By Aslaug Gotehus and Taylor Vaughn

Becoming authorized as a nurse in Norway requires a major investment of time for anyone. However, when you are moving to Norway from another country, the investment multiplies. When that country is outside of the European Economic Area (EEA), the investment multiplies again.

Leaving your country of origin and seeking new adventures and opportunities in a new country involves a range of investment costs along the way, emotional as well as economical. In addition to the cost of education and preparation for moving overseas, the nurses we’ve interviewed with an education from the Philippines face increasing costs of both time and money once arriving in Norway.

One of the main concerns of the nurses we have interviewed is being granted authorization as a nurse in Norway. Through our interviews with these nurses, we have come to realize just how difficult it can be to stay on top of the regulations.

Many of the nurses have expressed confusion and frustration over how often the nurse authorization regulations change and how difficult that makes it to be granted authorization. Along with these changes have come increasing fees.

by Marie Louise Seeberg

When policies meet people

Like most research projects nowadays, WELLMIG is organized into work packages. One of them delves into what we have called the “regimes” of migration and integration for nurses wanting to come to work in Norway. That these regimes look very different for people coming from our three countries Sweden, the Philippines, and Poland is something we have mentioned before. They are subject to different policies of authorization and recognition of qualifications.

What we have discussed to a much smaller extent is the impact of other Norwegian policies on their opportunities and experiences along the way. This is where it gets really complicated.

As is to be expected, we have been reading—or should we say perusing—plenty of academic books on migration, including books directly related to our project such as “Caring for Strangers” by Megha Amrith, but we have also read novels and poetry involving migration and migrants, often penned by immigrant writers. Below is a selection of our readings. Maybe we can inspire you to pick up some of these titles, too?

Marie Louise Seeberg 

“The Sympathizer” by Nguyen Viet Thanh (2016) is a spy novel and a love story, but first and foremost a book about living one’s life between two very different countries and realities.

A very different book but similar in just that one respect, “Mastering the Art of Soviet Cooking: A Memoir of Food and Longing” by Anya von Bremzen (2013) paints a vivid picture of life in the Soviet Union through the lens of food memories. Not Proust, but much more fun to read – and again, conjuring up very different realities that are dependent on one another.

Impossibly complex but a rolling good read all the same is “The Mushroom at the End of the World: On the Possibility of Life in Capitalist Ruins” by Anna Lowenhaupt Tsing (2017). Yes, it’s about mushrooms. It’s also about Hmong refugees in the US, and about Finnish and Japanese forestry. And just about everything else.

“In the Sea There are Crocodiles: Based on the True Story of Enaiatollah Akbari” by Fabio Geda is the devastating and beautifully written account of a young Afghan boy’s journey from his village through several countries and across the sea.

I like graphic novels too – and “Persepolis: The Story of a Childhood” by Marjane Satrapi is one of my favourites here. It lets you into the home and life of the author as she grew up in Iran during the years of the Islamic Revolution.

Finally, I’ll include “1947: Where Now Begins” by Elisabeth Åsbrink. This is a month-by-month recount of one year in history and not a particularly famous year at that. The fascinating thing here is that it lists sometimes unremarkable and always apparently unrelated events that are rooted in the preceding years of World War 2 (on which there must be millions of books), and that led to most remarkable events in the following years, such as the foundation of the state of Israel, the creation of the CIA, the invention of the Kalashnikov, and the beginning of the Cold War. All alongside quietly recorded events on the individual scale, in the life of the author’s father, then a 10-year-old refugee.

The Philippines is the world’s largest exporter of nurses. Filipino nurses can be found in the United States, Australia, the Middle East, and Europe. Many Filipino nurses work as au pairs or helsefagarbeider (auxiliary nurses) before they get registered as sykepleier (nurse).

Norway is attractive to Filipino nurses

Norway is very attractive to Filipino nurses, because of high wages, excellent social benefits, and exceptional quality of life. These incentives are sufficient for many Filipino nurses to take a risk and migrate to Norway thinking that they will find greener pastures there.

Seeking a job-seeker visa

After receiving her master’s degree, Taylor decided to apply for a job-seeker visa in Norway on the basis of having graduated from a Norwegian university. This visa would allow Taylor to work and remain in Norway for one year while looking for a job.

She didn’t really need to look for a job as she already had a contract from NOVA at OsloMet to work as part of the WELLMIG team. Unfortunately, the position was a part-time (50%) assignment. One needs to have at least an 80% position to apply for a work visa, but Taylor was optimistic that the job-seeker visa would allow her to continue working with our team. However, to Taylor’s dismay, her application was rejected on other grounds.

Blog post by Marie Louise Seeberg

A question of national regulations

However, what it means to be a nurse is also very much a legal question. The nursing profession is regulated. This means that “nurse” is a protected title. You can’t just call yourself a nurse even if you feel like one, if you don’t meet the legal criteria.

There is no global definition. Each country has its own criteria. What it takes to fulfil the criteria is based on the content, shape, and size of the country’s own nursing education. This, again, is linked to its history, demographics, and culture.

In WELLMIG, we grapple with this question at all stages of the research. In our project proposal, which also serves as a guideline for the research, we defined “our” nurses as nurses educated in Sweden, Poland or the Philippines who are working as nurses, auxiliary nurses or “unskilled” healthcare workers in Norway. This definition clashes with that of Norwegian authorities, who only recognise as nurses those who have obtained Norwegian nurse registration (“autorisasjon” in Norwegian legalese).

Conducting doctoral studies involves a lot of reading. Mostly, I read peer reviewed articles and books on theory and methodology, but I also try to find time to read novels. I believe that reading novels makes us better researchers and better writers.

In my PhD project, which is part of the WELLMIG project, I focus on the experiences of nurses educated in the Philippines. Although my focus is on the individual nurses and their experiences, getting to know the culture as well as the history of the people is also central.

In my ethnographic field research on Polish nurses in Norway, I’m focusing on their personal migration stories, work experiences, and adjustment to the Norwegian health care system. Obviously, these issues vary depending on migration strategies, recruitment arrangements, and particular workplaces, but they all also inform our understanding of the complexity of the Norwegian health care system.

Although some nurses I’ve met during my research work in Norwegian hospitals, the majority of the Polish nurses have found employment in nursing homes (sykehjem) scattered around Oslo. The concept of nursing home, though commonly known and present in many welfare states, seems to be imagined and practiced differently. These differences don’t stem solely from the “usual” case of economic conditions and the state’s policy approach to care of the elderly. The social and cultural understandings of care play a pivotal role in “who,” “why,” and “how” we should be looking after the elderly.

Through various discussions I had with Polish nurses working in sykehjem, it became obvious that in order to understand their work, as well as the differences in the approach to care in Poland and Norway, I myself needed to spend some time in a nursing home and experience it as a place of emerging social relations and cultural meanings.  

As we interview migrant nurses from the Philippines and Poland living in Norway, we reflect on the role language plays in our research. Both of us speak Polish, English, and Norwegian. These abilities position us in particular ways linguistically vis-á-vis the nurses we interview.

Does it make a difference to be interviewed in your mother tongue, or not? Is it different than talking to researchers in your second or third language? Does it matter that you and the interviewer share several languages? And what can we, the researchers, do in order to not get lost in translation, but stay true to what our interviewees tell us? As we conduct interviews, we keep in mind the old adage: “It is important not only what people say, but also how they say it.”

Researchers go to conferences to present their work, give and get feedback, brush up on the latest developments in their fields of study, learn new things, and get to know other researchers with similar interests.

The Nordic Migration Research Network

As I am writing this, I am on my way back from a conference organized every other year by the Nordic Migration Research network. This conference is organized on a rota basis between the Nordic countries and draws an audience of around 300 scholars mainly from Norway, Sweden, Finland, and Denmark, as well as from other parts of Europe and a few from other continents.