This paper attempts to identify one ethical problem that arises from the practice of recruiting nurses from other countries. Ethical problems have to be resolved by invoking the application of ethical principles. An attempt is therefore being made here to discuss the ethical problem using one such ethical principle.
The subject matter is examined in the light of available online studies and reports relating to the issue of outsourcing nursing staff. For instance, the Outsourcing Journal has a story by Todd Hintze, entitled "Healthcare providers' perfect storm and how outsourcing can help weather the winds." NewsFactor Magazine Online however points to the "Possibilities and pitfalls of outsourcing." The American Journal of Nursing cited "The global reach of nursing shortage." Ludwick and Silva wrote a well-researched article on "Nursing around the world: Cultural values and ethical conflicts." Details of the literature reviewed are given under 'References' at the end of this paper.
The shortage of qualified and competent registered nurses in hospitals has emerged as a major problem being faced by healthcare institutions worldwide, especially after the start of the new millennium. In the United States, for instance, this has taken on the color of a significant staffing crisis. Susan Trossman, reporting for the American Journal of Nursing (2002), cited a 2001 survey by the American Hospital Association (AHA) that disclosed a vacancy roster of over 126,000 registered nurses across 715 hospitals throughout the country. The report also showed that this phenomenal shortage was not limited to the US, but as estimated by the International Council of Nurses (ICN), several other countries, including UK, Canada, Netherlands, and Zambia were in no better position. Canada, for instance, would require about 10,000 new nursing staff every year through to 2011, but can only train about half that number domestically. Healthcare institutions and individuals in the US have been lobbying hard with federal and state governments to ease immigration rules to allow greater influx of foreign-educated nurses to meet the growing shortfall (2002).
In the United Kingdom, the nursing sector hires more foreign workers than any other sector. The Information Technology sector comes second, with about 85% of a total of 22,000 expatriate IT staff hired in UK hailing from India alone. Ann Swain, CEO of the Association of Technical Staffing Companies (ATSCo) made an interesting remark: "The irony is that while low-skilled IT jobs continue to be shipped to India, highly skilled Indian professionals are coming to the UK to take up managerial roles." (CIPD, 2005). Rosenthal reports about outsourcing in the customer relationship management (CRM) process at the Cedars-Sinai Medical Center in Los Angeles because "hospitals need nurses on the floor, not answering the phone"(2005).
Ethical Issues and Conflicts
Ethics is all about cultural and moral values that have come to be traditionally recognized by society. Ludwick and Silva (2000) have defined it in these words: "Ethics has many definitions but, typically, ethics is viewed as a systematic way of examining the moral life to discern right and wrong; it also requires a decision or action based on moral reasoning." Ethics are