Nursing Brain Drain, How Do We Retain Our Internationally Qualified Nurses: A Close Examination of Push and Pull Factors

Recruitment of internationally qualified nurses (IQN) may be an effective way to address acute nursing shortages in New Zealand (NZ). However, the difficulty in retaining IQNs long-term requires serious consideration. We employed a survey design to identify factors that influence IQNs to leave NZ. 1,782 IQNs who graduated from a Competency Assessment Programme over 11 years (2012 to 2023) were invited to participate in the online survey. Participants reported a wide range of factors to migrate including unsupportive workplace culture, lack of professional development opportunities, financial motivators, personal, and social factors including better quality of life. Nearly 50% of IQNs either had left or were planning on leaving NZ soon after obtaining their registration, with an average length of stay for all IQNs of just over 30 months, with nearly 100% of all IQNs leaving NZ within that time. This is the first study that provides policymakers with valuable insights of IQNs recruitment and retention including IQN reasons for migration. There is a need for policymakers and employers to urgently prioritize the development of local nurses instead of depending on IQNs who are difficult to retain long term. Furthermore, as current data indicates a surplus of IQNs in NZ it is crucial for potential IQNs to carefully consider the current oversupply before undertaking the costly, lengthy, and complex process of obtaining registration. Policymakers, employers, educators, and regulators need to work together to develop a robust nursing workforce plan to address the current surplus and include accurate forecasting of future workforce needs.