In the 1991 film The Doctor, William Hurt plays Jack MacKee, a doctor who changes his views about life, illness, and human relationships after being diagnosed with cancer. As Jack experiences life as a patient, he reflects on his relationships with his patients.

When he returns to work, he begins to teach new medical interns about the importance of showing compassion and sensitivity towards their patients, which in turn will make them better doctors. Jack puts the interns in patient gowns, assigns them various illnesses and orders tests for them to “feel” the experience that they will soon put their patients through.

In our research, we focus on nursing practices and lived experiences within different regimes of immigration and integration. It is not surprising that each of the Polish nurses I have met during my fieldwork has a different story to tell.  The field-driven narratives vary in terms of migration decisions, initial expectations, and opinions about the recruitment procedures, including the role of recruitment agencies. However, most of the Polish nurses agree on one thing – that caring and nursing mean “something different” in Norway.

As an anthropologist, I am interested in the notion of “something different” – in its meanings and the social and cultural practices that it entails. It tells us a lot about the ways of caring and helps to problematize ‘taken for granted’ ideas, imaginaries, and understandings. In other words, by exploring nursing practices and experiences, we not only learn about the health care system, but also about what care means in a particular cultural context and how it is embedded in wider social relations.

While pointing out the differences between nursing and caring in Poland and in Norway, many nurses have used the phrase, “I had to learn how to….” This entails both learning how the Norwegian health care system works, and also learning how to practice nursing and caring in new ways.

We combine different qualitative methods. Some of our research is done by participating at workplaces and other social settings where nurses from the three countries take part. Another substantial part of the research is done through interviews. By now, we have interviewed approximately 60 nurses, including Filipino nurses residing in Norway as well as Filipino nurses in the Philippines, and Polish nurses who have worked in many different parts of Norway.

In order for us to better understand and contextualize our ethnographic and interview data, we have begun compiling the information we already know and are finding out about the structural conditions, or regimes, shaping the migration and integration of nurses to Norway. These regimes may be further broken down into formal and informal sets of rules.

The main body of data in WELLMIG is qualitative. However, the study design calls for supplementing these data with quantitative descriptions that can give us an overview of the migration and integration of nurses from Sweden, Poland, and the Philippines.

In order to provide quantitative indicators of integration, we need registry data, that is data that is collected and stored by Statistics Norway. About a year ago, we sent the application for access to unpublished data and tables to Statistics Norway. Data are of course no Godot, but with the patience of Vladimir and Estragon, we are still waiting for statistics …

It is about paying back to my parents, to be a provider for them

(Male nurse in Cavite who aspires to move overseas.)

The Philippines is the world’s largest provider of foreign-educated nurses. The training of nurses for overseas migration was implemented by the Marcos regime (1965-986) as a short-term solution to alleviate the high unemployment rate and high foreign debt. More than 40 years later, the number of trained nurses that leave the country annually is still immense.

Filipino nurses have been migrating to Norway since the 1970s. By 2010, approximately 1,000 Filipino nurses, mostly women, had settled and worked in Norway.

In an attempt to understand the phenomenon of Filipino nurse migration to Norway, I spent a few weeks in the Philippines interviewing nursing students and hospital nurses in Metro Manila, and the provinces of Cavite, Leyte and Iloilo.

By Marta Bivand Erdal

In the Wellmig project, we explore both lived experiences of nurse migrants from the Philippines, Poland, and Sweden working in Norway and immigration regimes facilitating their access to employment and integration into the labour market and the wider Norwegian society.

Nurse migration from the Global South to the Global North has a long history. In recent years, however, active recruitment by government actors in some Global North countries has been abandoned, mainly because of concerns that nurse emigration might adversely affect national health care systems in the origin countries.

Meanwhile the international migration of nurses is a fact. But both the Global North and the Global South lack skilled nurses. In this context, the manner in which gaps between needed supply of nurses and availability of trained nurses in the labour market are filled, matters.

While the training of nurses as a way to increase a supply of nurses across the globe has been identified as a lasting solution, international migration remains an important dimension to this picture.

Norway is among the countries which have formally banned active government recruitment of nurses from countries with a nurse deficit of their own, but this has not stopped the migration of nurses who want to work in Norway. Our field research suggests that Filipino, Swedish, and Polish nurses have different experiences with access both to immigration and to nursing authorization.

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The notion of precarity has gained considerable prominence in migration studies. The dominant trend in contemporary migration scholarship focuses on precarity of the most vulnerable – low-wage, poorly trained migrants – whose precarity is often associated with ‘illegality’ and ‘deportability.’ As health professionals and citizens of the European Union, Polish nurses in Norway are neither low skilled nor without appropriate authorization. Yet, they too experience periods of precarity.

The most precarious is the situation of newly arrived nurses who have secured their jobs with the help of recruitment agencies. Don’t get us wrong, many of the nurses we interviewed spoke highly of the assistance they received from various recruiters. Some thought that without the assistance of recruitment agencies they would have never been able to get a job in Norway. At the same time, recruiters are not always able to place Polish nurses in a full-time employment, be it in a hospital, a clinic, or a nursing home. Rather, recruiters line up a series of assignments. Sometimes the assignments are several weeks or months long, but often they are of a much shorter duration. As a result, there is a lot of “stand-by” time between assignments. Most nurses go to Poland to stay with family if the “stand-by” time is longer than a couple of days. Those who are provided with housing, often have to vacate the room or apartment as they await a new placement.

Every research project requires intensive field research as well as extensive reading. In addition to peer-reviewed literature, we are also reading popular accounts of migrant nurses’ experiences in Norway. After all, in this ethnographic study we are trying to uncover the insiders’ points of view.

Beata Babiarczyk worked in Bergen for four years in the early 2000s. Between 2000 and 2002, she published short dispatches from the field in a nursing and midwifery periodical. In 2007, these letters were published in a small volume titled Norwegian Memoir (Pamiętnik Norweski).

In the memoir, Beata narrates her professional migration journey. We learn about hear tearful departure from Poland and a dramatic arrival in Bergen—three plane rides, horrific turbulence, and a lost luggage—as well as the mundane details of working in a Norwegian hospital on a post-operative ward.

Beata shares her awe of Norwegian nursing equipment, her surprise at the truly collaborative partnership between doctors and nurses, the mutual respect doctors and nurses accord each other, and the comradery among all hospital staff.

These positives, however, could not keep Beata in Norway forever. She made a decision to return to Poland. She cites her love of her native land as the main reason for her return. But while she now lives mostly in Poland, she returns to Norway to work there during summers. Beata is cognizant of her privilege of being able to continue to work in Bergen from time to time. She realizes this privilege every time she listens to her nursing friends in Poland who barely make ends meet on their meager salaries.

Beata’s account of her four-year sojourn in Norway is not a candidate for the Nobel Prize in literature, but it is a delightful little book that seems to be appreciated by her fellow nurses (and our research team). We plan to interview Beata this fall to see how she is doing in her teaching job training student nurses. Stay tuned!

By Elzbieta Gozdziak