Working conditions and intent to leave the profession among nursing staff in Europe

Aims and objectives. Aims of this study were to describe (a) the Romanian nurses' reasons for emigration and the difficulties experienced in the first six months of integration, (b) their perception of the level of professional independence and competence gained in the first six months of working and (c) the strategies that either facilitated or impeded their development of professional independence at a teaching hospital. Background. The international recruitment of nursing staff is a strategy adopted by the Italian State to confront nursing shortages. Although the critical aspects and the opportunities available have been reported for many years, little has been written about the professional autonomy perceived by these nurses six months after their placement in the host country. Design. A descriptive study involving Romanian nurses working at the Udine University Training Hospital (Italy) was used. Methods. The participants were interviewed using anonymous questionnaires, which contained eight open and 20 closed questions. With their consent, the interview was done in the ward and took on average 45 minutes (from 30-60 minutes). Given a choice of language to use by the bilingual researcher, half the participants chose Romanian. Results. The small, homogenous group of Romanian nurses used as the sample and employed at the University Training Hospital, felt satisfied (in the areas of culture/placement/integration) and recorded similar facilitating factors and obstacles as those documented by other authors. By the sixth month following placement they felt they had a sufficient level of autonomy, but this was not the case in many skills, which are an essential part of Italian nursing. Conclusions. The expectations of the hospitals involved in international recruitment are higher than the Romanian nurses can guarantee, especially in the first six months. Integration obviously needs substantial investment, less 'red-tape' and a longer period of time for adjustment. Relevance to clinical pratice. It is necessary to help and support the placement of these nurses into the Italian workforce with programmes where their practical work is supervised by permanent trained staff, allowing them to develop autonomy and ensuring an optimal standard of nursing care for the patients. It would be necessary to continue these programmes for more than six months.