Transcript Gender and Globalisation – Care Across borders

Nurse migration and hierarchies of
care in the Norwegian health care
sector
By Susan Savides.
Paper at the National
Metropolis Conference
in Vancouver 2006
Single nurses
“We were very explicit in whom we were going to select, that
we want those who are alone…. Unmarried! Adventurous! To
bring a whole family is, you know…. And then the kids are not
content, the wife is not content (…) we have to view this from
the employer’s perspective. So if we can choose between
someone who is married and someone who is unmarried, and if
they are equally qualified, than we have chosen the ones who
are free and single. It is much easier, you know, they can live in
a rented room. For the others, we have to try and find an
apartment and it is not easy for them. And than you have the
need for kindergarten and maybe the husband doesn’t get a job
and that may cause some conflicts. So, here you need to be a
little selective." Employer)
Employers’ success stories

“We have chosen many handsome young men
[Germans]. There is one male who has become a
head nurse, and then we have the guy in surgery.
Like, we have many. They are very, very proficient,
and they have really contributed. So this summer,
when I was going to place one, then she said: “Oh
God, do you have another man? We really want to
keep the male that we already have, and we would
like to have another one!” So, it has been
successful.” (Employer)
Being “similar” means being “inside”


“Germans slide into Norwegian society. The
Norwegian and German cultures are very
similar. Germany and Norway are like little
brother – big brother and vice versa”
(Recruitment agent)
“The Germans are very committed to
language” (employer)
Medical terminologies vs. private
conversations

“It was much more pleasant to participate in work related
discussions than private conversations. I still have troubles with
that today. I become insecure, I mean when the clock strikes at
three and I am finished at work and I am going to talk to them in
private, then I become fairly insecure and I don’t have so much
to talk about, and I am not used to none-hospital terminologies.
I mean, those hospital terminologies resemble… they resemble
a lot the German terminologies, right. So you use a little Latin
and English and then you may have the same expressions (…)
Everything is very similar, also the procedures are very similar,
right. (…) I opened the closet, and what I found were German
bandages, everything was in German, even the procedures
were the exact same as I had thought or as those we had in
Germany” (Male German nurse)
Being “different” means being
“outside”

“It was a nightmare, I must say (…) We demanded that they
[the polish nurses] had to pass the Norwegian language
courses, otherwise we wouldn’t allow them to come .They
passed, but even though they passed we weren’t satisfied.
They knew a lot less Norwegian than the Germans did. (…) We
had to initiate extra courses. (…) I talked to a couple of them
[polish nurses] and they said that they don’t need any extra
even if there had been complaints about them. So I tried to tell
them that there were a couple of vacant places [at the language
course] and that it would have been fun for them to try it. So
that’s also a big difference because we were used to them
[Germans] being eager to learn and wanting to learn more. As
for the Poles they had received this piece of paper and they
knew enough (…) It was a very big difference” (employer).
Troublesome Polish nurses

“The nurses are kind, but the requirements are so strict and
there are so many circumstances (…) Their language is so
completely different than the Germans and otherwise that they
struggle so hard to learn it [Norwegian]. And when things are so
unsettled with the Ministry regarding authorization, so we
have… We have spent recourses. The wards have spent an
incredible amount of recourses because they constantly need
training. The patients have probably noticed… (…) We have
told them that we have obligations of professional secrecy, but
we have become too much like a social service office”
(employer)
Coming from the “east” means coming
for money

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Employer2: “If you go and talk to them [the polish nurses], then
you will find out… (…) The motivation for coming to Norway
was probably not about coming to Norway or this city…”
Employer1: [interrupts] “Money! It’s about putting aside some
money. Plain and simple. And some are trying to bring their
families here. (…) They sent all the money home to Poland,
right. And then they came here and said that they needed
money for food”.
Emloyer2: “More money! Had to explain to them that you have
to keep some money so that you will be fine. You must not send
off the entire amount.”
Upwards professional and social
mobility

You have very traditional hierarchical systems [in Germany] (…) You
don’t work as autonomous; you’re an assistant, a doctor’s assistant.
Not a slave, right, but it is the doctor who is in charge. Here [in
Norway] it is a completely different reality, here you have an
independent profession with a lot of competence (…) Here you have
more democracy, the way I have experienced it. I know that not
everybody… especially nursing homes are different, but the way I
have experienced it; you sit down together in the morning, you chose a
group leader, you distribute tasks evenly as best as you can, you
evaluate, you have time for feedback. It’s a dream job. You have better
salaries, shorter work hours, you work every third weekend which is a
dream. (…) (German male nurse)

And then the whole world looks at Germans like; oh they are so
competent, and things like that, so therefore people listen to you right
away when you say something. (…), so you are representing a society
you really don’t know that much about. Like, I didn’t know that
Germany was so ahead with everything. (…) (German male nurse)
Loss of status and self confidence
“I had so much self confidence and believed that I knew a lot, that I often said:
“I do understand a lot, really I do understand a lot. Maybe I cannot express
myself as well, but I understand a lot”. But now, when I think about it, I realize
that I didn’t understand very much (…) I mean communication is a different
thing. It is very important at work, in my profession, because we work with
people. We don’t work with apparatuses or machines, but we work with people.
(…)What bothered me is that I felt really stupid. I wasn’t used to that because in
Poland I had achieved a high status as a nurse. I was head nurse and... so I
had high status and I was the one guiding and teaching the others. Now I was
reduced to the most stupid one at the hospital ward. Maybe..... well my
colleagues didn’t say this or give me the impression that they thought I was
stupid. I thought so myself. I felt very stupid, and then I had the impression that
patients... that they thought and maybe they said to themselves ” Oh my God,
who is that person taking care of me, who is that, she doesn’t know anything”
and that wasn’t right because I have..... I had very good qualifications and....
but I couldn’t explain anything...” (Female polish nurse)
Important things in life and “emotional
surplus value”

“Yes that was wonderful [working in the nursing home]. I never
thought that it would be that good. In my professional life I
always worked in emergency rooms. It was surgery.
Operations... I was used to action, adrenalin and things
happened all the time, and so I thought; Oh, how will it be
working with elderly people when doing the same things all the
time and talking about the same things - no challenges at all?
...things like that. But it was really good. I have experienced a
lot. I have learned a lot and I knew other values in life before,
but those are not the most important in the world. The most
important is for example to sit beside someone and holding
someone’s hand and let him talk, for example, and things like
that. So it was very, very good”. (Female Polish nurse)
Language and patient communities in
a nursing home
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“No, most of our patients are senile. They do not
remember us from the one moment to the next. They
are totally dependent on around-the-clock care from
us. They cannot eat, drink, go to the toilet or do
anything without help (Female Latvian nurse)
“Old people and nursing home patients talk a
language typically for their generation and a
language that is only relevant for situation as
patients. When I come out in society, young people
like me use different words that are more modern….”
(Female Latvian nurse)