Navigating the Health Professional Migration Tsunami in the Era of COVID-19 and Globalization: A Call to Action for a Collective and Coordinated Response from Government and Non-Government Organizations.

Migration has always been a part of human history [...].

A Conceptual Model for Professional Identity in Nursing: An Interdependent Perspective.

The purpose of this initiative was to define the development, verification, and evolution of the conceptual model for Professional Identity in Nursing. This action research design occurred over two phases, utilizing observations, a modified Norris process for model development, and focus groups. Analysis consisted of conventional content analysis and the Fawcett method for conceptual model analysis and evaluation. The model was modified, and results are presented based on the model's philosophical underpinnings, content, socialness, and evolution. The model resonates with nurses both in the United States and internationally. The interdependency shown in the model encourages collaboration, accountability, and sustainability within the profession and society.

Guaranteeing dignity and decent work for migrant nurses and health care workers beyond the COVID-19 pandemic.

AIM(S): The main aim of this article is to outline the devastating aftereffects of COVID-19 in terms of ethical recruitment and the respect of dignity of nurses and health care professionals. BACKGROUND: Nations experience the ominous impacts of the COVID-19 pandemic in terms of an exacerbated shortage of nurses worldwide. In this situation, migration flows of nurses are skyrocketing and the respect of the migrant nurses' dignity as human beings should be guaranteed. EVALUATION: Data from reports elaborated by the International Centre on Nurse Migration (ICNM) were examined and outlined the central role of the respect of dignity of every nurse to prevent unethical exploitation of them. KEY ISSUE(S): The respect of human dignity is a complex concept. Human dignity denotes the inner nature of human beings but also their rights at work. CONCLUSION(S): In a post-COVID-19 world with increased flows of nurse migration, it is crucial to guarantee dignity at work for migrant nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse leaders should prioritize the ethical recruitment of health care workers and give a prominent role to the WHO 'Code of Practice on the International Recruitment of Health Personnel' which recognizes the ethical bedrocks of employment.

International Nurse Recruitment Beyond the COVID-19 Pandemic: Considerations for the Nursing Workforce Leader.

The global demand for nurses was both proven and exacerbated by the COVID-19 pandemic. With global migration on the rise, hospitals and health systems are looking to supplement their workforces with migrant nurses. Foreign-educated nurses bring expertise and diversity, but ethical recruitment must consider the balance between "brain drain" and an individual's right to migrate. This paper highlights the contributions of foreign-educated nurses in the United States; explores the landscape, policy perspective, and market element of nurse migration, recruitment, and retention; and identifies key considerations that chief nursing officers should make as they look to build diverse and sustainable workforces.

Nursing in Albania: A Catalytic Force in Transforming Health Professionals and Health Care.

PURPOSE: Transitions in nursing education and professionalism that align with global nursing standards are elucidated as critical success factors in transforming health professionals and health care in Albania. Progressive educational and regulatory pathways throughout the 2000s (1999-2020) are emphasized for their impact on the Albanian health system, including the achievement of universal healthcare coverage. METHODS: Data collected by the Ministry of Health and Sport and the Regulatory Authority for nursing and other healthcare professions in Albania were analyzed and outcomes explicated with regard to Albania's major health challenges. DISCUSSION AND CONCLUSIONS: Three milestones affirmed nursing as a driving force in the Albanian healthcare system: (a) nurses constitute the largest health professional workforce via a nurse-patient ratio of 1:400 in contrast to a physician-patient ratio of 1:2,500; (b) nurses are frontline care providers via clinical leadership in the management of primary healthcare centers, which ensure universal healthcare coverage; and (c) nurses are first responders via their presence and compassionate caring in the primary healthcare centers, including making critical shifts in converting primary healthcare centers to urgent care centers as needed. CLINICAL RELEVANCE: Nursing advancements have implicated quality care and professionalism in Albania across the health professions via three critical pathways: (a) health professional education at a university degree level for entry into practice (since 1999), which was prompted by and driven by nursing's quest to be a self-regulated profession (achieved in 2007); (b) healthcare global standards sparked by nursing's mandate toward professional autonomy, as achieved via regulatory procedures and policies; and (c) interprofessional healthcare initiatives that serve as collaborative platforms for innovative educational, clinical, and research projects.

The Contributions of Immigrant Nurses in the U.S. During the COVID-19 Pandemic:: A CGFNS International Study.

No other event has put health care-and nursing-at the forefront of local, national, and global discussions in the same way as the COVID-19 pandemic. Studies suggest that immigrant nurses are a critical part of US health care, and we are increasingly reliant on the skills they bring and the care they provide. To quantify and qualify this contribution, CGFNS International designed a data-collection survey and distributed it to nearly 74,000 foreign-educated health care professionals currently practicing in the United States during the early months of the COVID-19 pandemic. Although some challenges were reported, most nurses surveyed reported working with patients diagnosed with COVID-19 and having access to adequate personal protective equipment, and many felt the public perception of nurses has improved since the beginning of the pandemic. Continued research on the experiences of immigrant nurses during the ongoing global pandemic response and beyond could provide more comprehensive information on the immigrant nurses that drive the US health system.

Leveraging the trust of nurses to advance a digital agenda in Europe: a critical review of health policy literature.

This article is a critical and integrative review of health policy literature examining artificial intelligence (AI) and its implications for healthcare systems and the frontline nursing workforce. A key focus is on co-creation as essential for the deployment and adoption of AI. Our review hinges on the European Commission's White Paper on Artificial Intelligence from 2020, which provides a useful roadmap. The value of health data spaces and electronic health records (EHRs) is considered; and the role of advanced nurse practitioners in harnessing the potential of AI tools in their practice is articulated. Finally, this paper examines "trust" as a precondition for the successful deployment and adoption of AI in Europe. AI applications in healthcare can enhance safety and quality, and mitigate against common risks and challenges, once the necessary level of trust is achieved among all stakeholders. Such an approach can enable effective preventative care across healthcare settings, particularly community and primary care. However, the acceptance of AI tools in healthcare is dependent on the robustness, validity and reliability of data collected and donated from EHRs. Nurse stakeholders have a key role to play in this regard, since trust can only be fostered through engaging frontline end-users in the co-design of EHRs and new AI tools. Nurses hold an intimate understanding of the direct benefits of such technology, such as releasing valuable nursing time for essential patient care, and empowering patients and their family members as recipients of nursing care. This article brings together insights from a unique group of stakeholders to explore the interaction between AI, the co-creation of data spaces and EHRs, and the role of the frontline nursing workforce. We identify the pre-conditions needed for successful deployment of AI and offer insights regarding the importance of co-creating the future European Health Data Space.

Nurse and health professional migration during COVID-19.

The COVID-19 pandemic has exposed the vulnerabilities of nursing supply flows, domestically and internationally. Its impact at the country-level has further highlighted preexisting nurse supply gaps and the effect of staffing shortages. Internationally, the pandemic has disrupted global supply chains. The world has witnessed the closing of borders, the interruption of travel, and, in some countries, the restriction of outflows. The State of the World's Nursing Report (SOWN) (WHO, 2020) noted a shortfall of almost six million nurses immediately pre-COVID-19, a shortage suffered particularly by low- and middle-income countries. This is of major concern given that increased international outflows of nurses in the new post-COVID era could undermine, even more than before, the readiness of those countries to meet healthcare demands (ICN, 2020). In this default scenario, some, but not all, highincome destination countries will continue to rely on international inflow of nurses to a significant extent, as they did pre-COVID- 19, further exacerbating the suffering of poor countries. Put simply, without country-level policy changes related to the nursing workforce and backed by international organisations, pre-COVID-19 trends of increased nurse flows from low- to high-income countries will likely continue. In this scenario, the iniquitous maldistribution of nurses may become more pronounced. This "do nothing" option risks undermining both country-level progress towards the attainment of Universal Health.

CE: Original Research: The Recruitment Experience of Foreign-Educated Health Professionals to the United States.

BACKGROUND: In 2007 AcademyHealth published a landmark report on the U.S.-based international nurse recruitment industry. This article provides an update to that report, describing the current state of recruitment of foreign-educated health professionals (FEHPs), in particular foreign-educated nurses (FENs), to the United States. Areas covered include the regulatory landscape, economic issues, recruitment industry changes, and current demographic and migration trends. PURPOSE: To learn more, CGFNS International, Inc., formerly known as the Commission on Graduates of Foreign Nursing Schools, and its Alliance for Ethical International Recruitment Practices division conducted a study designed to elicit qualitative and quantitative data that would further illuminate the recruitment experience. METHODS: Researchers conducted a survey of FEHPs, recruited from those who used VisaScreen services between 2015 and 2017, designed to assess their recruitment experiences. They also conducted interviews with a smaller sample of FENs and recruiters to elicit greater detail. RESULTS: While there was evidence of progress relative to the ethical recruitment of FEHPs, issues such as high breach fees, inadequate orientation, and misalignment of expectations regarding work environment and location were also revealed. CONCLUSION: Given that FEHP migration to the United States is likely to continue its upward trajectory, better strategies to implement market-wide practices that ensure the safe, orderly, and ethical recruitment of FEHPs are needed.

Evolution of Care and Nursing: Moving With the Patients.

Health care costs are growing exponentially. They will continue to erode disposable income, especially among those most in need of health care-the poor and elderly. As the baby boomer generation ages, we will see dramatic growth in health care spending, which will influence the health care market in new ways. Increased government intervention and technological advancements will only further this shift. Factors driving the need for health care transformation include fragmentation, access problems, unsustainable costs, suboptimal outcomes, and disparities of care. Nurses now have more tools (ie, mHealth, telemedicine, and electronic health records) that they can use to provide assistance to their practices outside of acute care settings. These realities are all contributors to an evolving trend: retail health.

Digital Health: Join the Movement.

Digital health, defined as "the cultural transformation of how disruptive technologies that provide digital and objective data accessible to both caregivers and patients leads to an equal level clinician-patient relationship with shared decision-making and the democratization of care," will create a cultural transformation of traditional health care. Exponential advances in science and technology have-and continue to-transform health and medicine, as they give consumers more control over, and more responsibility for, their own health. Digital health is on the precipice of a major breakthrough to disrupt the traditional models of health care delivery. Health professionals, regardless of what part of the health care industry they serve, must embrace this disruption wholeheartedly in practice, education, and regulation. Health technology is more important than ever and will have deep impacts on culture, politics, and society.

Disrupting Policy and Practice: Refugees Shaping the Future.

For decades, refugee policies on local, national, regional, and international levels have set the narrative surrounding refugees' identities and roles in society. Often, these policies negatively affect refugees and can hinder any effort for successful integration (ie, employment). The focus of this article is to identity how refugees, specifically refugee nurses, are reshaping standard policy practices when it comes to integration and inclusion, as well as economic and social well-being. With an estimated 68.5 million forcibly displaced persons worldwide (25.4 million of which are refugees), it is important to shed light on the importance of including their voices in the dialogue during all stages of the policy development process. They should be included in the dialogue, from agenda setting to evaluation, in order to challenge current beliefs and attitudes. It is critical for societies to recognize refugee nurses' professional qualifications, skills, and abilities in order to address the ongoing shortages of health professionals that many nations are facing today.

International Nursing: GSD International Nursing Academy: An Italian Case of Practical Disruption Highlighting the Worth of Nursing Within Health Care Organizations.

It is strategic to describe and disseminate available examples of how nurses find the modus operandi to being fully integrated in their organizations, including the nurse role in determining improvements in clinical practice, management, education, and/or research. This article describes the recent experiences of Gruppo San Donato International Nursing Academy. The disruptive case shared here underlines the worth of nursing within health care organizations. The Gruppo San Donato International Nursing Academy aims to be a striking model to innovate health care delivery through the optimal utilization of the nursing workforce, uniting the areas of nursing management, nursing education, and research into a unique organizational platform.

The Role of Nurses in Advancing the Objectives of the Global Compacts for Migration and on Refugees.

Nurses and other health care professionals are in a unique position to shift the paradigm around migration debates. As caregivers and advocates for patients and other providers, nurses are crucial to the health and well-being of individuals, families, and communities. This is especially true for migrants, including increasingly vulnerable refugee populations around the world. As negotiations surrounding the Global Compact for Migration and Global Compact on Refugees come to a close, nurses' roles are becoming more apparent. Nurses are facilitators of migration and can help ensure that the benefits of migration are maximized and the challenges are mitigated. Often, nurses are migrants themselves. Leveraging nurses' knowledge, experience, talents, and compassion is crucial for attaining the objectives of both the Global Compact for Migration and the Global Compact on Refugees. Nurses are large contributors to the United Nations' 2030 Agenda for Sustainable Development and its 17 Sustainable Development Goals. The global nursing workforce has enormous potential to advance the achievement of these goals and objectives. In a world that appears to be increasingly xenophobic and hostile to migrants, nurses stand out as professionals who can change the narrative while providing compassionate care for the most vulnerable.

Current Data of Foreign-Educated Nurses in Italy and the Recognition of Their Professional Qualifications.

Up-to-date data on foreign-educated nurses (FENs) in Italy and the recognition of their professional qualifications are pivotal to boost international discussion, and to improve the engagement and involvement of multistakeholders in the nursing profession. Currently, FENs in Italy represent roughly 6% of the total number of registered nurses. FENs are predominantly females between 35 and 54 years old. This article discusses FENs' paths to achieve their professional qualification to practice in Italy. It also offers insights for regulators and stakeholders, such as the need to enlarge the scope of practice for nurses.

Advocating to Protect Our Nurses: Addressing Unethical Recruitment of Foreign-Educated Nurses.

Advocacy in the nursing sector is often about advocating for patients. However, nurses have begun to put more effort into protecting their rights as workers. Advocacy on behalf of foreign-educated nurses has been a critical component of this advocacy. While foreign-educated nurses can make our nursing workforce stronger, this can only happen if they are well-treated and well-trained. Organizations across diverse missions and perspectives have come together to promote fair treatment of foreign-educated nurses, which ultimately ensures that all nurses are working as effectively as possible and that patients receive proper care. The Alliance for Ethical International Recruitment Practices' Health Care Code for Ethical Recruitment and Employment Practices represents a bottom-up agreement on which market practices constitute ethical recruitment. From a top-down level, the World Health Organization's Code of Global Practice establishes obligations and reporting requirements for member states that commit to ensuring ethical recruitment. This combination of efforts, bolstered by strong advocacy, is gaining traction as nursing migration grows at the global level. The collaboration across diverse stakeholder groups and the combination of legal, voluntary, and global efforts to promote the rights of foreign-educated nurses provides a model to apply for advocacy in different areas.