Análisis y prueba de campo en elementos de sistemas industriales

In this study, the quantitative data were managed using descriptive statistics, and qualitative data were reduced into codes and themes. The available data from all three strands of this study are compared in the following Table 19; they are also compared with the relevant literature. Even though the quantitative data was originally expected to take priority, the priority slowly shifted toward a qualitative approach (Onwuegbuzie and Leech, 2006), mainly due to the limits in sampling and sample size. However, the qualitative approach allowed for a collection of rich data on Czech migrating nurses.

Some results and findings from this study on Czech migrating nurses differ from previously conducted studies. A deskilling of the migrating nurses is often described in the literature (Tjadens et al., 2013), but my sample of Czech nurses migrating mainly to Saudi Arabia did not report deskilling very often. Migrants who work abroad below their qualification level usually lose their previous professional skills and knowledge, but the very opposite was reported by my respondents and participants. Similarly, the typically very demanding credentialing procedure in the destination country (Newton et al., 2012), was not considered to be overly difficult by my respondents.

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While nurses are reported to return from some destination countries more than physicians for example (Kingma, 2006), the most common destination country in this study (the Kingdom of Saudi Arabia) probably facilitated return migration. Moreover, the Czech population reported preferring temporary migration (Vavreckova et al., 2006). Even though a repeated, circular migration is nowadays common (Schultz and Rijks, 2014), the majority of the Czech nurses did not migrate repeatedly. The returning Czech nurses seemed to start working in Czech hospitals, it is unclear from our results whether and how many will stay in their clinical positions permanently.

Being encouraged to migrate by the family and sending remittances to the extended family remaining in the home country is a very common strategy for migrants from the Philippines, Africa and Asia (Humphries et al., 2009a), but is does not appear to be a tactic employed by my respondents. Instead, a personal financial improvement, in combination with other benefits (an improvement of language skills and having new adventures), seem to be the motivators of Czech nurses in this study. This expectation of multiple benefits has been described in other studies (Dywili et al., 2013).

Some results of previous studies are rather similar to my results and findings. The communication barrier in the destination country (Palese et al., 2007) has been consistently reported, and it was an issue for my respondents and participants as well. Two other such aspects were the differences in nursing practice between the host and home countries (Blythe et al., 2009) and the limited ability to transfer new skills and knowledge back to the source country’s nursing system after return (Tjadens et al., 2013).

183 Information from literature 1st _{qualitative strand} findings 2nd_{quantitative strand} results 3rd _{qualitative strand} findings Migrating registered nurses often work abroad below their qualification (Tjadens et al., 2013)

Register – Not assessed Recruiting agency only sends abroad nurse as RNs

70% of the respondents eventually work abroad as RNs

Saudi Arabia – only as RNs UK – more worked as non-RNs

Not assessed - All of the participants worked as RN, it was an inclusion criterion in the 3rd _strand.

Nursing skills and knowledge - often reported

deterioration (Haour-Knipe and Davies, 2008)

Register – not assessed Recruiting agency was positive about the increase in nursing skills of the returning nurses, It causes problems with reintegration

79% of the respondents reported an improvement of their skills and

knowledge

83% very and moderately positive experience of migration

Unanimous improvement of professionals skills and attitudes, transformation is so fundamental that they cannot reintegrate

Return migration common (Kingma, 2006)

Register- Not assessed Recruiting agency – temporary return to CR

46% of the respondents returned, 16% returned but are not sure if permanently, 10% no plans to return 25% migrating for 2-3 years

9 nurses out of 10 returned, but convenience sample of available nurses Circular migration is common (Szpakowski et al., 2016), (Schultz and Rijks, 2014)

Register – Not assessed Recruiting agency – circular migration 2-3x, then family

77% did not report circular migration (28% does not want to migrate again)

About half migrated repeatedly Nurses send remittances to home country (Humphries et al., 2009a)

Buy real estate upon return (Massey, 1998)

Not assessed Majority (58%) does not send remittances, 43% bought real estate after return

Not assessed

Economic

improvement is the main motivator for migration (Dywili et al., 2013)

Register - Economic reasons, adventure Recruiting agency – not assessed

Language skills

improvement is the main motivator

New experience - second place

Fundamental improvement in language skills, economic gain is important but not vital

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Financial motivation - third place

Working as RN after return - not assessed

Register – Not assessed Recruiting agency – they start working as RN, but only temporarily

50% of the respondents work in the CR as RN after return

14% maternity leave 10% out of health care 8% teachers and managers

3 participants out of 10 work as part time RNs, but one is planning another migration

1 works as a teacher 2 maternity leave 2 out of health care Problems with

credentialing (Cuban, 2010), (Newton et al., 2012)

Register – easier within EU, automatic recognition common now, easy to SA Recruiting agency administers credentialing procedure 40% no problems with credentialing 20% credentialing took long time Not assessed Nursing practice is different abroad (Blythe et al., 2009)

Register- not assessed Recruiting agency – yes more developed, we should use this potential

Yes, different nursing practice causes difficulties after arrival

Agreement that nursing practice abroad is different + more developed

Communication in foreign language – main barrier (Palese et al., 2007)

Register – not assessed Recruiting agency – language skills main obstacle for more migration

The most difficult issue connected with migration 57% reported that their language ability was sufficient for common situations, but not for solving sensitive or difficult issues 18% rather insufficient

Agreement that the language barrier was a big problem initially,

influencing integration

Inability to use new skills after return (Tjadens et al., 2013)

Register – not assessed Recruiting agency confirms it

28% cannot use their new skills, 37% only some 38% of returnees well accepted by colleagues

Problems with

implementation of the new skills

Not very well accepted

Various studies Recruiting agency – younger, post-secondary

Female, younger, single, educated in similar

Female, slightly older, mainly post-secondary

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education or specialization Register - younger

percentage at high school level, specialization, post- secondary level

education,

Cascade pattern of migration

(Dumont and Zurn, 2007)

Recruiting agency - Gulf region countries Register – Gulf region countries, UK, Austria and Germany, other.

Destination - Saudi Arabia RNs,

German speaking countries, English speaking countries

Destination - different countries, Saudi Arabia 6x

Parents encouraging migration (Alonso- Garbayo and Maben, 2009)

Not assessed 70% of parents did not encourage Not assessed Discrimination of internationally educated nurses (Jose, 2008), (Newton et al., 2012), (Moyce et al., 2015)

Not assessed 61% never or only few times experienced workplace discrimination, 71% never experienced workplace abuse Less often in UK

About half reported experiencing discrimination after arrival, connected with language ability

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5 Chapter – Discussion