WESolutions
International recruitment of nurses causes a global movement that is not only skilled individuals relocating to a new job but also a phenomenon that causes the workforce strategy, global ethics and systems stability to intersect. In the age of increasing demand on healthcare systems, including in the UK, the migration of nursing professionals raises questions about fairness, equity and sustainability. Let’s explore what nurse migration looks like, the positive impacts it can bring, the negative consequences for developing countries, the broader challenge of global health equity, and how collaboration between nations might help to create a more balanced future.
Understanding Nurse Migration
Nurse migration is a term given to the movement of nursing professionals trained in one country, relocating to another country to live and work. In most cases, these individuals are from low and middle-income countries, seeking jobs in higher-income countries for a better life and advancing employment opportunities. According to one comprehensive review, nurse migration is influenced by economic, workplace-related, social and structural factors in the home country. (BioMed Central)
In the context of the UK and the broader high-income world, migration of nurses has become central to workforce planning. A briefing by the Migration Observatory shows that the health and care sector in England has seen unprecedented numbers of overseas health-care workers in recent years, so the UK is increasingly reliant on international recruitment to fill workforce gaps. (Migration Observatory)
But migration is not simply one-way. Nurses may move temporarily, migrate onward, or return home after some years. The drivers for migration, and the consequences, are multi-layered: push factors (such as poor working conditions, low pay or limited career progression in the home country) and pull factors (such as better compensation, improved resources, and professional development opportunities abroad). Understanding these forces helps us see nurse migration not simply as a resource transfer, but as a complex human decision.
Positive Impacts of Nurse Migration
While much of the public discussion focuses on risk and loss, it is important to recognise the positive outcomes that nurse migration can generate, for individual nurses, for the destination health systems, and for broader global networks.
Career advancement and professional development
For many nurses from source countries, migration offers the opportunity to access advanced training, specialisms and career paths that may not be available locally. Exposure to different healthcare systems, technologies and management practices allows them to deepen their skills. Some return home with enhanced expertise and bring that knowledge back to their communities.
Wider workforce capacity and diversity in destination systems
Destination countries like the UK benefit from the arrival of skilled nurses who help fill staffing gaps, reduce pressure on local recruitment, and support service continuity. The presence of nurses from diverse backgrounds also enriches the workforce culturally, improving patient care in increasingly multicultural societies. The Migration Observatory briefing emphasised that overseas health workers have played a key role in meeting workforce demand in England. (Migration Observatory)
Remittances and economic benefits to source countries
When nurses migrate, they often send remittances back to their home countries. These financial flows can support families, communities and even local economies. While not a substitute for robust health-system investment, these contributions can make meaningful differences at the household level.
Opportunities for bilateral training and international cooperation
In some cases, migration prompts initiatives for partnership between source and destination countries, shared training schemes, return-versus-stay programmes, and knowledge exchange. These can be designed to improve health-system resilience globally, not simply extract talent. The International Council of Nurses (ICN) emphasises the need for bilateral agreements that strengthen both sides of migration. (ICN – International Council of Nurses)
In short, nurse migration is not necessarily bad; it can be a route to personal growth, institutional capacity and economic benefit when managed ethically and with foresight.
Negative Impacts of Nurse Migration on Developing Countries
However, the benefits come with significant risks, especially for the countries from which nurses migrate. These negative impacts demand careful attention.
Brain-drain and health workforce depletion
When large numbers of nurses leave LMICs, those countries may face weakened health systems. The State of the World’s Nursing Report (2020) estimated a global shortage of 5.9 million nurses, with the bulk of the gap in LMICs. (Health Policy Watch) In effect, the migration of nurses can exacerbate existing health workforce shortages in countries that can least afford it.
Loss of investment in training
Many source countries invest heavily in nursing education, only to see graduates move overseas. The economic cost of training is borne locally, while the benefit accrues elsewhere. A commentary points out that migration may perpetuate dependency and hamper the achievement of universal health coverage. (Penn LDI)
Inequity and ethical concerns
High-income countries are often recruiting from countries that the World Health Organisation (WHO) has placed on its workforce support and safeguards list, countries already under pressure to achieve adequate health workforce levels. This raises questions of fairness and sustainability. (Penn LDI)
Return migration and loss of skilled human capital
Some migrating nurses may ultimately relocate again, or not return to their home country. This can leave the source system with fewer experienced professionals. The ICN report notes that migration must be tracked to avoid dependency on professionals trained elsewhere. (ICN – International Council of Nurses)
Uneven benefits and exploitation risks
In some cases, migrant nurses face working conditions or contracts below expectations, meaning the benefits of migration accrue less than hoped. A systematic review of acculturation and retention found that international nurses may experience role mismatch, isolation, or limited progression. (ScienceDirect)
The negative side is not inevitable, but it is real, and the challenge arises when positive migration outcomes in one place cause harm in another.
The Global Health Equity Challenge
Health equity means that all individuals and populations should have fair access to the health services they need, delivered in a timely, effective and sustainable way. Nurse migration affects this in multiple ways.
Equity at destination
In the UK and other high-income countries, reliance on migrant nurses helps fill care gaps and supports service quality. Yet if domestic training pipelines fail, the health system risks long-term dependency on external supply. The Migration Observatory noted that while migration supports staffing, it may not solve structural workforce weakness. (Migration Observatory)
Equity at source
If migrant nurses leave in large numbers, the population in their origin country may face poorer access to care, higher workloads for the remaining staff, and slower progress on health-system strengthening. This threatens global efforts such as the UN’s Sustainable Development Goals, especially around universal health coverage.
Ethical recruitment and international obligations
The WHO’s Global Code of Practice on the International Recruitment of Health Personnel calls for ethical recruitment, transparency, sustainability, and monitoring of migration impacts. The ICN report also urges the use of self-sufficiency indicators (proportion of overseas-educated nurses in a workforce) and bilateral agreements that strengthen source systems. (ICN – International Council of Nurses)
Systemic resilience and global interdependence
Health systems are now interconnected in ways that were not fully visible a generation ago. A shortage in one country may become scarcity elsewhere, and global shocks (such as pandemics) expose weaknesses. Nurse migration is therefore less a zero-sum game and more part of a global ecosystem of care labour. The commentary on workforce data stresses the need for high-quality data for equitable planning. (PMC)
Ultimately, global health equity is affected when nurse migration is unbalanced, not managed, and when destination reliance coincides with source depletion. The challenge is to create a system in which migration supports rather than undermines equity.
The Role of Global Collaboration
If the goal is to harness the benefits of nurse migration while mitigating its negative consequences, collaboration is key.
Bilateral and multilateral agreements
Source and destination countries should enter into agreements that share benefits: training support, return-path incentives, funding for source-country health systems, and ethical recruitment frameworks. The ICN emphasises that recruitment must not harm vulnerable health systems. (ICN – International Council of Nurses)
Investment in source-country capacity
Rather than simply recruiting, destination countries and international agencies should invest in training, education, and workforce retention in source countries. This strengthens the global supply and reduces brain-drain risk. The commentary on health-workforce data underlines the need to reduce inequities by building domestic self-sufficiency. (PMC)
Data, monitoring and transparency
To guide policy and ethical recruitment, high-quality data is required on nurse migration flows, retention, destination entry, remittances, impact on source systems and workforce sustainability. The Migration Observatory briefing highlights data gaps as a key obstacle. (Migration Observatory)
Professional development and return pathways
Origin-country trained nurses who migrate should have options to develop careers and ideally return or contribute remotely to their home systems. Some models propose “circular migration” or temporary placements that benefit both countries.
Ethical frameworks in recruitment agencies
For organisations specialising in international recruitment (such as WEsolutions), it is vital to adhere to ethical codes, avoid active recruitment from countries facing critical health workforce shortages, ensure fair employment terms, monitor outcomes and promote integration.
If the global nursing workforce relies more on collaboration than the extraction of talents, it could serve the needs of the patients with better benefits, as the resources are shared more equitably.
Conclusion
Nurse migration has the power to transform health systems, both for better and for worse. In high-income contexts like the UK, international nurses are part of the solution to workforce pressures. But if migration is unmanaged or one-sided, it may deepen inequities in source countries and undermine global health equity.
For healthcare providers, recruitment agencies and policy-makers alike, the critical question is how to shape migration so that no country or community is left behind. By recognising positive impacts, addressing negative consequences, embracing data, ethical practice and collaboration, we can move towards a fairer world of care. In the end, every nurse who moves country carries both hope and responsibility, and our collective challenge is to ensure that the global movement of nurses builds health equity, not health divides.
References
- Migration and the health and care workforce (Migration Observatory)
- Health workforce data needed to minimize inequities associated with health-worker migration (PMC)
- Global migration and factors that support acculturation and retention of international nurses: A systematic review (ScienceDirect)
- International Council of Nurses report submitted to the World Health Organization in July 2024 as part of the latest reporting round on implementation of the WHO Global Code of Practice on the International Recruitment of Health Personnel (ICN – International Council of Nurses)
- Addressing Global Nurses’ Shortage Means Tackling Ethics Of Migration, Working Conditions & Gender Equity. (Health Policy Watch)
Prioritizing drivers of nursing migration: a summative content analysis of influential factors (BioMed Central)
