Provision 10

Well-resourced countries ought to create a sustainable national nursing workforce. Nurse migration increases the cultural diversity of the U.S. workforce, bringing diversity of work experience and enriching the caring experience for patients. However, care must be taken so that well-resourced countries are not relying on recruiting nurses from other nations due to shortages in their own countries. Policies and practices must respect the autonomy of nurses who choose to migrate and avoid harm to the healthcare, health, and well-being of the people of other nations by drafting their nursing workforce. Nurse migration should benefit the nursing and health of both the source and destination nations. Nursing works against the challenges of undue inducements in recruitment and provides a welcoming environment for all nurses irrespective of their educational background and country of origin. This includes internationally-educated nurses who voluntarily migrate to other countries, international nurses who migrate to the U.S., and U.S.-educated nurses.

Nurses from the U.S. also work with international agencies such as WHO, health or disaster organizations, faith-based groups, and humanitarian NGOs. Nurses working in these settings (employed or as volunteers) should prepare for such service by developing basic language skills and familiarity with the history, customs, laws and norms of the community and nation. Nurses in communities or nations outside the United States show respect for patients’ way of being in the world, understandings of health and illness, and health and illness practices, without imposing their own cultural norms. Nurses serve as learners, listeners, and health partners who seek to earn the trust and goodwill of the community. Nurses in the military face unique challenges in a range of settings, including armed conflict zones, combat arenas, or humanitarian missions, each with different ends and distinctive challenges. Nursing care of enemy combatants, at times hostile enemy combatants, poses diverse clinical and interpersonal challenges and risks. Nurses strive to affirm the personhood of all patients, including enemy combatants, and provide care according to the individual needs of the patient.

Nurses practicing in global settings often face language and cultural barriers that affect patient choices and care. In the care of civilians or during humanitarian efforts, nurses, whether military or civilian, prepare themselves in advance, as much as possible, to cross language and cultural barriers in order to provide respectful and compassionate care that affirms the individuality and dignity of the patient. In disaster zones, there are particular challenges when resources are limited, the risk of injury is present, and there is a necessity for triage. Nurses engage in triage equitably and without partiality in accord with the canons of triage decision making and observance of international wartime conventions.