Motivations, migration and experiences of Black African nurses in the United Kingdom

Personal Author: Likupe, Gloria 
Year: 2011.
Dissertation: Thesis (PhD) -- University of Hull 

Abstract

Background

This study explored motivations for black African nurses who move to the United Kingdom (UK). It describes their experiences once they arrive and are working in the UK.  Experiences of ward managers who work with black African nurses were investigated to gain managers’ perspectives on their perception of the experiences. The 1990s and early 2000s saw unprecedented recruitment of nurses from overseas to the UK, to work both in the NHS and in the private sector. As a result the health sector has experienced an increase in the diversity of its workforce. A number of researchers have concluded that minority ethnic groups in UK come from different backgrounds, face different forms of stereotyping and display differences in class and cultural backgrounds (Kenny and Briner, 2007 and RCN, 2008). These factors are likely to impact on the way different ethnic groups are treated within the workplace, and may account for the differences in the levels of workplace discrimination perceived by different ethnic groups. Existing research fails to explore these potential differences (Kenny and Briner, 2007).

Aims

The aims of the study were to explore historical and political factors that influence black African nurses from sub-Saharan Africa to migrate to the UK, to investigate how these factors affect experiences of these nurses in the UK and to raise awareness of discriminatory practices in the National Health Service (NHS) experienced by this group of nurses.

Method

A qualitative approach was used to investigate black African nurses’ motivations for moving to the UK and their lived experiences once in the UK. Individual interviews and focus group discussions were used as tools for black African nurses and their managers to express their lived experiences. The sample comprised of 30 nurses and 10 managers. Data were tape recorded and transcribed verbatim before analysis.

Findings

The key findings of the study were:

  1. Migration motives for black African nurses moving to the UK are complex and inherent in historical links and global values. This is consistent with most migration theories such as Neo-Classical Theory, Dual Labour Market Theory, New Economics of Labour, Migration Network Theory and World Systems Theories (Massey, Arango, Hugo, Kouaouci, Pellegrino, and Taylor, 1993). However integration of macro and micro-processes such as government policies and personal reasons are also responsible.
  2. Black African nurses said that mostly the practices of nursing in the UK were similar to those in Africa but felt that their skills were not utilised. These similarities were in the technical aspects of nursing such as drug administration, wound dressing, prevention or pressure sores and so on.  However, nurses said they were shocked at how poor infection control practices were in nursing homes and hospitals. Other differences involved the social and cultural aspects of nursing such as treatment of the elderly, etiquette among nursing staff, discharge planning and communication.
  3. Black African nurses felt that they were objects of racist discrimination from managers, white UK nurses and other overseas nurses.
  4. Managers displayed prejudice and stereotyped attitudes toward black African nurses.
  5. Managers cited language as one of the most important factors to be considered when employing overseas nurses and stated that any nurse whose first language is not English needs to be assessed to ensure patients safety.

Discussion

This research highlighted motivational factors for black African nurses wanting to move to the UK and experiences of black African nurses once they have arrived and are working in the UK. The study has also discussed managers’ perspectives on their experience of working with black African nurses. The data demonstrates that black African nurses suffer racism from patients, British nurses, other overseas nurses and their managers and are discriminated in the workplace. This is despite the various Race Relations Acts since 1976 and the Equality act 2010.
The study demonstrates that advanced nursing skills are increasingly important in the UK, especially with the reduction of junior doctors’ working hours. It is therefore in the UK’s interest to assess overseas nurses’ skills adequately and to allow them to exercise their scope of professional practice so that their skills are effectively utilised. In addition the data indicate that it is possible to train pre-registration nurses to perform technical skills. It would be cost-effective for the NHS if nurse pre-registration nurse education was to incorporate technical skills which would put UK nurses on an equal footing with in other parts of the world.

The study suggests that the practice of giving English tests to nurses from outside the EU is discriminatory to those nurses especially as nurses from Europe, most of whom do not speak English, are exempted from the test.  In addition, the practice puts patients at risk when nurses from the EU, whose first language is not English, are allowed to nurse patients without taking the English test.

Contribution to Nursing Scholarship and health Care Practice

Part of the literature review published in the Journal of Clinical Nursing in 2006 has been one of the most quoted papers by black and ethnic researchers, thereby contributing to the ongoing discussion on valuing diversity. In 2006 part of this research was presented to All Party Committee in the House of Commons and has contributed to the debate on overseas nurses’ recruitment policy.

The study has highlighted the gendered nature of nurse migration and its associated problems which not received much attention in the past.  It has pointed the need to assess all overseas nurses English language proficiency.
The findings could be instrumental in recommending that the government assesses nursing needs and ensure adequate numbers of nurses are trained to meet demand. This will prevent large international recruitment, together with destabilisation of health services which it brings on developing countries. It may prevent competition among overseas nurses in the UK, together with discrimination and racism that competition may bring.
The study provides insight into the need for cultural competence and understanding among nursing staff and between staff and patients.  

Access the full e-thesis

Likupe, G (2011) Motivations, migrations and experiences of Black African nurses in the United Kingdom, PhD, University of Hull

 

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