Exploring the push and pull factors affecting third-country migrant nurses in Malta

Abstract

Background: The Maltese healthcare system is heavily dependent on its foreign nursing workforce. Most of these migrant nurses are third-country nationals (TCN) as they come from countries outside the European Union (EU) such as India, Pakistan, and the Philippines. As of October 2022, there were 1627 TCN nurses actively registered in Malta. The retention of these key workers is essential in delivering an effective and efficient universal healthcare system. An exploration of the push and pull factors affecting TCN migrant nurses in Malta was therefore needed to inform policy which can improve the retention of this key workforce. Methodology: An exploratory qualitative research design with a multi-method approach was employed in the research study. Eight TCN nurses participated in online semi-structured interviews, five of whom also participated in a private, anonymous online asynchronous forum. Transcripts from the in-depth interviews and the online forum were coded and thematically analysed. Findings: Pull factors that may attract and retain TCN nurses in Malta include good quality of life, rich culture, civil and political rights, presence of family, Maltese hospitality, English-speaking country, and availability of opportunities. Conversely, push factors that may influence TCN migrant nurses to leave and move to other countries include issues with quality of life, racism and inequality, difficulty settling in and achieving stability, bureaucracy in visa processing, and less desirable work conditions. Conclusion: The identified push and pull factors were found to be multi-dimensional, context-sensitive, idiosyncratic, dynamic and may overlap each other. TCN nurse migration cannot be attributed solely to economic motives. Personal factors can also play a significant role in their decision-making process, and such factors can influence their migration choices. The research study presented a list of recommendations in relation to research, education, policy, and practice.