Italian-Moldovan international nurse migration: rendering visible the loss of human capital

Aim: To describe the process of the migration of Moldovan nurses to Italy. Background: Formerly a part of the Soviet Union, the Republic of Moldova gained independence in 1991. Currently, there are 25 848 nurses (60.6 per 10 000 inhabitants) working mainly in the public health system. Each year, around 2000 nurses leave the country in search of better working conditions and a better quality of life. Methods: A longitudinal study design was adopted (2006-2007). In the first phase, we contacted all known nurses living in Moldova and their available colleagues following a snowball sampling strategy. Inclusion criteria were nurses who had decided to migrate to Italy and had already prepared the migration documents and/or were awaiting their departure. In the second phase, we interviewed the same sample of nurses on arrival in Italy. Findings: After one year, only 25 nurses out of the 110 initially interviewed (22.7%) had arrived in Italy; none were working as nurses. The cost of the migration process incurred by each nurse was around 3278 euros, and the waiting time from the decision to leave until arrival was around 24 months. Conclusions: All Moldovan nurses involved in this study, once they arrived in Italy, ceased to exist from an official perspective. Policy and recommendations need to be developed to ensure the integration of Moldovan-educated nurses into the health-care system and to monitor the amount of human capital (in terms of care drain, brain drain and youth drain) that this process risks wasting.