International Recruitment and Nursing Shortage in the Nordic Region: Ethical Implication and the Global Code: A Policy Analysis

AIM: To communicate ethical concerns about recruiting internationally educated nurses (IENs) from outside the European Union/European Economic Area (EU/EEA) to the Nordic region. BACKGROUND: Nurse migration from low- and middle-income countries to the Nordics is increasing, and national and international organizations have raised ethical concerns about active recruitment. METHODS: This paper employed a reflective analysis using heuristic experience in a postmodern paradigm drawn from secondary sources and experiential knowledge from nonprofit work. FINDINGS: Key ethical issues include high costs from multiple service fees, IENs' limited understanding of contracts and working conditions, and deskilling after arrival, where nurses perform tasks below their competence. Even experienced registered nurses are often placed in practical nursing programs and first hired as care assistants. DISCUSSION: Existing laws on labor exploitation and trafficking alone are insufficient, covering the complex exploitation in transnational nurse recruitment. Without legal frameworks, international nurse recruiters can ignore the principles of the World Health Organization (WHO) Global Code of Practice on the International Recruitment of Health Personnel CONCLUSION: States relying on international nurse recruitment should enact laws regulating recruitment actors and embed ethical guidelines in national legislation to protect IENs from exploitation. WHO member states must monitor international recruitment and ensure compliance with the WHO Global Code of Practice. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nursing science perspectives and transnational migration governance must be integrated into policy-making and implementation to protect IENs, their colleagues, patients, and families, and to prepare nurse managers to handle ethical issues in international recruitment.