this situation the termination date of your work permit would apply.
  • Is there a possibility of renewing the contract if both sides wish to do this? Would this involve a change of work permit? Would an increase of salary be offered?

11. Health care and health insurance

  • Does the employer/recruiter provide you with private health insurance as part of the employment package? If not, will you be required to arrange your own? How much does this cost?
  • Is a UK passport holder entitled to use the public health service on the same terms as residents of the country?
  • Does your health insurance cover the cost of repatriating you to the UK if necessary and who decides whether this is necessary?
  • Consider taking out personal injury accident insurance subject to the conditions of cover being applicable to your working situation.

12. Professional indemnity

Members who undertake overseas work should ensure that they have adequate indemnity and insurance cover. 

Please see our Indemnity scheme terms and conditions  for more information. 

The RCN scheme does cover the overseas work of volunteers in certain countries to the extent that a clinical negligence claim might be brought against them.

However, there are other considerations about how a volunteer is supported, particularly if working in a dangerous environment. Any member considering volunteering should give careful thought as to what will happen if they need support with their own health whilst overseas, for example. Volunteers can be given support from organisations that arrange volunteer activity.

If you are involved in an incident overseas that you think might lead to a patient or colleague making a claim against you, you must contact us as soon as possible. You must never admit responsibility for an incident or submit a written statement about it until we have agreed for you to do so.

13. Other considerations:

You should also check your contract for the following:

  • sickness policy and entitlement
  • grievance/disciplinary procedures and trade union representation
  • language training
  • accommodation
  • transportation for work
  • responsibility of costs of the return airfare from the UK to the host country
  • overseas employment contracts are usually interpreted according to the laws of the host country

Finally, look into the cost of living in that country and the  laws of the host country beforehand.

Joining a union and/or nursing association

The RCN is not a trade union outside of the UK, Channel Islands and Isle of Man and we do not have representatives in other countries. Although we may be able to provide general advice to help you deal with an employment problem we are unable to offer formal advice or representation for matters arising in your host country. Please note UK law is applicable in the UK only and you will be bound by the laws of your chosen country.

We strongly recommend   that you join a trade union or professional association as soon as you arrive in your chosen country just in case you require employment relations or legal advice. Employees of the UK armed forces are not permitted to join a trade union but may join a professional association such as the RCN.

Contact details of national nurses' associations which are members of the International Council (ICN) can be obtained from the  ICN website .

If you choose not to become a member of a trade union or professional association and you subsequently need legal or employment relations support you should contact the national nurses' association of that country. They may be able to help or recommend an organisation that can. Please be aware that not all organisations will be able to provide advice and support if you were not in membership at the time of the incident for which you require support.

The RCN is able to offer support to members working for Soldiers, Sailors, Airmen and Families Association (SSAFA) working within military establishments in Europe. SSAFA recognises the RCN as a trade union. If you require employment advice, please contact us.

If you wish to maintain your RCN membership you will continue to have access to number of member benefits, for example:

The best method of paying your RCN subscription while abroad is via direct debit from your UK bank account. You can also make an annual payment by credit card.

Personal safety and wellbeing

More information is available in our Wellbeing, Self Care and Resilience subject guide and on our Health, safety and wellbeing  page. 

If you are currently taking any medication it is useful to check the government website for information on what you need to do when abroad .

Ensure that you are following the guidance in relation to COVID-19 – both in the country you are travelling to and upon your return to the UK. Guidance in this area often changes at short notice so it is important update yourself regularly.

Conflict zones

Conditions may be physically stressful and emotionally overwhelming. Expect long working days, the strain of working with people who are traumatized, and insufficient supplies. Make sure you are taking care of your emotional and physical health too.

Ukraine crisis

The best way to support ukrainians.

The best way to help Ukrainians is to donate directly to credible international and Ukrainian organisations that are working around the clock to help those displaced by the conflict. For primary care professionals looking at how to meet the health needs of patients from Ukraine, we recommend reading Arrivals from Ukraine: advice for primary care .

Managing stress during the crisis

As a health care professional, you may already experience burnout from COVID-19 and the demands a two-year-long pandemic has placed on you, your family, and your colleagues. It's tempting to "doomscroll" through bad news or feel guilty about working in relative comfort while nursing colleagues and civilians in Ukraine are suffering.

Instead, focus on what you can do. For example, donating now or in the future. Remember, that you can help spread the word and encourage others to donate time or money in support of Ukraine. Above all, take care of yourself so that you can continue taking care of others.

Volunteering in Ukraine

There are currently limited options for volunteering in Ukraine. There are some organisations in surrounding countries where you may find options. You may also want to investigate what your employer is doing.

Please be sure to reach out to these organisations directly to get the most up-to-date information on volunteering before you decide to travel. 

Be sure to verify any organisation, especially ones you aren't already familiar with. Unfortunately, while human suffering like the humanitarian crisis in Ukraine can elicit profound compassion and the desire to help, it also attracts scammers who prey on this.

The FCDO advise against all travel to Ukraine. For up-to-date information please visit the FCDO website .

NMC revalidation and working overseas

 Revalidation with the NMC applies to all nurses and midwives, regardless of the role or sector in which they are operating and across all fields of practice.

If you are a nurse or midwife practising overseas and want to maintain your UK registration, you will have to comply with the revalidation process  every three years and continue to pay your annual retention fee to the NMC. 

If you are working overseas (or have worked overseas for part of your three year renewal period) as a nurse or midwife you can meet the practice hours on the basis of your registration with the NMC. The NMC advises that you should always register with the appropriate regulator in the country in which you are practising.

If you work wholly overseas you can seek confirmation from your line manager where you undertake your work. If you do not have a line manager, you will need to decide who is best placed to provide your confirmation. The NMC advises that wherever possible your confirmer is a nurse or midwife regulated where you practise, or another regulated healthcare professional. The  NMC online confirmation tool  provides further guidance about who can act as your confirmer.

If you are asked to provide ‘verification’ information to support your revalidation application, in relation to practice hours you need to provide information about whether you are registered with the appropriate regulating body.

It is important that the NMC has an up to date address for you and you should  register with NMC online  to ensure that you know your revalidation date and that the NMC can send you relevant information.

More information is available from the NMC on ' How to revalidate '.

Pensions and wills

Nurses in the NHS pension scheme who leave the scheme may have their pension benefits frozen. If you are moving to a new non-NHS employer, whether in the UK or abroad, you should seek independent advice as to whether you are able to transfer your membership into your new employer’s scheme.

Contact the relevant NHS pension agency for further details about the options available as follows:

England and Wales: NHS Business Services Authority  www.nhsbsa.nhs.uk

Northern Ireland: Health and Social Care Northern Ireland  www.hscni.net

Scotland: Scottish Public Pensions Agency  www.sppa.gov.uk

For further information, or if you have a non-NHS pension please go to:

The Pension Service

The Pensions Advisory Service

The Pensions Regulator

Quilter Financial Advisers can provide free financial advice to members planning employment abroad. This is particularly useful if you have financial commitments in the UK such as a mortgage, pension, savings plan etc.

It is a good idea to make a will particularly if you have dependants and financial commitments. The legal situation is very complicated if a person dies overseas without having made a will. You could take advantage of the RCN’s will writing service. For further information, please see our will writing  page.

Returning to the UK

Your nursing career is a long-term investment. We recommend that you plan your return to practice in the UK before you leave. You will need to consider how to present your overseas experience in a positive light to UK employers and to demonstrate that you are broadly in touch with general developments in nursing and health care in the UK. The RCN has a number of resources which may help you when you return to the UK. These include:

  • RCN careers service **
  • RCN jobs bulletin
  • The Nursing Standard
  • RCN Agenda for Change advice guide
  • RCN Contract advice guide

Add any qualifications you have obtained overseas both to your CV and your personal professional portfolio. If you have completed education equivalent to a qualification for another part of the register (for example, as a midwife) you may apply to the NMC to have the qualification registered. Your application may be assessed through the 'overseas' route and compared to the UK course and you might be required to undertake supplementary training in the UK. When you return to the UK and are planning further study, you may be able to obtain credit for this study through schemes such as Assessment of Prior Learning (APL) and Assessment of Prior Experiential Learning (APEL). General information concerning APL/APEL is available from  UCAS .

The NMC is not involved with recognition of academic qualifications such as first or higher degrees. You can check the comparability of degrees obtained overseas with UK ENIC - the UK National Information Centre for the recognition and evaluation of international qualifications and skills.

**Please note: the Careers service can only check CVs for members working within the UK and are unable to provide advice about working overseas.

Useful contacts for popular destinations

The NMC have published some guidance regarding nurses who are or who may want to work in the EU following Brexit.

You can contact these organisations directly for advice:

Working outside the EU

Australian Nursing & Midwifery Council

Australian Nursing Council

Australian High Commission

British High Commission Canberra

Ministry of Health

Bahrain Embassy

British Embassy Bahrain

Canadian Nurses Association

Canadian High Commission

British High Commission

College of Nursing Hong Kong

Nursing Council of Hong Kong

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International Travel Nursing: How to Work Abroad as a Nurse

Written by: university of tulsa   •  jan 22, 2024.

A nurse smiling and holding a tablet in a medical facility.

International Travel Nursing: How to Work Abroad as a Nurse                                                 ¶

Offering care that improves patient outcomes is a global health care goal, but it can be difficult to achieve. A worldwide nursing shortage has left care facilities in need of skilled, qualified nurses who can help them meet their goals. The shortage provides unique opportunities for those interested in travel nursing to take their expertise abroad.

International travel nursing provides advanced professional nurses the ability to deliver care where it’s most needed around the globe. It also enables them to see the world, a view that can make the role even more satisfying. Those interested in the role should be prepared to add a few extra steps to their advanced nursing journey.

The International Demand for Nurses  ¶

The nursing shortage is a growing issue across the globe. Domestically, the supply of registered nurses (RNs) dropped by more than 100,000 in 2021 , according to a Health Affairs study. This represented the largest drop in the field in four decades. 

The shortage also carries a global impact. In 2020 — the beginning of the COVID-19 pandemic — the World Health Organization (WHO) set the estimated need for nurses around the globe at 7.07 million . One year later, data gathered by the International Council of Nurses (ICN) suggested that this need would climb to almost 13 million worldwide by 2030. 

The shortage correlates with poor economic development. According to an ICN policy brief, 89% of nursing shortages are generated from low-income and low- to middle-income countries. The brief also noted the impact of an aging nursing workforce relating to the shortage, as 1 in 6 nurses worldwide is projected to retire by 2030.

The data represents not only the global need but also potentially abundant opportunities for those seeking to advance their careers as travel nurses. A qualified nurse with the right credentials can also pursue a role in international travel nursing and deliver holistic patient care to places in the world where their services are needed.

An international travel nurse can help ease the stress of long-term nursing shortages, but they can also travel to places that need nurses due to sudden or unexpected circumstances, such as a disease outbreak or a natural disaster. Exposure to different countries and cultures can help these nurses enhance their skill sets in unique ways, such as learning about a new medical technique or picking up a new language. 

Additionally, international travel nurses get to see the world through their work. This can make the job personally enriching for individuals interested in exploring the globe and experiencing different cultures, customs, and traditions.

Several other benefits are associated with international travel nursing. These additional benefits include gaining hands-on experience with treating issues uncommon in the U.S., gaining exposure to different work environments and treatment strategies, and gaining exposure to patients with diverse cultural backgrounds. 

Becoming an international travel nurse isn’t for everyone. The role requires flexibility and a willingness to adjust to the differences that may exist within different countries, such as unfamiliar facilities or societal health care norms. For some, these differences may make the role uniquely enticing and an ideal career choice.

How to Work Abroad as a Nurse  ¶

Becoming an international travel nurse is a complex process. The journey involves several steps typically associated with becoming a nursing professional. It also involves unique steps designed to allow nurses to be eligible and fully prepared to travel abroad and provide nursing services. Those interested in the career must fully understand how to work abroad as a nurse before embarking on this journey, as failure to do so may disrupt the process.

Step 1: Earn a Nursing Degree            ¶

As is the case with any advanced nursing career, the first step to becoming an international travel nurse is to earn a nursing degree . This allows nurses to develop the foundational knowledge and skills needed to perform the essential patient care tasks that they may face while working abroad.

While earning a Bachelor of Science in Nursing (BSN) is the educational benchmark for an international travel nurse, earning an advanced nursing degree, such as a Master of Science in Nursing (MSN) can further fortify a nurse’s acumen. This may make them even better prepared for the unique challenges of international travel nursing. 

Step 2: Pass the NCLEX-RN Exam             ¶

Individuals with a nursing degree must pass the National Council Licensure Exam for Registered Nurses (NCLEX-RN) before they’re allowed to practice nursing as an RN. The exam is intended to ensure that nurses are fully prepared to put their knowledge into practice in a real-world environment. In addition to this exam, nurses may need to meet the requirements of the state where they intend to work.

Step 3: Gain Experience            ¶

RNs must typically have at least two years of clinical experience before they can become an international travel nurse. The experience allows nurses to not only develop their skills individually or with nursing mentors but also pursue a specialty within the nursing field, which is usually required for the profession. Common specialties include pediatric nursing, surgical nursing, intensive care nursing, and emergency room nursing.

Step 4: Obtain Additional Credentials             ¶

International travel nurses often must carry credentials beyond licensing that can transfer from state to state. The credentials can include a valid passport, a work visa, up-to-date vaccinations, and a language test. Nurses need to double-check the requirements of any prospective country before pursuing nursing opportunities there.

Tips for Prospective Travel Nurses  ¶

Finding work in international travel nursing can be a daunting task. Fortunately, plenty of tips and resources are available to make the process easier for nurses to navigate.

Using an International Nursing Recruiting Agency          ¶

Travel nurse agencies are staffing organizations designed to connect travel nurses with international employment opportunities. The opportunities are based on experience and whether credentials align with a country’s guidelines, among other key metrics. Several agencies may also require candidates to have a minimal understanding of the assigned country’s language.

Some agencies may provide free housing for the duration of the assignment. Other agencies may provide a stipend to cover travel and housing costs for the opportunity. Typically, assignments last between two and six months.

An individual can connect with an international nursing recruiting agency in several ways, including the following:

  • Lead websites. Lead websites enable nurses to provide key professional and contact information to various nursing agencies at once.
  • Rating services. Rating services provide feedback from peers in the field regarding their agency experiences, giving deeper insight into an organization’s operations.
  • Networking websites. Networking websites allow nurses to directly connect with agencies. This can lead to referrals or connections to agency recruiters.
  • Peer referral. Peer referral requires nurses to correspond with networked colleagues to ask them directly about their agency experiences.

Tips for Success       ¶

Before using a staffing agency to land an international travel nursing position, individuals must be aware of a few things to make the process efficient. These will not only streamline the potential opportunities but also allow them to confirm whether the opportunity is an ideal fit for them.

  • Ensure proper licensing. Nurses should double-check that their licensing and credentials satisfy the country offering the position. These opportunities are only available for nurses with the correct credentials.
  • Learn the requirements. In addition to having travel documents, such as passports and visas, some countries may require other documents for travel nurses. These can include birth certificates, work permits, and professional sponsorships. Some jobs may also require certification in a nursing specialty.
  • Understand logistics and budgeting. Nurses should be aware of assignment length to properly plan for consistent work opportunities while minimizing lengthy unemployment gaps. They must also analyze the economics of each assignment to ensure that the salary is satisfactory, that they’re properly prepared for taxes and exchange rates, and that they can comfortably handle expenses like housing and food.
  • Weigh the pros and cons. Examine the advantages of each potential opportunity and weigh them against the potential challenges. If the challenges outweigh the advantages, it may be wise to pass on the opportunity.
  • Explore multiple opportunities. Seeking details on a wide range of potential travel jobs can allow nurses to find a travel role that best suits their knowledge and skills. It can also prevent individuals from merely settling for pursuing the first ill-fitting role or two they encounter.

Resources  ¶

Here are some resources for prospective travel nurses.            

  • Health Carousel : This travel nurse job board provides a host of tips for first-time travel nurses. The tips highlight assignment preparation and strategies to succeed within the new work environment. 
  • Verywell Health : This medical website provides a curated resource list for the top travel nursing services as of 2023. The list is based on metrics such as best track record, best benefits, best job board, and so forth.
  • LeaderStat : This health care job site provides a checklist covering documentation commonly associated with travel nursing. It also highlights other requirements that may be associated with certain assignments, such as physical exams.
  • CollectivCare : This travel nurse-focused website features resources for mobile apps designed to help travel nurses stay organized and efficient while abroad. The apps can also help travel nurses integrate with new surroundings both foreign and domestic.
  • Travel Nursing Central : This travel nurse review website has a list of foreign nursing boards that can provide further information on travel nurse requirements by country. It also provides tips on travel nurse preparation and cultural traditions.

Deliver Care Around the World ¶

International travel nursing provides professionals with unique opportunities to explore the world, learn new care techniques, and expand their knowledge. More importantly, the work of these nursing professionals makes the delivery of quality patient care possible. This level of care can have a positive impact on other people’s lives, making the role of the international travel nurse one of the most satisfying professions the health care field has to offer.

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What to Know About Working as an International Travel Nurse

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As countries across the world experience nursing shortages, international nursing job opportunities will continue to expand. According to The World Health Organization (WHO), one in eight nurses finds employment in a country other than the one where they were born or received training. The field of international travel nursing provides opportunities for nurses to see the world while using their training to help others.

If you are a current or aspiring nurse, international travel nursing can offer you competitive salaries and benefits working in a variety of clinical experiences with diverse populations. Learn more about international travel nursing, how to prepare for and find jobs, and what countries offer the highest pay.

International Travel Nursing At a Glance

What is international travel nursing.

Registered nurses (RNs) from various clinical backgrounds and specialties can find well-paid positions as international travel nurses in settings throughout the world. Rather than apply directly to overseas medical facilities, they find placements by working with recruiters from independent staffing agencies.

The recruiter finds the best placement based on skills, prior work experience, and preferred destinations. Once the nurse agrees to commit to the placement, the agency arranges the salary and benefits package. Depending on the contract, benefits include housing stipends, direct deposit and currency transfer fees, referral bonuses, meal or travel reimbursements, and paid time off.

While travel nurses working in the U.S. usually take assignments that last six months or less, international travel nursing jobs require longer commitments. International nursing jobs in Europe and Australia require nurses to work at least a year. Nurses placed in Middle Eastern countries often take contracts that last a minimum of two years.

Several organizations, including the Red Cross, United Planet, Project Hope, and International Volunteer HQ, offer volunteer opportunities in international nursing . While these travel nurses do not earn a salary, they gain valuable experience while providing essential healthcare services to people who may not otherwise have access. These international nursing volunteers take on crucial roles during public health emergencies and natural disasters as part of medical relief teams.

The duties of an international travel nurse are as varied as the destinations where they work. They provide services to patient populations from infancy through old age. Depending on the setting, they may have the same responsibilities as American RNs e.g., performing tests, administering medications and vaccinations, monitoring vital signs, and compiling reports.

Because international nurses work in an array of environments, from well-equipped modern hospital facilities to rudimentary clinics in underserved, remote communities, their responsibilities depend on the needs of the patients in these settings. Those who work in emergency or epidemic situations must adjust to rapidly changing and stressful conditions.

Work Environment

International travel nurses will find employment anywhere experiencing nursing shortages. These nurses work in urban and rural areas, in hospitals, doctors’ offices, outpatient care centers, and community clinics. Nurses with surgical, intensive care, emergency room, and labor and delivery specialties are in particularly high demand. Staffing agencies work with nurses to find placements that best fit their training and interests.

Which Countries Need International Travel Nurses?

Nursing shortages are a global phenomenon. According to the WHO’s 2020 State of the World’s Nursing Report , nurses make up the largest occupational group in the healthcare industry, accounting for 59% of all health professionals. The global nursing shortfall had grown to almost six million, even before the onset of the COVID-19 pandemic. These shortages have been driven by several trends, including the decline in the number of nurses entering the profession, retirements, and increasing demands for healthcare from the growing world population.

The opportunities for U.S. trained nurses to work overseas have never been better. International nursing jobs run the gamut from well-paying clinical positions at state-of-the-art facilities in modern urban areas to remote clinics or refugee camps in developing nations.

Low and lower middle-income countries in Africa, Southeast Asia, the Eastern Mediterranean region, and parts of Latin America experience the most severe nursing shortages. Among the more affluent nations, the United Kingdom, Canada, Australia, New Zealand, and the United Arab Emirates face the highest need for nurses.

How Much Do International Travel Nurses Make?

While international travel nurses typically earn more than full-time RN staff, salary ranges vary significantly based on education and skill levels, specialties, years of experience, and placement location. According to the online employment service ZipRecruiter , the majority of international travel nurses earn between $60,500 and $106,000. Each travel nurse agency handles compensation differently. Some offer housing and travel benefits as part of the contract while others provide nurses with stipends to make their own arrangements.

RNs should consider several factors when searching for international travel nurse jobs. While some countries may not match U.S. salary levels, they offer a lower cost of living, making essentials like housing, food, and utilities more affordable. Middle Eastern nations like Saudi Arabia and the United Arab Emirates offer the most attractive compensation packages that include tax-free salaries, free air travel, free furnished housing, and 30-day annual vacations.

The Benefits of Becoming an International Travel Nurse

RNs choose international travel nursing for several reasons, including the chance to travel the world, earn top salaries, expand their careers, or serve others in high-need regions. International travel nurses often cite these professional and personal benefits:

How To Become an International Travel Nurse

International travel nurses follow the same educational pathway as nurses preparing for careers as staff RNs in the U.S. Although each country or employer may have specific requirements for a preferred degree, specialty area, and years of experience, travel agencies typically recruit nurses who hold an undergraduate nursing degree and have passed the NCLEX-RN examination.

While licensed practical nurses and RNs with an associate degree may find international positions, most travel agencies represent overseas employers who strongly prefer BSN degree-holders with a valid RN license. Nurses should also have certification in Basic Life Support and Advanced Cardiac Life Support. Most agencies require applicants who have completed at least one year of clinical experience .

While not required for all international nursing jobs, specialized certifications in high-demand areas such as labor and delivery, intensive care, and emergency medicine may lead to better-paid placements.

Working as an International Travel Nurse

​​In addition to completing a nursing degree and obtaining a valid RN license, international travel nurses will need to acquire additional credentials to work abroad.

Nurses need to have a valid passport and work with their travel agency to find out about work permits, visas, and other forms of sponsorship required by the country where they intend to work. Overseas employers may request birth certificates, immunization records, criminal background checks, and transcripts that verify educational qualifications. Gathering the necessary documentation may take several months.

Nurses must have a basic knowledge of a country’s language to provide patient care and communicate with staff. Most placements require international travel nurses to demonstrate a working knowledge or conversational ability in the country’s primary language.

Some employers may require nurses to take a test to verify their language ability. Many English-speaking countries like Canada and the United Kingdom require work visa applicants to take an English-language test to demonstrate their fluency, even if English is their native tongue.

English-speaking travel nurses sometimes get around the language barriers by restricting their employment choices to English-speaking countries or international healthcare organizations that have adopted English as their official language. Certain facilities in the Middle East, for example, require English as the work language for all staff and for all medical documentation.

International travel nursing jobs can offer tremendous personal, professional, and financial rewards, but the process requires research and planning. The most successful international travel nurses have invested the time to learn as much as possible about qualifications, how to choose a travel agency, and what to expect when working abroad.

Reviewed by:

Portrait of Brandy Gleason, MSN, MHA, BC-NC

Brandy Gleason, MSN, MHA, BC-NC

Brandy Gleason, MSN, MHA, BC-NC, is a nursing professional with nearly 20 years of varied nursing experience. Gleason currently teaches as an assistant professor of nursing within a prelicensure nursing program and coaches graduate students. Her passion and area of research centers around coaching nurses and nursing students to build resilience and avoid burnout.

Gleason is a paid member of our Healthcare Review Partner Network. Learn more about our review partners here .

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  • v.42(3 Pt 2); 2007 Jun

Nurse Migration from a Source Country Perspective: Philippine Country Case Study

To describe nurse migration patterns in the Philippines and their benefits and costs.

Principal Findings

The Philippines is a job-scarce environment and, even for those with jobs in the health care sector, poor working conditions often motivate nurses to seek employment overseas. The country has also become dependent on labor migration to ease the tight domestic labor market. National opinion has generally focused on the improved quality of life for individual migrants and their families, and on the benefits of remittances to the nation. However, a shortage of highly skilled nurses and the massive retraining of physicians to become nurses elsewhere has created severe problems for the Filipino health system, including the closure of many hospitals. As a result, policy makers are debating the need for new policies to manage migration such that benefits are also returned to the educational institutions and hospitals that are producing the emigrant nurses.

Conclusions and Recommendations

There is new interest in the Philippines in identifying ways to mitigate the costs to the health system of nurse emigration. Many of the policy options being debated involve collaboration with those countries recruiting Filipino nurses. Bilateral agreements are essential for managing migration in such a way that both sending and receiving countries derive benefit from the exchange.

This case study provides information on Philippine nurse migration patterns and presents a sending-country perspective on the benefits and costs of this phenomenon. Our aim is to identify strategies that will ensure that international nurse migration is beneficial for both sending and receiving countries.

The Philippines is the largest exporter of nurses worldwide. For many decades, the country has consistently supplied nurses to the United States and Saudi Arabia. In recent years, other markets have emerged and opened for nurses including the United Kingdom, the Netherlands, and Ireland. This case study synthesizes existing information and reports on new findings to establish the magnitude and patterns of nurse migration and explore debates within the country regarding the impact of this phenomenon.

Data from a health worker migration case study commissioned by the International Labor Organization (ILO) was reanalyzed to focus specifically on nurses ( Lorenzo et al. 2005 ). Literature review, records review, and focus groups comprised of health workers from five geographic districts were also conducted. Previous studies on Filipino worker migration were reviewed and integrated with available data from government and other field records to validate study results and make the study more robust. In addition, key informant interviews were conducted with selected stakeholders including professional leaders and policy makers to determine their perceptions of nurse migration, describe current migration management programs, and explore future policy directions for nursing and health human resource development in the Philippines.

Precise figures on nurse migration are difficult to obtain because many of those who seek work overseas are recruited privately and not officially documented by Philippines Overseas Employment Agency (POEA). Moreover, Department of Foreign Affairs data are also incomplete as many people leave as tourists and subsequently become overseas workers. We therefore suspect that the data we present on both migration of all occupations and nurse migration specifically are generally underreported.

CONTEXT OF NURSE MIGRATION

The Philippines has too few jobs for its population. The unemployment rate has steadily increased from 8.4 percent in 1990 to 12.7 percent in 2003 ( BLES 2003 ). Even for those with jobs, conditions are difficult. One out of every five employed workers is underemployed, underpaid, or employed below his/her full potential. As a result, the number of Filipinos working abroad has steadily risen and from 1995 to 2000; overseas deployment of workers increased by 5.32 percent annually. Employment abroad provides work to job-seeking Filipinos and is a major generator of foreign exchange. Remittances from overseas Filipino workers of all occupations have grown from U.S.$290.85 million in 1978 to U.S.$10.7 billion in 2005 ( Tarriela 2006 ). A large portion of this comes from international service providers, with nurses constituting the largest group of professional workers abroad.

Filipino labor migration was originally intended to serve as a temporary measure to ease unemployment. Perceived benefits included stabilizing the country's balance-of-payments position and providing alternative employment for Filipinos. However, dependence on labor migration and international service provision has grown to the point where there are few efforts to address domestic labor problems ( Villalba 2002 ).

Movement of health workers from the Philippines as temporary or permanent migrant workers can be traced back to the 1950s. At that time, the objective of working overseas was generally to obtain more advanced training and return home to improve the quality of Filipino health services. Beginning in the late 1960s, countries in the Middle East and North America began to actively recruit health workers. Many of those who went to North America as students stayed on as migrant workers and were ultimately granted residency status ( Corcega et al. 2000 ). By the late 1990s, in the face of widespread global nursing shortages, recruitment conditions changed and destination countries like the United States made recruitment offers both more attractive and more permanent, creating strong “pull factors.”

There are an estimated 1,600 hospitals in the country, about 60 percent of which are private. The government is the biggest employer of nurses with an estimated 16,000 jobs at the national and government facilities. There is no reliable estimate for the number of nursing positions at small local or private institutions ( DBM 2005 ). Both the conditions and the quality of care provided by the small and private hospitals vary greatly and poor working conditions and low pay at many of these institutions also impact nurse migration by creating “push factors.” As a result, the Philippines has begun to experience massive migration of nurses and other health workers to the point that domestic demand for these workers is not being met.

PATTERNS OF NURSE MIGRATION

Nurse supply and employment.

Nurses now make up the largest group of direct health care providers in the Philippines. While physicians have traditionally dominated the health care system, in recent years nurses have emerged as a strong force, often co-managing health care facilities. Both the domestic and foreign demand for nurses has generated a rapidly growing nursing education sector now made up of about 460 nursing colleges that offer the Bachelor of Science in Nursing (BSN) program and graduate approximately 20,000 nurses annually ( CHED 2006 ). Based on production and domestic demand patterns, the Philippines has a net surplus of registered nurses. However, the country loses its trained and skilled nursing workforce much faster than it can replace them, thereby jeopardizing the integrity and quality of Philippine health services.

The total supply of nurses who were registered at some time, adjusted for deaths and retirement, was 332,206 as of 2003, according to data provided by the Professional Regulations Commission, ( Lorenzo et al. 2005 ). Of these, it is estimated that only 58 percent were employed as nurses either in the Philippines or internationally. There are no data on why the remainder left the profession. As shown in Table 1 , the majority (84.75 percent) of employed nurses were working abroad. Among the 15.25 percent employed in the Philippines, most were employed by government agencies and the rest worked in the private sector or in nursing education institutions ( Corcega et al. 2000 ).

Estimated Number of Employed Filipino Nurses by Work Setting, 2003

Source : Corcega, Lorenzo, and Yabes (2000) .

These figures were calculated based on known positions in the domestic market and recorded deployment abroad.

Additionally, as in many countries, there is geographic mal-distribution of employed nurses, with a strong correlation between place of education and place of employment. The national capital region (NCR), including Metro Manila, consistently contributed the highest number of licensed nurses with 33.4 percent of total licensure examination passers between 2001 and 2003 ( PRC 2005 ). Similarly, doctors tend to practice in large urban areas such as the NCR (21.78 percent) and region IV (11.59 percent), while many rural areas and towns are left unattended. These urban areas have also a disproportionately higher share of health facilities in the country. More remote geographic regions report chronic shortages of nurses, doctors, and other health care workers ( NSO 2005 ).

Doctors who have retrained as nurses (known as “nurse medics”) in order to seek overseas employment are a new and growing phenomenon. While exact numbers are not available, a study on this trend showed that in 2001, approximately 2,000 doctors became nurse medics and by 2003, that number increased to about 3,000 ( Pascual, Marcaida, and Salvador 2003 ). In 2005, approximately 4,000 doctors were enrolled in nursing schools across the country ( Galvez-Tan 2005 ) and in 2004, the Philippines Hospital Association estimated that 80 percent of all public sector physicians were currently or had already retrained as nurses ( PHA 2005 ).

Nurse Outflows and Destination Countries

While the numbers of most health professionals who go abroad has remained relatively constant over the years, nurse migration has fluctuated a fair amount as shown in Figure 1 . We have used data from the Professional Regulation Commission, which we consider the most accurate source, although they acknowledge that because of the multiple entry routes to the United States, data on migration to that country are severely underreported. As noted in the introduction, data on migration, including that from the POEA, are often severely underreported because they cover only certain types of emigrants and because many nurses leave the country using other types of visas, such as student or tourist visas ( Adversario 2003 ). POEA also does not include nurses that have returned to the Philippines or those who renew their contracts with the same employer ( POEA 2005a ). In one example, the U.S. Embassy in Manila reported that about 7,994 nurses were deployed under the temporary H1B and permanent EB3 visas in 2004 ( Philippine Embassy 2005 ). For the same year, however, POEA reported only 373 newly hired nurses deployed to the United States ( POEA 2005b ).

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Trends of Deployment Filipino Nurses, 1994–2003

From 1992 to 2003, the major destinations of Filipino emigrant nurses have been Saudi Arabia, the United States, and the United Kingdom. These countries have employed 56.8, 13.14, and 12.25 percent, respectively, of the cumulative total of Filipino nurses sent abroad since 1992 ( POEA 2004 ). These remain the preferred destinations because of perceived advantages in compensation, working conditions, and career opportunities. Other common destinations for deployed Filipino nurses were Libya, United Arab Emirates, Ireland, Singapore, Kuwait, Qatar, and Brunei (POEA 2004). The majority of nurse medics also go to the United States, United Kingdom, and Saudi Arabia (POEA 2004).

Profile of Filipino Nurse Migrants

Data for this section were derived from 48 focus groups held in five localities, both urban and rural, with Filipino health workers, some of whom also plan to leave the country. They reported that nurses leaving the country to work abroad are predominantly female, young (in their early twenties), single, and come from middle income backgrounds. While a few of the migrant nurses have acquired their master's degree, the majority have only basic university education. Many, however, have specialization in ICU, ER, and OR, and they have rendered between 1 and 10 years of service before they migrated ( Lorenzo et al. 2005 ).

According to Pascual, the migrant nurse medics have a slightly different profile. They are also predominantly female, but are older, more likely to be married, and have higher incomes. About 24 percent are single, while 76 percent are married with an average of one to three children and they are 37 years old and older. The nurse medics' income bracket in the Philippines ranges from below U.S.$2,400 to U.S.$9,600 annually. They have specializations in the following areas: internal/general medicine (30 percent), pediatrics (14 percent), family medicine (13 percent), surgery (8 percent), and pathology (6 percent). The remaining 29 percent have other specializations including orthopedics, obstetrics, anesthesiology, and public health. The majority (63 percent) of them had practiced as doctors for more than 10 years. Thirty-four percent have pending applications abroad, while 26 percent have been offered jobs abroad already. More than half (66 percent) plan to leave the country in 6 months to 2 years time. The United States is their top destination country ( Pascual 2003 ).

Reasons for Leaving: Push and Pull Factors

A variety of reasons for migrating have been reported. The focus groups revealed the following perceived push and pull factors for migrating.

Push Factors

  • Economic : low salary at home, no overtime or hazard pay, poor health insurance coverage.
  • Job related : work overload or stressful working environment, slow promotion.
  • Socio-political and economic environment : limited opportunities for employment, decreased health budget, socio-political and economic instability in the Philippines.

Pull Factors

  • Economic : higher income, better benefits, and compensation package.
  • Job related : lower nurse to patient ratio, more options in working hours, chance to upgrade nursing skills.
  • Personal/family related : opportunity for family to migrate, opportunity to travel and learn other cultures, influence from peers and relatives.
  • Socio-political and economic environment : advanced technology, better socio-political and economic stability.

Focus groups were also conducted among nurse medics who still serve as government doctors in two urban areas in the South. They were employed in provincial and local government unit (LGU) hospitals, were municipal health officers, or were private practitioners. They reported that their career shifts were attributed to the very low compensation and salaries in the Philippines, feeling of hopelessness about the current situation of political instability, graft and corruption in the Philippines, poor working conditions, and the threat of malpractice lawsuits (Galvez-Tan, Fernando, and Virginia 2004). Nurse medics were also drawn to attractive compensation and benefits packages, more job opportunities, career growth, and more socio-political and economic security abroad.

Return Migration

While most health workers who seek employment abroad do not return to the Philippines, particularly those who bring their families, others return en route to another job abroad, and some return permanently. For nurses who return, the reasons identified through the focus groups were personal/family, professional, financial, and contract related. The predominant personal reasons included to get married and/or raise children in the homeland, have vacation, return due to homesickness and depression, and to retrieve family members to join them abroad. Professional reasons included wanting to share expertise and seeking professional stability. Financial/social reasons reported were that they had saved enough money to set up a business and or buy a house and a car. Job-related reasons included expired contracts and plans to retire.

IMPACT OF NURSE MIGRATION

Not surprisingly, results from the focus groups revealed that individual migrants and their families were seen as primary winners of the exodus. Respondents pointed out that if the health workers returned to the country, migration would provide benefits to the country in terms of learning technologies used abroad. The migrant was, however, also seen as contributing to the local economy through remittances and reduction of unemployment. Respondents viewed the Filipino health care system and society in general as the losers in the migration equation.

Migration was perceived to impact nursing in the Philippines negatively by depleting the pool of skilled and experienced health workers thus compromising the quality of care in the health care system. One concern among health services managers is that the loss of more senior nurses requires a continual investment in the training of staff replacements and negatively affects the quality of care. Human resources also become more expensive. One health worker expressed this plainly when he said, “We are the one in need of better service yet we are the losers; those countries with better facilities enjoy better care from health professionals” (translation from Filipino statement) ( Lorenzo et al. 2005 ).

Hard evidence regarding the impact of massive nurse migration is only now beginning to be assembled. The Philippine Hospital Association (PHA) recently reported that 200 hospitals have closed within the past 2 years due to shortages of doctors and nurses, and that 800 hospitals have partially closed for the same reason, ending services in one or two wards ( PHA November 2005 ). Shortages have led to failure to meet accreditation standards, which in turn hinders reimbursement and eventually brings financial crisis. Nurse to patient ratios in provincial and district hospitals are now one nurse to between 40 and 60 patients, which is a striking deterioration from the ratios of one nurse to between 15 and 20 patients that prevailed in the 1990s ( Galvez-Tan 2005 ). While previous ratios were not ideal, the current ratios have become dangerous even for the nurses, adding to the loss of morale and desire to migrate for those still employed in the Philippines.

Further evidence of problems can be observed in coverage data reported by the National Statistics Office. The proportion of Filipinos dying without medical attention has reverted to 1975 levels with 70 percent of deaths unattended during the height of nurse and nurse medics migration in 2002–2003 ( NSO 2005 ). This represents a 10 percent increase in the last decade, and many observers attribute the growth of this problem to the nurse medic phenomenon and the resulting shortage of physicians. Perhaps the most troubling indicator of declining access to health services is the drop in immunization rates among children, which have gone from a high of 69.4 percent in 1993 to 59.9 percent in 2003 ( Galvez Tan 2005 ). While there are undoubtedly multiple factors that impact this decline in immunization rates, the association between the lack of health human resources and immunization coverage is indisputable.

POLICY DEBATE

As a result of the impact of nurse and nurse medic migration, a flurry of policy debate has developed as both proponents and opponents of nurse migration realize that health workforce planning is urgently needed. Three major spheres of policy relate to this topic: the labor and employment sector, the trade sector, the health sector, and within that the nursing community.

The labor ministry provides for the promotion, regulation, and protection of migrant workers. The Philippine government first adopted an international labor migration policy in 1974 as a temporary, stop-gap measure to ease domestic unemployment, poverty, and a struggling financial system. The system has gradually been transformed into the institutionalized management of overseas emigration, culminating in 1995 in the Migrant Workers and Overseas Filipinos Act, or RA 8042, which put in place policies for overseas employment and established a higher standard of protection and promotion of the welfare of migrant workers, their families, and overseas Filipinos in distress ( M.T. Soriano, in OECD 2004 ). That act also, however, foresees moving toward a less regulated international recruitment process, in which the government would eventually have a far smaller role.

Reflecting a generally promigration stance, the Department of Labor and Employment and its attached agencies, the POEA, and Overseas Workers Welfare Administration (OWWA) actively explore better employment opportunities and modes of engagement in overseas labor markets and promote the reintegration of migrants upon their return. Instruments developed to this end include predeparture orientation seminars on the laws, customs, and practices of destination countries; model employment contracts that ensure that the prevailing market conditions are respected and the welfare of overseas workers is protected; a system of accreditation of foreign employers; the establishment of overseas labor offices (POLOs) that provide legal, medical, and psycho-social assistance to Filipino overseas workers; a network of resource centers for the protection and promotion of workers' welfare and interests; and reintegration programs that provide skills training and assist returning migrants to invest their remittances and develop entrepreneurship.

Within this sector, the current migration debates center on two issues. The first issue relates to the impact of deregulation and liberalization of the migration services of recruitment entities. Strong differences of opinion exist as to whether this would be positive for the nation and/or for individual migrants. A second issue revolves around whether or not the government should shift its policy from “managing” the flow of overseas migration, which is reactive, to “promoting” labor migration, which is proactive. Right now, migration policy is implicit and reactive to overseas demand. Promoting labor migration would mean actively seeking out international markets and marketing Filipino human resources in selected markets.

The trade and investment sector of the country has shown interest in developing the Philippines' health sector as a magnet for new revenues in their hospital tourism and medical zones initiatives. There has been debate as to whether this would hurt or benefit the Philippines health system. While this might provide significant incentives for retention of the most qualified health workers, jobs developed in this sector may also draw the remaining nurses and physicians away from the already-depleted public and less-profitable private sector facilities that primarily serve the poor.

The issue of nurse migration is, of course, of great concern to the health policy makers. In the area of health workforce policies, the most serious proposal currently being considered is the Department of Health HRH Masterplan for 2005–2030. The HRH Development Network was established in 2006 in order to implement the Masterplan. The Network is composed of representatives of the executive branch, the legislative branch, the private sector, and civil society groups. Congress is currently considering converting this group into a Commission that would be charged with the following:

  • Review of the past, current, and future scenarios of the nursing and medical human resources.
  • Create a database of Filipino health human resources.
  • Develop a 25-year National Health Human Resources Policy and Development Plan.
  • Develop a unified HHR policy and a National HHR Policy Research Agenda.

Major objectives being considered include the following:

  • Rational utilization to make more efficient use of available personnel through geographic redistribution, the use of multiskilled personnel, and closer matching of skills to function.
  • Rational production to ensure that the number and types of health personnel produced are consistent with the needs of the country.
  • Public sector personnel compensation and management strategies to improve the productivity and motivation of public sector health care personnel.

The nursing sector has also brought to the table a series of proposals that are being considered as part of the Philippine Nursing Development Plan. These strategies include:

  • The institution of a national network on Human Resource for Health Development, which would be a multisectoral body involved in health human resources development through policy review and program development.
  • Exploration of bilateral negotiations with destination countries for recruitment conditions that will benefit both sending and receiving countries. Through bilateral negotiations the Philippines may devise investment mechanisms that could be used to improve domestic postgraduate nursing training, upgrade nursing education, increase nurses' compensation, and establish nursing scholarships. Alternatively, multilateral negotiations may be forged with the guidance of international agencies such as the ILO and WHO.
  • Forging of North–South hospital-to-hospital partnerships so that local hospitals benefit from compensatory mechanisms for every nurse recruited from them. One proposal is that for each nurse recruited, the cost of postgraduate hospital training (estimated at U.S.$1,000 for 2 years at 2002 prices) would be remitted to the hospital from which the nurse has been recruited, allowing the hospital to then train another nurse to join their staff.
  • If hospital nurses are hired by foreign counterparts, it is suggested that they be given a 6-month leave to return and train local hospital nurses. Health care organizations should also establish returnee integration programs in order to maximize the potentials for skills and knowledge transfer.
  • The institution of the National Health Service Act (NHSA) which would compel graduates from state-funded nursing schools to serve locally for the number of years equivalent to their years of study.
  • Health-related organizations such as the PHA, Philhealth, the Board of Nursing, and the Philippine Nurses' Association (PNA) should work to prevent work-related exploitation domestically.
  • The Philippines should actively participate in debates moderated by international agencies such as the World Health Organization, the International Council of Nurses, and the ILO.

Nurse leaders are hopeful that these strategies will be incorporated into a draft executive order that the Commission would present to the President.

While the outcome of this process is unfolding, it is encouraging that the health sector has taken the lead to shift the terms of the debate. Labor and trade sector buy-in is still essential, but most policy makers agree that the goal should be to manage migration such that both sending and receiving countries benefit from the exchange ( WHO 2006 ). If the Philippines were able to produce and retain enough nurses to serve its own population, there would be widespread support for additional quality nurse production and migration. Attending to source country needs will also benefit the global health workforce and ensure improved quality of health care services for all.

  • Adversario P. “Nurse Exodus Plagues Philippines” 2003. [May 2003]. Asia Times Online. Available at http://www.nursing-comments.com .
  • Bureau of Labor and Employment Statistics. 2003. Occupational Wage Salary.
  • Commission on Higher Education (CHED) 2006. List of Nursing Schools and Permit Status.
  • Corcega T, Lorenzo FM, Yabes J, De la Merced B, Vales K. Nurse Supply and Demand in the Philippines. The UPManila Journal. 2000; 5 (1):1–7. [ Google Scholar ]
  • Department of Budget and Management. 2005. Interview of Director Edgardo Macaranas and others.
  • Galvez Tan J. “The Challenge of Managing Migration, Retention and Return of Health Professionals” 2005. Powerpoint Presentation at the Academy for Health Conference, New York.
  • Galvez Tan J, Sanchez F, Balanon V. The Philippine Phenomenon of Nursing Medics: Why Filipino Doctors Are Becoming Nurses, Powerpoint presentation October 2004.
  • Lorenzo FM, Dela FRJ, Paraso GR, Villegas S, Isaac C, Yabes J, Trinidad F, Fernando G, Atienza J. “Migration of Health Workers: Country Case Study” The Institute of Health Policy and Development Studies, National Institute of Health, September 2005.
  • National Statistics Office (NSO) QUICKSTAT. Databank and Information Services Division, February 2005.
  • Pascual H, Marcaida R, Salvador V. “Reasons Why Filipino Doctors Take Up Nursing: A Critical Social Science Perspective” 2003. Paper Presented During the 1st PHSSA National Research Forum, Kimberly Hotel, Manila, September 17, 2003. Philippine Health Social Science Association, unpublished report.
  • Philippine Embassy. RP Embassy to Pursue Continued Deployment of Filipino Nurses in the U.S. Philippine Embassy” News Release, February 2005.
  • Philippine Hospital Association Newsletter, November 2005.
  • Philippine Overseas Employment Administration (POEA) 2004. Statistics 1990–2004.
  • Philippine Overseas Employment Administration (POEA) 2005a. OFW Deployment by Skill, Country and Sex (1992–2003)
  • Philippine Overseas Employment Administration (POEA) 2005b. Statistics 1992–2003, August 2005.
  • Professional Regulations Commission (PRC) Nurse Licensure Examinations Performance by School and Date of Examination, 2005.
  • Soriano MT. in OECD, 2004 [incomplete reference]
  • Tarriela FG. “OFW Remittances: Insights” Manila Bulletin, April 11, 2006.
  • Villalba MAC. “Philippines: Good Practices for the Protection of Filipino Women Migrant Workers in Vulnerable Jobs” 2002. Working Paper No. 8. Geneva: International Labour Office, February 2002.
  • World Health Organization. “Working Together” 2006. World Health Report.

GoAbroad

  • Jobs Abroad

Nursing Jobs Abroad

Nurses are in high demand worldwide, but especially in underserved nations where disease and poverty rates are high, and where the educational system is not strong enough to supply the local demand for nurses. More than 50 percent of healthcare workers abroad are nurses, and in some countries, where the need is great and the access to medical treatment is low, nurses are the frontline providers and first lifeline for patients. Nursing jobs abroad are an opportunity to expand your knowledge, gain an appreciation of new cultures and ideas, and add a new perspective to your nursing skills.

Treating patients whose background, life experiences, and culture are different than your own will expose you to different types of medical treatments and procedures, teach you a new way of approaching problems, and help you communicate better with patients from all walks of life.

Jobs abroad are a great experience for people who want a little adventure in their lives, and like to travel independently. International nursing jobs provide personal and professional growth to every nurse, through providing care, administering medicine and treatments, working on language skills, and supplying education to patients in a foreign country.

Due to high demand and low supply, international nursing jobs are available in just about any country you can think of!

New Zealand has a shortage of registered nurses that is projected to increase over the next two decades as nearly half of its current nursing workforce is approaching retirement age. The country is small (about 4.4 million people) and employers may recruit workers for nursing jobs in New Zealand under the country’s skilled migrant immigration policy.

Australia , though much larger, more diverse, and more populated than New Zealand, has a similar nursing shortage. They have a medical recruitment process with a fast-track visa certification process for available nursing jobs abroad.

China has a shortage in nurses due to its rapidly expanding economy, and its failure to keep its brightest nursing minds at home. There are about 500,000 nursing students in China, but many switch occupations or emigrate for work because of the lack of competitive nursing opportunities at home. As a result, China has only about one nurse per 1,000 people. Still, salaries for nursing jobs in China can be low and working conditions often challenging.

To fulfill an international nursing job, you will probably have to pass a licensing exam in order to practice locally in whatever country you have chosen. Once you have the appropriate licensing figured out, nursing jobs abroad are plentiful and varied.

What makes these jobs valuable abroad versus in your home country. Treating patients whose background, life experiences, and culture are different than your own will expose you to different types of medical treatments and procedures, teach you a new way of approaching problems, and help you communicate better with patients from all walks of life. Nursing jobs abroad are a great experience for people who want a little adventure in their lives, and like to travel independently. 

Professional benefits you can gain. International nursing jobs provide personal and professional growth to every nurse through providing care, administering medicine and treatments, working on language skills, and supplying education to patients in a foreign country.

A day on the job. Day-to-day duties at nursing jobs abroad can vary widely, especially depending on your role, experience, and location. Of course, every nurse can expect to be interacting with patients and performing common procedures on a daily basis.

The best and most lucrative nursing jobs abroad go to those with the most education and experience (particularly previous international experience, professional or volunteer), and those who are fluent in the local language. In many cases, perks and benefits greatly enhance the value of your salary package for an international nursing job.

Except in a few highly specialized fields, working in nursing abroad is not an exceptionally high-paid profession. Salaries vary widely depending on the country, location (rural, major city, mid-sized city), and need, but in most places, the starting salary for a nursing job will range from $27,000 to $32,000 a year. In some places, such as in Europe, a liberal and generous vacation policy sweetens most nursing job opportunities. In the Middle East, starting salaries for nursing jobs are more in the $36,000 to $42,000 range.

The best and most lucrative nursing jobs abroad go to those with the most education and experience (particularly previous international experience, professional, or volunteer), and those who are fluent in the local language. In many cases, perks and benefits greatly enhance the value of your salary package for an international nursing job. Except in a few highly-specialized fields, working in nursing abroad is not an exceptionally high-paid profession. Salaries vary widely depending on the country, location (rural, major city, mid-sized city), and need, but in most places the starting salary for a nursing job will range from $27,000 to $32,000 a year.

A skilled nurse is always in demand, and working abroad in nursing can increase your competitiveness and desirability in almost any field of nursing. International nursing jobs give nurses experience working in locations where techniques, medical challenges, diseases, and methods of treatment are different than what they learned in school. Sometimes international nurses will even have the chance to work with medical treatments still in the experimental stage. Working in nursing abroad will teach you new ways of communicating cross-culturally, as well as alternative cultural approaches to the treatment of health issues.

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List of Clinical Research Jobs Abroad: By Top Countries

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  • Apr 2, 2024

Clinical Research Jobs

The study of the efficacy and safety of novel medical therapies, equipment, and practices is known as clinical research. It is an essential component of the healthcare industry and helps create new medications and treatments that can prolong patients’ lives. Clinical research may be a great career option for you if you are thinking about working in the medical field or if you are driven to improve people’s lives. Clinical research jobs are the key to a fantastic career in science , according to several practitioners.

This Blog Includes:

Why should you choose clinical research as a career, new zealand for clinical research jobs , australia for clinical research jobs, united kingdom for clinical research jobs , canada for clinical research jobs , usa for clinical research jobs , skills required for clinical research jobs .

There are ample reasons for choosing Clinical Research as a career. Let’s Explore why Clinical Research is a good career, we have mentioned a few pointers; 

  • In the healthcare sector, clinical research is crucial. Research studies can contribute to the development of novel medications, treatments, and gadgets that enhance patient outcomes and quality of life. 
  • One of the most fulfilling career choices is working in clinical research. Being a clinical researcher will put you at the forefront of creating novel cures and treatments.
  • There is a great need for qualified individuals in the highly specialized sector of clinical research. Pay in this industry is therefore usually competitive.
  • Opportunities for professional and personal development can be found in the field of clinical research. You will pick up new abilities while working on research projects, like project management, data analysis and communication. 

If you want to read about a Career in Public Health which pays you a high salary read this article 

5 Best Countries for Clinical Research Jobs 

There are some good countries, such as the United Kingdom, the USA, Canada, Australia, and New Zealand, to get a good job in the clinical research field. All these countries have facilities for medicinal study and are often regarded as the world’s best countries for medical studies owing to their top-notch hospitals, world-class medical schools, expert faculty, opportunities, and progressive research.

New Zealand is one of the good places for doing jobs in the clinical research field. As there are a lot of clinical research jobs provided by reputed companies. 

Also check what are the part-time jobs in New Zealand for International Students 

Here is a list of some good job opportunities in Australia that pay you a good salary. 

Here is the list of Highest Paying Jobs in Australia for indians

There are several job options in the chemical research field in the United Kingdom . Following are a few of them:

Here you can Explore the High Paying Jobs in UK

There are several job options in the chemical research field in Canada . Following are a few of them:

What is the Average Salary in Canada & Top Job Opportunities in 2024

The USA is also one of the good places for doing jobs in the field of clinical research. As there are a lot of clinical research jobs provided by reputed companies. 

You Can also explore various Part time jobs opportunities in USA for International Students 

To get a clinical researcher job, you are required to have the following skills: You can utilize these skill sets to improve while doing a job in clinical research.

  • Project management skills 
  • Good communication both verbal and interpersonal 
  • The ability to motivate others
  • A flexible and adaptable approach to work 
  • Presentation Skills 
  • IT and administrative skills 
  • Detail-oriented and data-capturing 
  • An understanding of the importance of good clinical practice.  

Following is a list of Highest Paying Clinical Research Jobs  Clinical Research Coordinator Clinical Research Associate Research Scientist Clinical Research Manager 

To be qualified for employment in the clinical research industry, you usually require a bachelor’s degree in life sciences, nursing, biotechnology, or a related clinical science. These degrees will give you the groundwork required to comprehend the work that is done.

You must be able to prioritize your responsibilities and multitask as a clinical research coordinator. You must finish four years of a bachelor’s degree in medical technology, microbiology, or public health administration in order to be eligible for the best-paying position in clinical research.

Following is the list of Clinical Research Job options A Clinical Data Manager (CDM) Clinical Research Associate (CRA) Clinical Research Coordinator. A Clinical Research Scientist. Clinical Trial Manager. Clinical Trial Monitor. Pharmacovigilance Associate (PVA) Regulatory Affairs Manager (RAM)

It was all about clinical research jobs. If you want to read more about this interesting profession and its salary, follow Leverage Edu .

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  • UNC Chapel Hill

UNC Project-Malawi

Research Registered Nurses

Number of Positions: 3

Job Summary

The Research Registered Nurse in the UNC Project is responsible for consenting and counseling research subjects, collection of data, provision of full physical and pelvic examination, and collection of specimens. As a clinical care provider, she/he is expected to perform his\her duties with the dedication and professional zeal that the Malawi Nurses and Midwives council expects. She/he is expected to be in good standing with his/her professional bodies at all times. She/he is expected to help with supervision of subordinates and analyze financial activities of the Study She/he is working on.

Main Duties / Responsibilities

Clinic and Care Management

  • Ensures availability of clinic resources in collaboration with the Chief Nursing Officer.
  • Organize counseling and examination rooms in preparation for clinical trials/ day’s activities.
  • Conduct clinical research in accordance with the ICH, GCP, NHSRC on ethical conduct in research involving human beings.
  • Assess and analyze each patient’s condition to establish the continuing care plan, appropriate action and future participation in the study in consultation with the treating clinician or the trial investigator.
  • Ensure efficient use of clinic/research resources.
  • Maintain safe environment for self and study subjects.
  • Ensure effective and efficient channels of communication.
  • Assist in visiting students in their orientation and projects.
  • Provide clinical care for research clients to the best of his\her ability and in line with Malawi government regulations and policies.
  • Assume responsibility for daily operational issues in regard to clinical protocols and subject recruitment, in the absence of senior staff
  • Resolve complaints timely and seeks assistance where necessary.
  • Adapt to a flexible approach to working hours in order to meet the requirements of the research protocols and subject recruitment.
  • Perform HIV, pregnancy, hemoglobin, blood glucose, lactate, blood gas, and other assigned point-of-care testing and related quality control as per SOP.
  • Perform any other duties assigned
  • Ensure collection of accurate and legible data
  • Ensure that subjects are given detailed information about the study before commencement of any study procedures
  • Endeavor to understand subjects’ views/problems
  • Develop an awareness in the study subjects of the days study procedures
  • Ensure that all other study activities are performed in line with ‘Good Clinical Practices’
  • Perform any other duties as assigned

Audit and Quality Control

  • Participate in the development of Study Operational Procedures (SOPs) for all studies involved in
  • Conduct study procedures according to the SOPs
  • Ensure completeness of data collected
  • Check for accuracy of data collected before data faxing
  • Participate in completing quality control reports
  • Participate in dispelling misconceptions about the study in the community through the Community Advisory Board (CAB)

Education and Personal Development

  • Take own initiative in learning basic computer skills
  • Take responsibility for own personal and professional development through advice from superiors and colleagues
  • Participate in orientation of new research personnel
  • Ensure personal and professional development by undertaking short/long term courses.
  • Participate in  National Health Programs

Qualifications and Experience

  • Degree in Nursing
  • Registered with the Nurses and Midwife Council of Malawi
  • From none to 8 years’ of experience

Please send your applications via email to:

The Country Director

UNC Project

[email protected]

Deadline for receiving applications:

Monday, April 15, 2024

Only shortlisted candidates will be acknowledged.  Successful candidates after interviews are expected to report for work on Monday April 22, 2024.

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NHS nurses protest outside St Thomas' hospital in London on 15 December 2022.

Thousands of foreign nurses a year leave UK to work abroad

Exclusive: Surge in nurses originally from outside the EU moving overseas prompts concern Britain is a ‘staging post’ in their careers

Almost 9,000 foreign nurses a year could be leaving the UK to work abroad, amid a sudden surge in nurses quitting the already understaffed NHS for better-paid jobs elsewhere.

The rise in nurses originally from outside the EU moving to take up new posts abroad has prompted concerns that Britain is increasingly becoming “a staging post” in their careers.

The number of UK-registered nurses looking to other countries doubled in just one year between 2021-22 and 2022-23 to a record potential 12,400 and has soared fourfold since before the coronavirus pandemic.

Seven out of 10 of those looking to leave last year – 8,680 – qualified as a nurse somewhere other than the UK or EU, often in India or the Philippines. Many had worked in Britain for up to three years, according to research from the Health Foundation.

The vast majority of those quitting are heading to the US, New Zealand or Australia, where nurses are paid much more than in the UK – sometimes up to almost double.

Experts have voiced their alarm about the findings and said the NHS across the UK, already struggling with about 40,000 vacancies for nurses and hugely reliant on those coming from abroad, is increasingly losing out in the global recruitment race.

“It feels like the NHS is falling down the league table as a destination of choice for overseas nurses,” said Dame Anne Marie Rafferty, a professor of nursing studies at King’s College London.

“Worryingly, it feels as if the UK is perceived not as a high- but middle-income country in pay terms and as a staging post where nurses from overseas can acclimatise to western-type health systems in the search for better pay and conditions.”

Last year, 12,400 nurses working in the UK applied for a certificate of current professional status (CCPS), which they need to have to move to work in another country, the Health Foundation report shows. It is not clear exactly how many of these actually went ahead and left the country.

The largest increase among that group was in overseas-trained nurses who had only worked in the UK for three years or less. That pronounced trend in short stays suggests that for many recruits from abroad “the UK may be a stepping-stone prior to moving to other destinations”, the thinktank said.

It pointed out that OECD data showed that while a nurse in the UK earned on average $46,000 a year (£36,500) – “substantially less than in Australia ($71,000 or £56,350), New Zealand ($57,000 or £45,000) and the US ($84,900 or £67,000)”.

Application for a CCPS to work in America rose tenfold between 2021-22 and 2022-23 after a change in its visa policy meant many more foreign nurses were able to move there.

The Royal College of Nursing said the growing exodus of overseas-trained nurses was due to the significant erosion in pay the nursing profession has suffered since 2010.

Prof Pat Cullen, the RCN’s chief executive and general secretary, said: “It is deeply worrying to see more and more overseas nurses choosing to leave the UK. The recruitment of domestic nurses is collapsing and services are gripped by workforce shortages.

“With patient needs already going unmet, the prospect of losing more of our international colleagues doesn’t bear thinking about.

“The reality is that sustained attacks on pay and poor working conditions are leaving the UK’s healthcare services unable to compete on the world stage. International nurses, like all nurses, have every right to choose to work in countries that better value their skills and expertise. It’s no joke that nurse pay in the UK is joint bottom of 35 OECD countries [as a proportion of the national average wage].”

Report co-author Elaine Kelly, the assistant director at the Health Foundation’s research centre, said that, with an acute nursing shortage and so many overseas nurses quitting the UK, “if the NHS is to avoid becoming a stepping stone to careers elsewhere, it needs to be a more attractive place to work for all nurses, regardless of where they were trained”.

She said the brain drain was especially worrying because it cost the NHS about £10,000 to replace each foreign recruit who then moved elsewhere.

The Department of Health and Social Care said it did not recognise the Health Foundation’s figures. The latest Nursing and Midwifery Council data showed fewer nurses – those trained in the UK and outside it – leaving the NHS, a spokesperson said.

“We hugely value the care provided by our fantastic nurses, which is why we negotiated a fair and reasonable deal with the trade unions delivering a 5% pay rise, two additional one-off bonuses equivalent to 6% of pay and a series of non-pay measures to support the NHS workforce [in England].

“We also delivered on our commitment to recruit an additional 50,000 NHS nurses six months early, and the first ever long-term workforce plan – backed by over £2.4bn of government funding – will provide the biggest training expansion in NHS history, ensuring that up to 130,000 fewer staff, including nurses, will leave the NHS over the next 15 years.”

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