International Recruitment and Nursing Shortage in the Nordic Region: Ethical Implication and the Global Code: A Policy Analysis

Abstract

Aim: To communicate ethical concerns about recruiting internationally educated nurses (IENs) from outside the EuropeanUnion/European Economic Area (EU/EEA) to the Nordic region.Background: Nurse migration from low- and middle-income countriesto the Nordicsisincreasing, and national and internationalorganizations have raised ethical concerns about active recruitment.Methods: This paper employed a reflective analysis using heuristic experience in a postmodern paradigm drawn from secondarysources and experiential knowledge from nonprofit work.Findings: Key ethical issues include high costs from multiple service fees, IENs’ limited understanding of contracts and workingconditions, and deskilling after arrival, where nurses perform tasks below their competence. Even experienced registered nursesare often placed in practical nursing programs and first hired as care assistants.Discussion: Existing laws on labor exploitation and trafficking alone are insufficient, covering the complex exploitation intransnational nurse recruitment. Without legal frameworks, international nurse recruiters can ignore the principles of the WorldHealth Organization (WHO) Global Code of Practice on the International Recruitment of Health PersonnelConclusion: Statesrelying on international nurse recruitmentshould enact lawsregulating recruitment actors and embed ethicalguidelines in national legislation to protect IENs from exploitation. WHO member states must monitor international recruitmentand ensure compliance with the WHO Global Code of Practice.Implications for Nursing and Health Policy: Nursing science perspectives and transnational migration governance must beintegrated into policy-making and implementation to protect IENs, their colleagues, patients, and families, and to prepare nursemanagers to handle ethical issues in international recruitment.