Producing Mobility, Withholding Authority: Epistemic Drain and Nursing Sovereignty in Nepal

Global discussions of nursing in low- and middle-income countries (LMICs) are dominated by the language of shortage, staffing, retention, and migration. Although useful, this technocratic vocabulary obscures a deeper philosophical crisis: nurses may be numerically produced yet institutionally denied authority over knowledge, care, and professional futures. Using Nepal as a theory-generating case, this conceptual article employs critical interpretive synthesis and philosophical analysis of nursing, policy, migration, and interdisciplinary scholarship to argue that the central problem is not workforce scarcity alone but a crisis of 'nursing sovereignty'. The paper introduces three concepts. First, epistemic drain extends the idea of brain drain by naming the erosion of mentorship, pedagogical continuity, professional memory, policy voice, research capacity, and the public credibility of nursing knowledge. Second, professionalised for exit captures a paradox of production in which nursing education expands global mobility more readily than local authority, making migration a morally justified reaction to constrained socioeconomic prospects, rather than a lack of professional dedication. Third, nursing sovereignty names the collective capacity of nurses to shape the ends, authority, knowledge, and institutional conditions of their profession. Drawing together social epistemology, feminist ethics, decolonial lens, political economy, sociology of professions, spatial theory, and digital pedagogy, the article argues that Nepal illuminates a wider LMIC condition in which nurses are essential yet disposable, mobile yet institutionally voiceless, and professionalised yet epistemically diminished. It concludes with a six-domain normative framework for institutional redesign: epistemic authority, educational integrity, governance voice, material justice, spatial and digital parity, and mobility justice. Reframing nursing in this way shifts debate from retention to justice, from labour supply to institutional re-design, and from workforce management to the political philosophy underpinning nursing practice.