Overseas-qualified nurses in Irish general hospitals: RN4CAST study results

1. Overseas-qualified nurses in Irish general hospitals: RN4CAST study results Matthews A, Scott PA, Kirwan M, Lehwaldt D, Morris R, Staines A Dublin City University

2. Outline • The RN4CAST study • Data sources • Distribution of Irish/overseas qualified nurses • Organisational data- hospitals • Nurse survey data- hospitals and wards • Characteristics of hospitals and wards- some exploration • Discussion

3. RN4CAST study • Framework 7 European study, 12 countries 2009-2011 • Ireland: 30 large acute general hospitals, 112 wards • Nurses completed a survey about their organisational working conditions, their own characteristics • General medical or surgical or mixed med/surg wards • Organisational profile data were collected for each hospital • Patient survey and discharge data were also collected • Question: Do these data help to explain the patterns of recruitment and retention of overseas qualified nurses in Irish general hospitals? • What is the extent and distribution? • What organisational factors are associated with high levels?

4. Nurse survey data • 1,406 responses, medical and surgical wards, 57% response rate • Asked if received basic nurse education in Ireland or not; if not, which country • Overall almost 40% qualified outside Ireland (n=536) • Just over half of whom qualified in the UK (n=274) • India (n=111) and the Philippines (n=92) – approx one fifth each • We did not ask about nationality • Other partners: % all overseas-qualified nurses: • Switzerland (22.1%) and England (16.7%), Norway (5.5%), Germany (5.1%), Greece (5.1%), Belgium (3.1%), Netherlands (2.4%), Sweden (2.3%), Spain (1.3%), Finland (0.9%), Poland (0%) • England: Philippines (31.0%, n=153) and India (22.7%, n=117) sub-Saharan Africa (15.9%, n=78) of overseas

5. Nurse data: qualified in Ireland/ not by hospital Number of nurses Hospital Source: RN4CAST nurse survey

6. Ward level: Irish/other qualified

7. Hospitals with 50% + overseas qualified

8. Organisational profile data • Numbers of nurses… • who qualified in another country ; with a non-EU qualification; who are not EU citizens • total number of registered nurses • Proportion of nurses with non-EU qualification • Could be calculated for only 12/30 hospitals (range 1-50%)

9. Non-EU qualified nurses as % all: Organisational and nurse data

10. Hospitals with 30%+ non-EU qualified nurses Using nurse survey data as available for all (though subject to response rate))

11. Discussion • Lack of hospital-reported data- not known or not available (‘work-to-rule’) • To some extent nurse-reported data provide baseline (only for medical and surgical wards, based on respondents only) , suggest extent and distribution • Not possible to clearly identify ward or hospital factors associated with distribution pattern • Cross-sectional data collected in 2009/10 cannot capture the dynamics of recruitment and retention • Current nurse-reported data limited to indicate ‘push’ away/ ‘anti-Magnet’ (of domestically trained nurses); • is it possible to identify stable/enduring organisational factors?

12. Thank you www.RN4CAST.eu Anne.matthews@dcu.ie Seminar DCU 14 March 2012, RN4CAST findings, workforce planning implications