Managing migrant nurses in Malta : an assessment of their integration and competencies in the health system

Abstract

Purpose: The purpose of this study is to determine the extent to which these recruits have become integrated into the Maltese healthcare system as well as to assess migrant nurses’ competencies and identify any clinical differences in the competencies between migrant nurses and Maltese nurses. Background: The recruitment of migrant nurses in Malta is inevitable as demographically, the Maltese population is in better health and is living longer and the demand for healthcare is continuously on the rise. As a consequence of this, healthcare providers are likely to continue to recruit nurses from overseas. The need for the provision of more long-term care beds is an issue that must be faced and tackled continuously. However, such needs should not be based on our current policies and practices which present nothing but a major lacuna when it comes to the provision of community care support. According to available literature on the subject, nursing shortages are not only experienced locally but are actually a global problem. On two occasions over the past five years, the Maltese health authorities have taken to step to recruit migrant nurses. At the time of this study, nursing shortages still existed but to a much lesser degree and this shortfall is generally filled with the new Maltese graduate nurses. Method: To reach the aim of this study, a mixed method approach was adopted which includes both qualitative and quantitative methods. The methods chosen were selfadministered structured questionnaires and in-depth interviews. Questionnaires were distributed to 260 migrant nurses and 68 responded, however seven questionnaires were excluded since they did not include enough details. Seventy five questionnaires were then distributed to Maltese nurses so as to have significant number of participants in each group. Interviews were carried out with three hospital managers, three Maltese and three migrant nurses from each hospital. These methods were conducted in parallel and only brought together once the data were being analysed. Discussion and recommendations: The results revealed that there was only a statistically significant difference from the domains of the tool in communication which was also highlighted in the interviews by the participants. Several aspects concerning human resources and nurse shortages in Malta were also highlighted. Results revealed that migrant nurse recruitment should lead to a better match between the skills of the migrant nurses and the needs of the local hospitals. Often, migrant nurses are not working in their fields of expertise. This study shows that the Maltese health authorities also need to focus more on other sensitive topics, such as racism and cultural differences. Several recommendations for further studies were identified to include the need to have specific structured adaptation programmes according to the country of origin of the migrant nurses and an evaluation of the impact of migrant nurses in the Maltese health care system. Finally this study highlighted the importance of encouraging more Maltese students to opt for a career of nursing.