Migration for welfare: nurses within three regimes of immigration and integration into the Norwegian welfare state

Immigration and welfare are closely linked. While immigrants do make use of welfare services, they also contribute to the organization and staffing of such services and, as a case in point, the Norwegian healthcare sector is increasingly dependent on migrant labour. In this project, we have explored how the expertise and labour of foreign nurses contribute to the Norwegian welfare state, and we have looked into barriers for the utilisation of their competencies. We chose to compare the ways into Norwegian society for nurses from Sweden, Poland and the Philippines, respectively. These groups represent not only three different nationalities, but also three different categories of countries, as seen in a Norwegian-centred perspective: Nordic countries (Sweden), EU countries (Poland) and countries outside of Europe (the Philippines). Differences in rules, educations, practices, and expectations mean that these three groups have very different opportunities and experiences. The comparison has allowed us to gain general knowledge about foreign nurses' pathways into Norwegian society, as well as to describe what applies to each single nationality and to nurses from the Nordic countries, from the EU, and from countries outside Europe. Regulations and the application of regulations for nurses from countries outside of Europe have undergone frequent and important changes in recent years. In addition, the total cost of fees and required additional education for this group has increased. In sum, these changes mean that nurses from the Philippines in particular experienced unpredictable processes and significant barriers to achieving employment as nurses in Norway. We also looked into how nurses from the Philippines experienced and handled the long and not always successful process of getting Norwegian nurse authorization, and how some nurses in the Philippines achieved social mobility not through emigration but by changing into a different career. Finally, we looked into how Filipino nurses and their often extended families and kin provided care mutually and across borders. For nurses from Poland, we found language to be a main experienced barrier to labour immigration and integration in Norway, especially because of the high cost on Norwegian language courses. Here we found some innovative solutions, for example Polish speakers who had studied Norwegian who were offering online Norwegian language training. Given the wage differences between Poland and Norway, the main motivation for Polish nurses seeking employment in Norway was the ability to improve their livelihoods. While some Polish nurses saw themselves staying in Norway and improving their knowledge of the Norwegian language in order to be upwardly mobile, other nurses saw their stay in Norway as a sojourn with a goal of saving money and moving back to Poland. Polish nurses experienced the Norwegian way of being a nurse as quite different to what they knew from Poland, and we took a closer look at some of these differences and how they came together to shape expectations and interactions in particular ways. When it came to nurses from Sweden, we found that they did not necessarily know and understand Norwegian as well as employers often assumed especially regarding medical terms and terminologies, while their frequent employment through recruitment agencies made for unclear and sometimes vulnerable workplace situations. For all three groups, there were differences in the organization and understanding of nurses' tasks and responsibilities as compared to what they were used to from their home country. Recruitment agencies also played a key role in recruiting nurses into Norway from all three countries, although they operated in different ways both in relation to the three countries and in adjustments to changes in regulations, practices and demand. More research is needed to provide a fuller understanding of the workings of recruitment agencies and other brokers in health worker migration. The project also uncovered how the term migration itself has become a generic term covering many different kinds of mobility, while at the same time shaping expectations, rights and categories that are largely taken for granted. This is also a main finding that requires more research.

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WELLMIG innovatively brings together the perspectives that migrants not only depend on, but also make significant contributions to the welfare state. On the one hand, nurses - male and female - with education from their countries of origin contribute directly to the institutions of a Norwegian welfare state in need of hands to take care of an aging population. On the other hand, they also gain rights of access to benefits and welfare provisions. The combination of these two aspects brings to centre stage some of the dilemmas that arise when the welfare state encounters the globalisation of labour. We propose to study the different pathways of Polish, Swedish and Filipino nurses into the Norwegian labour market and society, examining the impact of mobility regimes on migrants' lives. Comparing Scandinavian, EU, and non-EU migrants, we will explore how and when migration, gender, race and ethnicity matter, and bring together regimes of immigration and integration in a mutually informative way. The comparison offers the opportunity to examine the impact of these regimes on migrants' integration into work and society in Norway. The project also expands the concept of work-life balance across the life course and takes into account transnational lives. We plan for consistency and comparison across different fieldwork sites. Our methodology comprises mixed methods and multi-sited fieldwork, including fieldwork in sending states. While the issue of nurse migration is highly policy relevant, it raises theoretical questions of central concern to the social sciences, regarding the mutual relations between individuals and structures, between the transnational and the national, and between dimensions of power, identity, equality and difference. Applying an intersectional perspective on gender, migrancy and class, we will study how immigration and integration policies are shaped and interplay, and how they affect migrants' choices and experiences.