Nursing students intention to work abroad - a public health policy issue in Serbia

Abstract

Out-migration of nurses from less developed countries continues to exacerbate. In a country with poor economy and limited job opportunities students’ out-migration is not commonly understood as a problem rather is perceived as a solution for high unemployment of young health professionals. Attainment of a health care system intermediate objectives and goals may be challenged by lasting nurse shortages and inequity in distribution of nursing care. Study objectives were to identify the prevalence of intention to work abroad, to point to the predictors of intention to work abroad and predictors of having a firm plan to leave and work in a foreign country. Total of 719 nurse students attending the final years of state college and specialist studies in school year 2012/2013 voluntarily completed the questionnaire designed with regard to similar surveys carried out in pre EU accession period in Poland. Data were analysed with descriptive and multivariate regression analyses. 69.7% (501) respondents have considered working abroad. Among them majority was college nurses (70%), average age 22 years, females (80%), single (93%), from urban residence, unemployed (80%), with no foreign country’ professional experience, but with a relative or friend abroad. Most respondents speak one foreign language and prefer to work abroad right upon graduation permanently or temporarily. A firm plan to work abroad already had 13% nurses. Single nurses and those friend or relative abroad were more likely to consider working abroad than their counterparts (Odds Ratios were 2.3 and 1.7 respectively). The likelihood to consider working abroad was decreasing by 29% with the improvement in financial situation. Having someone abroad was associated with 4.8 fold higher likelihood for having a firm plan to go. Also associated were previous professional experience in foreign country, and financial improvement (5.4- fold and 2-fold higher likelihood). Serbia has no explicit policy to address nurse out-migration nor nurse student’ intention to leave. The high prevalence of intention to work abroad suggests putting the issue of student’ out-migration on policy agenda. Factors associated to work abroad instead in country are relevant to be understood, analyzed and effectively addressed in a short- and long-term multidimensional approach (labor, education, socioeconomic and health policy).