McElmurry Beverly J, Solheim Karen, Kishi Rieko, Coffia Marcia A, Woith Wendy, Janepanish Poolsuk
College of Nursing, University of Illinois at Chicago, Chicago, IL 60612, USA.
J Prof Nurs. 2006 Jul-Aug;22(4):226-35. doi: 10.1016/j.profnurs.2006.03.006.
International nurse migration is natural and to be expected. Recently, however, those who have fostered nurse migration believe that it will solve nursing shortages in developed countries and offer nurse migrants better working conditions and an improved quality of life. Whether natural or manipulated, migration flow patterns largely occur from developing to developed countries. In this article, nurse migration is examined using primary health care (PHC) as an ethical framework. The unmanaged flow of nurse migrants from developing to developed countries is inconsistent with "health for all" principles. Removing key health personnel from countries experiencing resource shortages is contrary to PHC equity. Often, nurse migrants are placed in vulnerable, inequitable work roles, and employing nurse migrants fails to address basic causes of nurse shortages in developed countries, such as dissatisfaction with work conditions and decreased funding for academic settings. Nurse migration policies and procedures can be developed to satisfy PHC ethics criteria if they (1) leave developing countries enhanced rather than depleted, (2) contribute to country health outcomes consistent with essential care for all people, (3) are based on community participation, (4) address common nursing labor issues, and (5) involve equitable and clear financial arrangements.
国际护士移民是自然且可预期的。然而，近来那些推动护士移民的人认为，这将解决发达国家的护理短缺问题，并为移民护士提供更好的工作条件和更高的生活质量。无论移民是自然发生还是受到操控，人员流动模式大多是从发展中国家流向发达国家。在本文中，将以初级卫生保健（PHC）作为伦理框架来审视护士移民问题。护士从发展中国家无序地流向发达国家，这与“全民健康”原则相悖。从资源短缺的国家抽调关键卫生人员，有违初级卫生保健的公平性。通常，移民护士被置于脆弱、不公平的工作岗位，而且雇佣移民护士未能解决发达国家护理短缺的根本原因，比如对工作条件的不满以及学术机构资金的减少。如果护士移民政策和程序能做到以下几点，就能满足初级卫生保健伦理标准：（1）使发展中国家得到加强而非削弱；（2）有助于实现与全民基本医疗相一致的国家健康成果；（3）基于社区参与；（4）解决常见的护理劳动力问题；（5）涉及公平、清晰的财务安排。
