This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Anthropology. Please check back later for the full article. The global migration of healthcare workers is one of the most widely studied issues in healthcare worldwide. Fueled by a global shortage of healthcare workers, this movement is considered a crisis in health sector human resources. Since the 1970’s, the need for skilled healthcare workers has increased in wealthy countries that have not been able to keep up with training and retaining enough labor force to fill demands and that have increasingly relied on foreign-trained healthcare workers. Migrants are motivated by push factors in their home countries and pull factors in receiving countries. While some countries are capitalizing on the market demand and are facilitating export of their workers, some poor countries that lost their skilled workers to more developed countries are concerned with brain drain. Private, for-profit recruitment firms are increasingly entering this market and shaping migration patterns. A general consensus of research in this field is that more work needs to be done globally to build the capacity for training healthcare workers, to increase recruitment and retention of healthcare workers in their local regions, and to manage the global movement of healthcare workers of their own accord.

Over its history, while nursing responsibilities have shifted from primarily hygienic tasks (vocational work) to more medically centered duties (professional work), the work of care remains at the core of the nursing profession. Nurses judge themselves and each other as professionals based on how well they are able to care for the patients in their charge. A professional nurse's ability to care centers on the institutional environment in which she works. Using an ethnographic case study of Czech nurses as migrants, this article explores how the discourse of care work enables nurses to examine their professional identities in different institutional contexts, that of their native Czech Republic and in foreign workplaces. At its foundation, I explore what happens when the institutional setting in which caring is supposed to take place hinders the production of caring practices.

Abstract:The Czech Republic is experiencing a growing trend of health-care worker emigration. Although some emigrate for long periods of time, many return after a few months or years abroad and re-enter the Czech health system. The nurses' narratives in this study draw on experiences in Czech, British, and Saudi hospitals to explore the role standardised medical policies, procedures, and protocols play in the development and maintenance of a nurse's professional identity in the post-socialist context. The author suggests that performance of protocols versus informality of practice in health-care settings provides a lens through which to view professional identity in post-socialism. In fi elds such as health care, standards operate as measures of security that create normative rules of governmentality, regulate behaviour, and prevent harm. The nurses in this study describe the majority of Czech hospitals as lacking standard protocols for patient care. Encountering strict rules of practice in foreign hospitals leads them to evaluate the professionalism and quality of Czech health care and their own selves as nurses. Their assessment is often based on their own ability to effectively perform within the standardised system. The author's primary analysis for this presentation will concentrate on the ways that standardisation relates to ideas about professionalism and nursing autonomy and status.

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