The ethical concerns being raised over hiring of foreign nurses

Nova Scotia's government has begun to recruit nurses internationally.

As regions like the Maritimes race to recruit foreign-trained nurses, the International Council of Nurses says there are many ethical issues to consider.

Howard Catton, the chief officer of the International Council of Nurses, said even before the pandemic, the world was short by about 6 million nurses. That’s only gotten worse.

He says countries like Canada, the US, UK and Germany are leading the way to recruit international nurses.

“But often when you look at the countries that they’re recruiting from, those countries have fewer nurses per head of population than the countries that are doing the recruiting,” Catton said.

Nova Scotia has seen a surge of interest from foreign-trained nurses ever since the Nova Scotia College of Nursing relaxed licensing rules for seven countries where the scope of practice is similar. These countries include the Philippines, Nigeria, India and the U.K. and U.S.A.

While the Philippines has long produced more nurses than it needs, and been a top world supplier of nurses, Catton points out how the country recently declared it’s short by about 350,000 nurses.

He adds India has also supplied a lot of nurses to the world but that country has ambitions to increase access for its own people and needs about 4 million nurses to do that.

“That means there really are some ethical issues and considerations here about the risk of harm to the countries that you’re recruiting from,” Catton said.

In a recent interview, Gail Tomblin Murphy, Nova Scotia Health’s chief executive nurse and vice-president of research, innovation and discovery, noted how Nova Scotia follows ethical recruitment principles created by the World Health Organization.

Tomblin Murphy said the NICHE program prioritizes internationally-educated nurses who are already in Nova Scotia over international recruitment, and it is building partnerships outside Nova Scotia to enhance the global nursing and healthcare workforce.

At the individual level, Tomblin Murphy pointed out how NSH is not only focused on bringing workers here, but making sure workers have a place to live, a job, and support.

“I feel very strongly that what we are doing is abiding by ethical principles and Nova Scotia is a leader in that regard,” said Tomblin Murphy.

Delegations from Nova Scotia have been travelling to India and Philippines to build partnerships.

“We can have faculty exchanges, where faculties from those countries India and Philippines, come and do some of the teaching with us and in Nova Scotia, and that our Nova Scotia, for instance, faculty can make exchanges as well,” said Tomblin Murphy.

Tara Sampalli, a senior director with Nova Scotia Health, has been part of delegations that have gone to India and the Philippines. She notes the aim of the NICHE program is to support people who’ve already made up their minds.

“For people who’ve already who’ve made the transition, they want to come. We want to make sure they’re not spending more money trying to make their way. But we say Nova Scotia wants you, we will support you end to end,” said Sampalli.

Catton says it’s important to consider the country as well as the individual.

“Are countries who are leading the recruitment effort, for example, are they building nursing schools? Are they providing health education lecturers to go in to support?” he said.

“Are they providing any financial compensation for the loss of those nurses and healthcare professionals because it’s the countries they’re recruiting from who have paid to educate to educate those nurses.”

Catton believes there needs to be a shift by all countries to invest more in health and make sure they’re educating enough people to meet their needs now and in the future.

Khalehla Perrault, a spokesperson with the Nova Scotia Department of Health and Wellness, said the province understands it has a responsibility to the communities they recruit from, and doing so in an ethical manner is always front of mind.

“In many cases, these nurses are people who have identified an opportunity to explore outside of their country and we want to make sure Nova Scotia is the best place for them,” Perrault said.

“In other cases such as our recruitment efforts in Kenya, we are giving people who need options an important opportunity.”

Perrault added the Office of Healthcare Professionals Recruitment is working hard to develop educational partnerships that will provide mutually beneficial arrangements through things like faculty and student exchanges.