A Future Threat to the Nursing Profession: Brain Drain

Year 2025, Issue: Advanced Online Publication, 384 - 397

Esma Aslan Seki

https://doi.org/10.54535/rep.1801747

Abstract

This study addresses brain drain in nursing as a multidimensional global health issue. Brain drain refers to the migration of qualified labor abroad as a result of attractive factors such as better pay, working conditions, and quality of life, combined with various push factors. WHO projections indicate that the nursing shortage will increase until 2030, while migration will deepen inequalities between countries, negatively affecting service quality and patient safety. In the Turkish context, the number of nurses is below the OECD average; the tendency to migrate is high among nurses and students, with economic conditions being the main determinant. In addition to the classic push-pull factors, this study discusses reverse brain drain, virtual/digital, and hidden brain drain. It has been determined that despite the existence of programs supporting reverse migration, the impact of deterrent and retraction measures remains limited. Furthermore, ethical recruitment principles, data-driven workforce planning, and international cooperation are emphasized in situations where migration is inevitable. In conclusion, it is predicted that brain drain in nursing will continue without comprehensive, long-term strategies targeting economic and professional motivation, rather than short-term solutions.

Keywords

Nurse , Brain drain , Brain drain in nursing

References

• Adovor, E., Czaika, M., Docquier, F., & Moullan, Y. (2021). Medical brain drain: how many, where and why?. Journal of Health Economics, 76, 102409. https://doi.org/10.1016/j.jhealeco.2020.102409
• Arslan, N. (2017). Brain drain and diaspora networks. Journal of Social Policy Conferences, 73, 1-33. https://dergipark.org.tr/en/pub/iusskd/issue/36332/414296
• Aysu Köksal, Y. (2021). Mutluluk ekonomisi ve beyin göçü: Türkiye örneği. Unpublished master's thesis, Aydın Adnan Menderes University. https://tez.yok.gov.tr/
• Bakırtaş, T., & Kandemir, O. (2010). Gelişmekte olan ülkeler ve beyin göçü: Türkiye örneği [Developing countries and brain drain: Example of Turkey]. Kastamonu Education Journal, 18(3), 961-974. https://dergipark.org.tr/tr/pub/kefdergi/issue/49056/625889
• Baş, H. (2022). The virtual brain drain in Turkey: A qualitative research on remote employees’ experiences in foreign firms. Istanbul Journal of Economics, 72(2), 915-951. https://doi.org/10.26650/ISTJECON2022-1154780
• BCG (2021). Pandemic causes virtual brain drain. https://www.bcg.com/ news/6march2021-pandemic-cause-virtual-brain-drain-independent-online
• Botezat, A., & Ramos, R. (2020). Physicians’ brain drain-a gravity model of migration flows. Globalization and Health, 16, 1-13. https://doi.org/10.1186/s12992-019-0536-0
• Brandi, M. C. (2001). The evolution in theories of the brain drain and the migration of skilled personnel. Studi Emigrazione, 38, 1-14. http://www.irpps.cnr.it/it/system/files/the evolution study.pdf.
• Bundesagentur für Arbeit Statistik, (2022). Statistics of the federal employment agency. https://statistik.arbeitsagentur.de/
• Çalış, Ö. A. (2019). Türkiye’ye tersine beyin göçü: Nitel bir araştırma [Reverse brain drain to Turkey: A qualitative research]. Unpublished doctoral thesis, Sakarya University. https://tez.yok.gov.tr/
• Esenlikci, A. C., ve Engin, M. A. (2019). 1960’dan günümüze avrupa birliği ülkelerinde yaşayan Türk göçmenlerin sorunları [Problems of Turkish migrants living in the European Union countries from 1960]. HAK-İŞ Internati̇onal Journal of Labour and Society, 8(20), 59-77. https://doi.org/10.31199/hakisderg.524500
• Hashish, E. A., & Ashour, H. M. (2020). Determinants and mitigating factors of the brain drain among Egyptian nurses: A mixed-methods study. Journal of Research in Nursing, 25(8), 699-719. https://doi.org/10.1177/1744987120940381
• Hejduková, P., & Kureková, L. (2017). Migration of nurses: Serious global health problem. In: Globalization and Its Socio–Economic Consequences, University Zilina, 644–651. https://intrel.lnu.edu.ua/wp-content/uploads/2015/09/part_ii_final_3.pdf
• International Council of Nurses. (2022). Nurses a voice to lead invest in nursing and respect rights to secure global health. https://www.icnvoicetolead.com/
• International Labour Organization, (2014). Promoting decent work across borders: a project for migrant health professionals and skilled workers. https://www.ilo.org/manila/projects/WCMS_173607/lang--en/index.htm
• IOM, (2020). World migration report 2020. https://reliefweb.int/report/world/world-migration-report-2020?gad_source=1&gclid=CjwKCAjw_e2wBhAEEiwAyFFFo0gz8ITwxC_y-jgfOTpvgqKCvO5QnDXEYbpan3cz75o0HhTLADtWgBoCv1kQAvD_BwE
• Ismail, M., Kunasegaran, M., & Rasdi, R. M. (2014). Evidence of reverse brain drain in selected Asian countries: human resource management lessons for Malaysia. Organizations and Markets in Emerging Economies, 5(1), 31-48. https://doi.org/10.15388/omee.2014.5.1.14240
• Jadhav, S. T., & Roy, S. M. (2024). The sociodemographic characteristics of Indian nursing students and their ıntentions to migrate overseas for work. Policy, Politics, & Nursing Practice, 25(1), 58-62. https://doi.org/10.1177/15271544231201347
• Kaya, M. (2003). Beyin göçü/erozyonu. ISGUC The Journal of Industrial Relations and Human Resources, 5(2), 18-34. https://dergipark.org.tr/tr/pub/isguc/issue/25513/269065
• Kaya, M. (2009). Beyin göçü/entellektüel sermaye erozyonu bilgi çağının gönüllü göçerleri: Beyin gurbetçileri. Eğitime Bakış Dergisi, 5(13), 14-29. https://www.ebs.org.tr/yayinlar/egitime-bakis-dergisi
• Kollar, E. (2020). Brain drain. International Encyclopedia of Ethics, 1-10. https://doi.org/10.1002/9781444367072.wbiee873
• Kurtuluş, B. (1988). Beyin göçü: Geçmişte, günümüzde ve gelecekte. İstanbul Üniversitesi İktisat Fakültesi Mecmuası, 46, 171-186. https://dergipark.org.tr/en/download/article-file/8437
• Kwok, V., & Leland, H. (1982). An economic model of the brain drain. The American Economic Review, 72(1), 91-100. https://www.jstor.org/stable/pdf/1808577.pdf
• Lee, E. (1966). A theory of migration. Demography, 3(1), 47–57. https://doi.org/10.2307/2060063
• Merriam-Webster (2024). Brain drain. https://www.merriam-webster.com/dictionary/brain%20drain
• Nadir, F., Sardar, H., & Ahmad, H. (2023). Perceptions of medical students regarding brain drain and its effects on Pakistan’s socio-medical conditions: A cross-sectional study. Pakistan Journal of Medical Sciences, 39(2), 401-403. https://doi.org/10.12669/pjms.39.2.7139
• OECD, (2019). Recent trends in ınternational migration of doctors, nurses and medical students. https://www.oecd.org/health/recent-trends-in-international-migration-of-doctors-nurses-and-medical-students-5571ef48-en.htm
• OECD, (2021). Health at a glance 2021: OECD indicators. https://www.oecd-ilibrary.org/sites/015d1834-en/index.html?itemId=/content/component/015d1834-en
• OECD, (2022). Gross domestic spending on R&D (indicator). Main science and technology indicators. https://doi.org/10.1787/d8b068b4-en
• OECD, (2022). Nurses (indicator). Health statistics. https://doi.org/10.1787/283e64de-en
• OECD, (2024). Health workforce migration. Healthcare Resources: Nurses. https://stats.oecd.org/index.aspx?queryid=30175#
• Owens, I. (2019). Stop the brain drain. Nursing, 49(7), 6. https://doi.org/10.1097/01.NURSE.0000559924.84567.9d
• Peters, A., Palomo, R., & Pittet, D. (2020). The great nursing brain drain and its effects on patient safety. Antimicrobial Resistance & Infection Control, 9(57), 1-3. https://doi.org/10.1186/s13756-020-00719-4
• Pretorius, C. (2018). South African nurse migration and reintegration of returning nurses. Doctoral dissertation, Stellenbosch University. https://scholar.sun.ac.za/server/api/core/bitstreams/0014f626-83d8-4d6d-8dc2-8d1cf908bbd1/content
• Ratha, D. (2005). Workers’ remittances: an important and stable source of external development finance. Global Development Finance, 9, 157-174. https://ssrn.com/abstract=3201568
• Shinwari, S. A., Currie, C., & Kumpf, J. (2021). Brain drain in global health. Military Medicine, 186(7-8), 175-177. https://doi.org/10.1093/milmed/usaa569
• T.C. Cumhurbaşkanlığı Strateji ve Bütçe Başkanlığı, (2022). Kalkınma planları. https://www.sbb.gov.tr/kalkinma-planlari/
• Tansel, A., & Güngör, N. D. (2006). Türkiye’den beyin göçü: Yurda dönmeyen öğrencilere ilişkin anket sonuçları [Brain drain’ from Turkey: Survey evidence of student non-return]. İktisat İşletme ve Finans, 21(246), 5-29. https://doi.org/10.3848/iif.2006.246.3884
• TDK, (2024). Beyin göçü [Brain drain]. https://sozluk.gov.tr/
• Teferra, D. (2003). Diasporas sicentifiques scientific diasporas. Paris, France: IRD Editions.
• Thapa, B., & Shrestha, K. (2017). Factors influencing brain drain among Nepalese nurses. Kathmandu Univ Med J, 15(57), 35-39. https://kumj.com.np/issue/57/35-39.pdf
• THD, (2023). Hemşire göç eğilim çalışması raporu. https://www.thder.org.tr/uploads/subeler/THD%202023/hemsire_goc_egilimi_calismasi_ra.2023-.pdf
• Torun, S., ve Bilgin, O. (2023). Sağlık ve bilim 2023: Sağlık ve hemşirelikte yönetim. Efe Akademi Yayınları. https://doi.org/10.59617/efepub202318
• TÜBİTAK, (2021). TÜBİTAK’tan tersine beyin göçü için 2. çağrı. https://tubitak.gov.tr/tr/haber/tubitaktan-tersine-beyin-gocu-icin-2-cagri
• Ulupınar, S., Şen, Y., & Eycan, Ö. (2024). Nurses' attitudes toward brain drain and the associated factors. AJN The American Journal of Nursing, 124(3), 22-32. https://doi.org/10.1097/01.NAJ.0001007672.35687.2d
• World Bank, (2019). Migration and brain drain, World Bank Eca Economic Update Fall. https://doi.org/10.1596/978-1-4648-1506-5
• World Health Organization (2016). Health workforce requirements for universal health coverage and the sustainable development goals. https://iris.who.int/bitstream/handle/10665/250330/9789241511407-eng.pdf
• World Health Organization (2017). The international platform on health worker mobility. https://www.who.int/publications/m/item/the-international-platform-onhealth-worker-mobility
• Yıldırım, T. (2009). Sağlık çalışanları ve uluslararası göç: Göç nedenleri üzerine bir inceleme [Health workers and ınternational migration: a study on the causes of migration]. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 62(3), 87-94. https://doi.org/10.1501/Tipfak_0000000727