She has helped open two community resource centers in West Jordan City Hall and Riverton and works continually to strengthen the relationship between South Valley Services and law enforcement. Melissa Worthen West Jordan, Utah In both her personal and professional lives, Melissa Worthen looks for ways to strengthen the community. Melissa goes the extra mile and our community is better because of it. The crew worked from daylight to dark each day.
They were working in difficult circumstances, but worked until the job was completed. I appreciate the willingness of these workers to volunteer for this duty, knowing that they would be leaving their families to aid others. It is an honor to be the Mayor of the City of Lawrenceville because of the dedication of the employees of the City of Lawrenceville.
Laurel Schneider Hamden, Connecticut Laurel Schneider began volunteering at Keefe community Center in March and has since performed over hours of volunteer service. She has performed administrative duties, assisted with food pantry distribution, and assisted in the computer lab with Hamden Youth Services and Community Services. Laurel recently accepted a part-time position as Job Developer with the Hamden Adult Education Pathways to Work Program and also continues as a volunteer.
Lucas Alexander Hamden, Connecticut Lucas Alexander began volunteering in Hamden Youth Services three years ago and has accomplished over hours of volunteer service. Lucas Alexander truly loves his volunteer activities and is motivated by a challenge. He greatly admires U. Senator Chris Murphy and aspires to devote his life to public service. Lucas is a Hamden resident entering his freshman year at Hamden High School. Lucas enjoys music, history and writing. Hamden Youth Services looks forward to future motivational endeavors with Lucas Alexander.
Lewis is an integral part of these support operations, and without his leadership many events held throughout Hamden would not be possible. Mayor Marti Shamberger Morgantown, West Virginia "I have had great examples throughout my life of people who 'go the extra mile. Acts of kindness, treating people with dignity, and being a voice for those who need help are a few of the actions I witness daily.
I believe through these actions we are leaving our world a better place. Without the Harpers, the skies of Canton would have been dark for the fourth. With their help, and the amazing outpouring of support from donors large and small, the city was able to celebrate Independence Day together with the traditions many have grown to love. Page Norwich, Connecticut Mr.
This is a Norwich resident that decided long ago he would donate his time and talents to improving our City and moving her forward. He has utilized his architectural background to ensure that new projects in the City comply with our Plan of Conservation and Development. In he was awarded a Certificate of Appreciation for Outstanding Contribution for the Protection of the Environment.
He is a Justice of the Peace and has traditionally provided transportation for the elderly and disabled citizens to the polling locations.
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Mayor Joseph Ganim Bridgeport, Connecticut "Going the extra mile is putting the needs of others before your own. It means doing far more than what is simply required; and standing up for something you believe in — even when it is not the popular thing to do. It requires passion, humility and strength. It may start with one person but its effects inspire a whole community.
The hardworking individuals and organizations that have gone the extra mile in Bridgeport have each in their own way raised the quality of life in our city, and we are forever grateful for their efforts. Reed Bridgeport, Connecticut Louis L. He has a great deal of passion for his community and has committed his life to empowering and coaching those in need of targeted re-entry services.
Louis provides exemplary life coaching, re-entry, and recovery-based services to individuals who "are in need of mobilizing their inner resources and tapping into greater potential to live a more purposeful life. He has made over referrals that ensured his participant's access to resources, supportive services and employment opportunities - which for so many have been life changing. BNT's mission is to lead, empower and change Bridgeport neighborhoods by improving quality of life through affordable opportunities, healthy homes and comprehensive home ownership counseling.
In addition, they make every effort to hire those that may need a Second Chance in life. Aerotek Bridgeport, Connecticut Aerotek is an employment agency that has provided support and employment opportunities for the Mayor's Initiative on Reentry Affairs MIRA , which addresses various needs of Bridgeport residents returning to the community from correctional facilities. Aerotek has displayed a willingness to work with people in need of a Second Chance. They have been committed to providing employment opportunities that assist out residents with becoming productive members of the Bridgeport community while providing opportunities to work and support their families and community.
LifeBridge Community Services Bridgeport, Connecticut LifeBridge Community Services is a nonprofit organization that provides a "holistic service approach and has a positive impact on the quality of life and economic health of the Bridgeport community. LifeBridge programs that influences economic empowerment, behavioral health, social enterprises and youth services.
Carbone has worked feverishly to make a difference in the Bridgeport community by bringing resource and funding to impact our community though an entrepreneurial approach on workforce and economic development pursuits. Joe's ability to leverage resources and access funding has provided a comprehensive framework of services for Bridgeport residents including, but not limited to programs serving the long-term unemployed, mature workers and returning citizens. Our community will nurture our children. This year we witnessed an outpouring of support in our third annual peanut butter drive.
Her projects include making small quilts for those in need and making pies to sell for the benefit of the fire dept. He also regularly collects eyeglasses from local opticians for Lions Club International. Having less trash around may be part of why foot traffic is increasing, and the pickers do report that they see a lot more people walking around downtown Barre in the evenings now than when they started.
Charles Dixon practiced law for more than 60 years in Hickory. He was recognized as a key leader in the community serving professionally and personally in an unsurpassed manner. Dixon served on the Bond Implementation Commission until his passing on July 5, The primary projects are the City Walk, Riverwalk, Streetscapes and Gateways in which they have, and continue to dedicate a considerable amount of time to meetings, planning, and fruition of the projects.
The park will contain unstructured play equipment, outdoor seating, and a splash pad. It will also feature pottery, mosaic tile, a music section, toddler area and bicycle repair stand. Her work never ends. She puts in countless hours for the City, Council, all Departments, and whoever needs help. He has been the chair person for the last 13 plus years. Bill does so much for our aging citizens in the community and his work is paramount. During the last two years he has worked on a Strategic Plan and now has it an almost final stage. The City of Arnold is so lucky to have someone of his talents.
Teresa heads up our Recreation Center, oversees planning, design, implementation and management of recreational programs, activities and special events in the areas of adults and youth services. She not only called our city businesses to donate food, but went to pick up each meal and served everyone. Everyone needs an employee like Teresa.
He is always there to help with whatever is asked of him and never any complaint. What is your purpose? See you at the finish line …. There is an energy of possibility in Wichita thanks to all of the great efforts to make Wichita the best it can be. His involvement spans from giving of himself through his local church to assisting with City-wide events such as the annual Tribute to Liberty. She celebrated her th birthday this year.
During her time on the boards she campaigned and became a crusader for the betterment of the citizens of Midwest City as she dedicated ten years toward the conception, funding and building of both the Soldier Creek Nature Trail and Memory Laneand was able to get many organizations in the community to donate time to help clear paths and do some of the manual labor for the projects, including a team of volunteers that worked to fund the project by collecting donations, holding fundraisers and applying for grants. Not only does she make sure that one sees the beauty at the entrances to the city, but her work is seen throughout Columbus.
Boswell and Mayor Robert E. Your organization helps to push these efforts. Arleen Hubble Longview, Washington Arleen Hubble has played a major role planning the annual Go 4th Festival Parade for 30 years and has served as the Executive Director for 10 years, taking care of every aspect even down to the smallest, caring detail of creating and sewing the banners that draped over Nichols Avenue. She is also a long-standing member of the Longview Downtowners and has organized the Longview Christmas Parade for over 30 years.
The project spearheaded by Arleen was that of installing additional lighting outlets at the Civic Center so that more Christmas lights could be displayed and enjoyed by all. Sarah Wallace Green River, Wyoming Sarah has done an outstanding job getting the business community involved with our program again. She works tirelessly to gather volunteers and organize events and has managed several successful downtown promotions. He is always ready and willing to do whatever needs to be done to make sure our events are successful.
He gives countless hours of his personal time to downtown revitalization and is a standout leader in our organization. Captain Gary Wallace, Middletown Police Department Middletown, Connecticut Captain Gary Wallace does everything in his power to help people; he is the consummate servant leader, always thinking of others and in the process helping others.
In addition to faithfully performing his duties in law enforcement, Captain Wallace also gives back to the following organizations: It often times only requires compassion, a little bit of time, and sacrifice. Drew Middletown, Connecticut "Going the extra mile means doing more than is required for the right reasons when no one is looking. If each one of us maximizes our personal contribution to community, imagine the difference we could make! Wayne Syth Hayden, Idaho Mr. Wayne Syth is a true example of someone who goes the extra mile to serve his community.
Franklin Farm Cumberland, Rhode Island Franklin Farm should be recognized for its passion for community outreach and helping others. Since , volunteers have harvested , pounds of crops for community food banks. The farm has also hosted hundreds of school children in outdoor learning plant days.
Principal Dixie Garrison quickly arrived on scene and sent a radio call out to the office to dial Price had completed a refresher CPR course just 10 days earlier and knew exactly what to do. Skyler was born with a heart defect that caused his heart to stop. He recently underwent surgery to install a defibrillator to get his heart beating should this happen again. Thanks to their quick thinking, heroic action, and appropriate training, Skyler is expected to make a full recovery.
She has been a faithful volunteer for the Midwest City Animal Sheltervolunteering anywhere from hours every week including assisting us during evening hours. She will feed animals, help answer the telephones and assist customers when we are short-handed, and evenroll her sleeves up and help clean. Barb can often be seen driving a front-end loader the extra mile! Brenda is a strong advocate for many things including: Summer meals and reading for kids, early childhood development, farmers markets and food advocacy, many north Salina projects, quality and equitable bus services City-Go fifth route, etc , and many more.
Brenda cheerfully goes the extra mile! Barb is simply the go-to person for many who are looking for help finding grant dollars or other funding sources, large or small, with limited information and usually on a tight deadline. EPA planning consultants for north Salina, rain barrels, radon detection, sustainability and pollution prevention, food security and advocacy, farmers markets, north Salina, etc. Barb tirelessly goes the extra mile! The staff and donors of the GSCF consistently go the extra mile!
Volunteer Connection Salina, Kansas Whether it be a fall fix-up, Spring Spruce-up, or a need for volunteers for a small event, the Volunteer Connection can always be counted upon to provide cheerful, willing workers for community projects. The staff, board and army of volunteers at the Volunteer Connection continually go the extra mile! Volunteer Connection Salina, Kansas. Mayor Jon Blanchard Salina, Kansas.
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The neighbors near this intersection have supported Mr. The City of East Peoria recognized Mr. The Beautification Commission also installed permanent sign at the location where Mr. Peterson has been taking care of the flowers. She expertly coordinates all of the library services and programs, provides direction to the youth services team and manages the bookmobile and administration staff.
She also serves as the president of Literacy Green Bay, a nonprofit organization dedicated to helping adults and families acquire the reading, writing, math, English language, computer, and workforce skills they need to function effectively as workers and community members. Greater Green Bay Habitat for Humanity, lead by Executive Director Cora Haltaufderheid Green Bay, Wisconsin Habitat for Humanity has embarked on a number of impressive activities over the last year, including 2 story home construction, plans for Twindominiums, and a successful Repurpose for a Reason event.
Their creative and inspirational approach is improving Green Bay neighborhoods and improving the lives of the families using their housing product. Baird Creek Preservation Foundation, lead by Executive Director Maureen Meinhardt Green Bay, Wisconsin The Baird Creek Preservation Foundation is responsible for facilitating the preservation and restoration of the Baird Creek Watershed in order to enhance its value as an ecological, recreational, and educational resource for generations to come. From invasive species removal to controlled burns to trail restoration, this group is doing a marvelous job maintaining the Baird Creek Parkway.
This space is in addition to their beautiful offices in the former Chamber of Commerce Building. One look around their offices and you can see why they are extremely successful in attracting creative, young talent. Representative Steffen has worked heroically on responsibly returning the excess stadium sales tax to the municipalities in Brown County. Sending this money back to the municipalities, rather than let it sit in an account for decades doing nothing, was the right thing to do. Over the years, we have heavily relied on the dedication and perseverance of our citizen volunteers as they lend a helping hand to our Palm Bay Police Department.
Collectively, our VCOP volunteers have provided over 20, hours of community service on countless projects. Their selfless service in conducting home security checks allows peace of mind for residents away on travel, and their ability to complete traffic crash reports enables our officers to remain on patrol and more fully serve the community. The work of our VCOP volunteers never goes unnoticed, and we are truly grateful to have them. Checker goes on to epitomize volunteerism by additionally serving as the Volunteer Emergency Response Team VERT coordinator, a program supporting police officers during critical incidents.
He is always readily available during a crisis and manages the Disaster Communications Services, which provides HAM radio services when police radio systems go down. Aside from his multiple leadership positions, Carlos plays a vital role in the success and growth of the program, working diligently to recruit a diverse group of volunteers. Sam Swan Palm Bay, Florida Sam Swan, operations supervisor of the VCOP program, continually demonstrates astonishing generosity and an unwavering willingness to give back to the community.
As of , Swan has volunteered 1, hours, and continues to seek additional opportunities to serve within the VCOP program. Paying meticulous attention to detail, Swan is responsible for training and scheduling VCOP personnel and patrols. As the City of Palm Bay continues its rapid growth rate, we cannot thank Sam enough for his dedication and success in staffing our community events. She has volunteered hours within the Palm Bay Police Department and continually seeks areas in which she can lend a helping hand.
Serving as a role model for our upcoming youth, Jordan coordinates all the educational tours of the Palm Bay Police Department. Martin is one of the biggest cheerleaders we have in this city. We see him picking up trash throughout the city no matter what the weather is.
He also volunteers regularly at a local food pantry. Everything he does is with a smile and warm greeting for everyone. She contributed countless hours on school committees and in the Whitefish community, always working selflessly and tirelessly for many efforts, and always keeping kids' best interests at heart before passing away on July 3, Pat was instrumental in rallying the Whitefish community to understand the importance of the need for a new Whitefish High School, and ultimately helped to pass, overwhelmingly, a local bond effort leading to the construction of the new Whitefish High School.
Perhaps most importantly, Pat was beloved by many in town, is certainly missed by us all, and we will all continue to be inspired by Pat's example. Jim and Lisa Stack Whitefish, Montana Jim and Lisa have been recognized for their many volunteer efforts and philanthropic contributions to the Whitefish community over the years. They have served for over 20 years on the Whitefish Lake and Lakeshore.
In their committee work, they always prioritize water quality and the protection of Whitefish Lake and local bodies of water. The display is synced up with music that people passing through can tune into their radio to watch the show and listen to the music as they drive through downtown Huntington. This is a very large project for the city and could not have been as successful as it was without the help of Chris and the Robotics Club.
The City of Huntington is very proud of our Christmas light displays and we are very thankful for the expertise of Chris and the Robotics Club! These are just the highlights! The City of Huntington is very grateful for the hard work and dedication that EUM has for serving the residents of Huntington. The Chain Rattlers have cleared sections of wooded areas to make trails for the course, poured concrete slabs, installed disc baskets, and signage.
They have put a great deal of time into mapping out and designing the course itself as well. Steven Friehofner Barre, Vermont Steven teaches English language skills to immigrants and refugees living in central Vermont. He has conducted workshops for Central Vermont Adult Basic Education staff and volunteers regarding best practices and techniques for those working with English language learners. Steven also offers English conversation classes at area learning centers. In addition to the classes, Steve continues to work one-on-one with several students and can often be found meeting with students at the local libraries.
His rock cover band Native Tongue frequently offers free concerts to benefit local organizations and needs. In addition to his dedication to downtown Barre, he has mentored and coached both football and basketball for Barre Youth Sports. Roy Somaini Barre, Vermont Roy served his community through municipal, church and community service committees and organizations, everything from the local hospital, Chamber of Commerce, homeless shelter and American Heart Association.
As a cancer survivor, Roy was very active in support groups through the Vermont Cancer Survivors Network. As a Rotarian, he traveled to Romania where he worked at a local orphanage and with local officials. We lost Roy in , yet his spirit lives on in the work he did and the lives he touched.
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He is a Mason and a Lion, and has served in leadership roles in both organizations. In , he assisted flood victims in Barre and Berlin. Tammy Conforti, Kenosha Dream Playground Project Coordinator Kenosha, Wisconsin The Kenosha Achievement Center teamed up with Tammy and expressed their support and interest in adopting the project with a commitment to see the project to the end. Tammy has gone the extra mile and then some to ensure that children of all abilities have the opportunity to enjoy all the amenities available to them.
The Kenosha Dream Playground officially opened on October 10, A simple, summer basketball league grew to include hundreds of families whose sons and daughters were able to hone some skills while learning the value of competitive play and respect. Visits from notable area sports heroes, including Caron Butler and TraeWaynes, helped create a favorable lasting impression of Lincoln Park and its amenities. CenterPointe Lincoln, Nebraska Grounded by the solid belief that every person has the ability to recover, CenterPointe makes pivotal treatment available for people suffering from mental health and substance use disorders.
Meeting people where they are and supporting them to gain control of their lives is what CenterPointe aims to do. By treating the whole person, mental health and addiction can be addressed together in real-time. This holistic approach, combined with open arms and open minds, distinctly sets CenterPointe apart.
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CenterPointe constantly push boundaries to find better ways in helping people be well and never gives up on the value of life. Alan Goracke Blaine, Minnesota Dr. Alan Goracke is Founder and President of Hope for The Community, a humanitarian organization that has fed over 20, families over 1,, pounds of food. In previous years he served as a chaplain for the Police and Fire Departments.
Goracke is the senior pastor at Hope Church and has lived in city of Blaine for 24 years. He has a passion for serving and helping people in need in the community. The City of Petersburg is doing just that on a daily basis for our residents and when our tourists come to visit us. We want to make sure our residents receive quality customer service and our tourists receive an excellent experience while in town.
When you think of Petersburg, we want you to think of our great people, inviting city and somewhere where you always feel at home. Patty has also served at the Senior Center with multiple activities, including driving the senior bus. This commendation is tendered with the sincere appreciation of the City Commission. Lou always steps up to help out for charitable efforts. Please review your cart. You can remove the unavailable item s now or we'll automatically remove it at Checkout. Continue shopping Checkout Continue shopping. Chi ama i libri sceglie Kobo e inMondadori. Buy the eBook Price: Available in Russia Shop from Russia to buy this item.
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The main finding to emerge from interviews with migrant nurses was that over half 11 of those interviewed intended to leave the country within the next five years. Verification figures from the Irish Nursing Board would appear to support this finding. In , Indian and Filipino nurses sought to have their Irish registrations verified by nursing boards in countries such as Australia, Canada and the United Kingdom Irish Nursing Board, unpublished data [ 14 ].
In other words, they had expressed their intention to migrate from Ireland. This could be seen to confirm the conclusion that "migration is becoming increasingly transitory"[ 35 ] or to support the belief that international recruits are unreliable [ 4 ]. However, most nurses interviewed in this study were leaving because Ireland had failed to provide sufficient long-term security, via residency or citizenship entitlements, to their families.
Although we had anticipated that the onward migration of migrant nurses might be an issue to emerge from the research, we had expected workplace-related factors or salary and cost-of-living issues to play a deciding role in the decision: Instead, interviews revealed that the desire to be settled and stable was more important for respondents and far outweighed career-related considerations and other endogenous health systems factors in determining whether they would stay or leave Ireland. Those who planned to remain spoke of being settled.
Those who planned to leave Ireland regularly cited the desire for stability as a major consideration. Whereas respondent nurses prioritized stability, destination countries such as Ireland hold a more short-term view of migration and are less likely to automatically provide migrants with entitlements to permanently settle. These "dramatic shifts in the destinations of migration, restrictions on residency and strict limitations on settlement" [ 36 ] have fundamentally altered migration for individual migrants, and for source and destination countries.
In the face of these changes, traditional explanations of migration, which emphasize the movement of people "pushed" from the source country and "pulled" towards the destination country so as to improve their financial situation, provide a limited and even misleading framework as the "rationale of economic calculation that this model presupposes is also too limited to embrace the complex motivations of migrants" [ 36 ]. Respondent decisions to remain in or to leave Ireland involved weighing up a complex range of factors, such as considering children's future educational needs and perhaps the long-term care needs of elderly parents, in addition to any personal or financial motivations for migration.
Factors influencing migrant nurse decisions to stay or leave Ireland adapted from Padarath, [ 28 ].
From such a perspective the question of personal choice may simply seem like the wrong question. It gives too much attention to the individual's present action, and blurs the complex networks of responsibilities that link a person to the past and future" [ 36 ]. It reveals that exogenous factors, i. This should serve as a "wake up call" for health service employers and health workforce planners, as it undermines several commonly held assumptions about the migrant nurse workforce. The first unfounded assumption is that migrant nurses from the developing world will be grateful to obtain employment in destination countries, such as Ireland, and will remain here for as long as required.
An Irish Director of Nursing involved in the early recruitment campaigns claimed to have been "greeted as 'a god' when she was in the Philippines to interview applicants" [ 39 ]. She proceeded to explain that migrant nurses were merely a short-term solution to the nursing shortage and that, as they become available, Irish nurses "will have first priority for jobs" [ 39 ]. This presumption, held by Irish employers including those involved in international nurse recruitment, "that migrant workers are essentially available on tap" [ 29 ] is a dangerous one, as it lulls workforce planners into a false sense of security, assuming that any skills shortfalls nationally can be met from a global skills pool, presumed to be unlimited.
It also presumes that migrant nurses have a limited set of options in terms of migration, which is far from being the case.
Secondly, the findings disprove the assumption that migrant nurses tend to be young, single and motivated primarily by financial gain. The primary objective of migrant nurse respondents — regardless of age or marital status — was to achieve stability for themselves and their families, specifically for their children and for their parents. Thirdly and finally, the research findings reveal as unfounded the impression that health employers or even the health system acting alone can apply strategies to retain migrant nurses in post, for example via the provision of permanent posts or via general retention measures.
In , Buchan noted that nursing shortages were a health systems problem requiring health systems solutions [ 5 ]. Our findings suggest that many of the solutions, at least in Ireland, lie outside the scope of the health system and require a wider policy response from government departments with responsibility for migration, family reunification, naturalization and education. Sustaining Ireland's reliance on internationally recruited nurses in the medium to long term will necessitate a much better understanding of the dynamics of nurse migration and a far more coherent approach to migration, involving joined-up policy thinking between various government departments and agencies.
Like most destination countries, Ireland appears to have envisaged international recruitment campaigns as a means of importing hard-working nurses on a temporary basis as a stop-gap solution to staffing shortages in the health system [ 39 ]. The underlying aim seems to have been to import nursing "units" with minimal regard for the individual nurses beyond arrival and adaptation.
However, the reality is that migrant nurses are individuals who seek what many of us take for granted — a job, a salary, a family life. For some, Ireland may be just the latest in a long line of destination countries that have failed them in their quest for a home away from home in which they can settle with their families as well as work.
The contradiction at the heart of the matter is that, despite the recognized need for migrant nurses, migrants are generally afforded a much cooler reception by destination countries [ 8 ]. This ambiguity is played out in the everyday experiences of migrant nurses in Ireland who, although actively recruited internationally, find their longer-term settlement and integration and that of their family, impeded by migration policies designed to accommodate lone workers migrating to work on a temporary basis, a system ill-equipped for the long-term retention and integration of health workers and accompanying family members.
Changes to the migration system, designed to retain migrant nurses in Ireland, have been instigated to avoid a "possible negative impact to both our healthcare services and private industry" [ 30 ], rather than to improve the quality of life of individual migrant nurses. This highlights Ireland's relative inexperience as an immigration destination, but it also reveals underlying assumptions about the nature of migration, specifically nurse migration. Migration policy continues to treat migrant nurses as a short-term, renewable resource, as "disposable cogs on a global assembly line of caregivers" [ 4 ].
The presumed abundance of migrant nurses internationally mitigates the need to retain them in service. Although destination countries, such as Ireland, compete fiercely to recruit migrant nurses from their countries of origin and subsequently to recruit them from other destination countries — Filipino nurses are recruited from the Philippines to Saudi Arabia, recruited onwards to Ireland and then to Canada or Australia — the effort put into retaining them is negligible [ 16 ]. The health workforce has been transformed by globalization and migration and yet the fundamental challenge — to retain nurses in the health system — remains unchanged.
Ireland's migration policies to date have focused on filling the specific skills needs of the economy via migration, for instance by actively recruiting migrant nurses to fill vacancies in the health services. But this approach, which sees migrants only as workers, is unsuited to the long-term retention of migrants and their families:. Insofar as migrants and their families may come to Ireland and for as long as they remain in Ireland, it is important that the wider reality of migrants' lives forms part of the focus of public policy" [ 29 ].
The suggestion is that a failure to attend to wider integration issues, such as family reunification, residency and citizenship entitlements, will result in a failure to attract or retain skilled workers such as nurses for whom there continues to be a demand. The short-sighted, economically-driven model of migration currently in place in Ireland has much in common with the " Gastarbeiter " guest worker migration systems favoured in mainland Europe in the s:.
They are not born: They have a single function — to work. All other functions of their lives are the responsibility of the country they came from" [ 40 ]. Given that the very functioning of the health system relies upon migrant nurses, the fact that some of Ireland's migrant nurses have expressed a desire to settle here should be seen as an opportunity. However, as our findings have shown, in order to retain these nurses in the health system on a long-term basis, it will be "necessary to address the nurses' migration experience as a whole" [ 34 ].
The current contradictions between Irish health and migration policies, whereby the migration system militates against the long-term settlement of migrant nurses and their families, may prove detrimental to a health system heavily reliant on a migrant workforce. In the meantime, actively encouraging nurses to work in Ireland — without putting in place policies and procedures to enable them to settle here with their families — indicates weak policy-making capacity by the Irish Government.
It also signals a reluctance to extend to migrants the protections afforded the family within the Irish Constitution [ 33 ]. Measuring the performance of health systems in addressing these three challenges requires evaluative evidence. Poor data availability is a frequent problem for health systems internationally; most require "much more detailed data collection, careful planning, and evaluation of the health care workforce" [ 4 ]. In the Irish context, an understanding of the dynamics of nurse migration and its impact on the nursing workforce is hampered by a lack of data [ 2 ].
Hongoro and Normand highlight the importance of human resource models in enabling health planners to estimate the length of a nursing career and to plan accordingly [ 42 ]. Without even a basic profile of its migrant nurse workforce, it is difficult to see how migrant nurses can be properly incorporated into Irish workforce planning strategies, or how their retention might be measured, let alone improved. Improved data are necessary to enable Ireland to incorporate nurse migration into "the overall workforce planning approach" [ 43 ] and in order to move away from the perception of international nurse recruitment "as a cheap option with 'expendable' migrant health professionals" [ 43 ].
In many cases, Ireland is the latest in a long line of destination countries to have failed respondents in their quest for a home in addition to an overseas nursing post. The findings illustrate the sacrifices behind the global migration of nurses and serve as a timely reminder — to policy-makers in Ireland and globally — of the social costs of nurse migration [ 4 ].
Countries, like Ireland, that rely heavily upon migrant nurses should not become complacent and presume that successful international recruitment campaigns have permanently "solved" their nursing shortages. International recruitment may defer but will not resolve nursing shortages unless implemented alongside retention measures to keep nurses both local and migrant in post. What is required is a more holistic and system-wide approach to international nurse recruitment, which recognizes that migrant nurses must adapt to life outside the health system as well as to Irish nursing practice and that the acquisition of a permanent nursing post means little if not accompanied by long-term residency and citizenship rights for migrant nurses and their families.
This will necessitate a sea-change in Irish migration policy, which to date has been market-led. What is required is a policy that recognizes the contribution migrants make — both in terms of skills and in terms of social contribution — and that encourages their long-term settlement and integration into Irish society. However, just as international recruitment initially offered destination countries a "quick fix" to nursing shortages, there may be little incentive to resolve underlying problems until the pool of international nursing recruits begins to dry up. NH carried out the interviews and data analysis and drafted the paper.
RB and HMG designed the study and provided editorial comment on the draft paper. All authors have read and approved the final manuscript. The authors would like to thank the migrant nurses who participated in this research for sharing their inspirational stories.
They would also like to thank the Irish Nurses Organisation, particularly Clare Tracey and the Chairperson of the Overseas Nurses Section, Cres Abragan, for their assistance in contacting potential respondents. Thanks are also due to the Honorary Filipino Consul, John Ferris, and to Michael Ancheta of Filipino Forum, for their help in raising awareness of the research project. National Center for Biotechnology Information , U. Journal List Hum Resour Health v. Published online Aug 6. Author information Article notes Copyright and License information Disclaimer.
Received Feb 20; Accepted Aug 6. This article has been cited by other articles in PMC. Abstract Background Although international nurse recruitment campaigns have succeeded in attracting large numbers of migrant nurses to countries such as Ireland, where domestic supply has not kept pace with demand, the long-term success of such initiatives from a workforce planning perspective will depend on the extent to which these nurses can be retained in destination countries.
Methods This paper draws on qualitative, in-depth interviews undertaken with 21 migrant nurses in Ireland, focusing specifically on their future migration intentions. Results Our findings indicate that more than half of the respondents are considering migration onwards, for the most part because the destination country has failed to provide them with sufficient stability, particularly in terms of citizenship and family reunification.
Conclusion This demonstrates the need for destination countries to take a broader and more long-term approach to international nurse recruitment, rather than regarding it as an inexpensive way to fill gaps within the health care system. Background The need to retain as well as recruit Active overseas recruitment strategies have succeeded in attracting large numbers of migrant nurses to countries where domestic production and retention have not kept pace with growing needs [ 1 , 2 ].
Global context The struggle to retain migrant nurses in Ireland takes place, as their recruitment did, in the context of an "international war for skills" [ 4 ]. This inevitably means that developed countries compete with each other to attract nurses, as Buchan explains: Methods Ethical approval for the study was granted by the Research Ethics Committee of the Royal College of Surgeons in Ireland and, in , in-depth interviews were conducted with 21 migrant nurses working in Ireland.
Results Of the 21 nurses interviewed, only four stated that they intended to remain in Ireland on a long-term basis. Reasons to remain in Ireland Most of the 10 respondents who planned to remain in Ireland for the foreseeable future sought to do so because they felt that they and their families had settled and also because they wished to avoid the disruption entailed by onward migration: For these comparisons, they drew on their own experiences of nursing in the Middle East and their friends' experiences in the United States: The reality of migration Despite these 10 respondents' having elected to remain in Ireland for the foreseeable future, they were frank about the difficulties inherent in living and working as a migrant nurse in Ireland.
Most had made personal sacrifices: Respondents found that the high cost of living in Ireland also diminished salary values and reduced the amount that they were able to remit: Others noted that although working in Ireland was financially attractive, remaining meant living apart from friends and family: This was a concern expressed by single nurses as well as those who were married or who had children: Reasons to leave Ireland Stability and integrity of the family unit The desire both for stability and to maintain the integrity of the family unit played a significant role in respondents' decisions to leave Ireland.
Some sought to reunite with siblings, others with their adult children whom they had been unable to bring to Ireland with them: The decision to emigrate to ensure the integrity of the family unit was particularly difficult for those who had moved to Ireland specifically to reunite their families after years of separation while nursing in countries that prohibited family reunification: Residency and naturalization A related concern for respondents 13 was the issue of long-term residency and citizenship, in that Ireland's naturalization procedures effectively meant that the integrity of families currently living together was threatened.
Although all family members may eventually achieve the same status in Ireland, in the meantime they hold a variety of immigration stamps and citizenship entitlements: A related issue for the children of migrant nurses was that, despite their residence in Ireland and their parents' employment in Ireland, they were not entitled to subsidized university fees, as Irish students are: The other alternative was for respondents to relocate as a family unit to another developed country that will provide long-term residency or naturalization to both migrant nurses and their families, thereby ensuring the long-term integrity of the family unit: At the time of interview, this had led some respondents to question whether they would ever actually acquire Irish citizenship: Once again, this prompted international comparisons: Although all respondents had secured permanent employment, some had purchased houses and all seemed to feel generally financiallysecure in Ireland, uncertainty surrounding citizenship entitlements caused respondents to question whether they had a long-term future here: Stability in emigration The uncertainty and inconsistency evident in Irish migration, residence and naturalization procedures encouraged respondents to examine their options globally.
Thus, in addition to ensuring the integrity of the family unit, migration to Canada was also seen as enabling respondents to offer migration opportunities to other family members: Opportunities overseas or retiring back home Onward migration also offered professional opportunities. Others spoke about keeping their options open in terms of emigration: Six respondents who planned to work in Ireland until retirement and then move back to their home countries following their retirement were certain of their plans: Mixed feelings about leaving The 11 respondents who were planning to leave Ireland, including the three with immediate plans, had mixed feelings about doing so.
Although excited about the opportunities available to them elsewhere, their excitement was also tinged with regret at having to leave Ireland, "But I'm telling you, if I'm going to leave this place, this Ireland In this case, the realization dawned as the children of this respondent approached school-leaving age: There was a sense of frustration among respondents at having to leave Ireland, having already invested considerable time and energy in settling here: