Implication of Brain Drain in the Nursing Profession on Quality Healthcare Delivery in Nigeria

Implication of Brain Drain in the Nursing Profession on Quality Healthcare Delivery in Nigeria

OYE Olubukoye^1,4,5, OYEYIPO Eyitayo Joseph^1,4,5*, AJIDE Olabisi¹, SALAKO Oluwaseyi Pius², ONYENWENYI Anthonia Confidence³, JOLAYEMI Karimat Itunu³

¹Department of Sociology, Landmark University, Nigeria.

²Department of Public Health, Adeleke University, Nigeria

³Department of Nursing Sciences, Adeleke University, Nigeria

⁴Landmark University SDG 10 (Reduced Inequality)

⁵Landmark University SDG 16 (Peace Justice and Strong Institutions)

*Corresponding Author

DOI: https://dx.doi.org/10.47772/IJRISS.2024.8100041

Received: 24 September 2024; Accepted: 28 October 2024; Published: 30 October 2024

ABSTRACT

Brain drain, or the migration of healthcare professionals, especially those within the nursing profession, possess serious threat to Nigeria’s healthcare delivery system. This essay examines the vivid implications of the nursing profession’s migration on the quality of healthcare delivery system in Nigeria. Several factors, including unfavourable working conditions, low remuneration, cloudy prospects for professional advancement, and inadequate infrastructure, contribute to the migration of nurses abroad. The implication of such movement result to understaffing, inadequate care quality, excess work load for the remaining healthcare professionals, and hampered healthcare delivery are all effects of brain drain. These difficulties make healthcare inequities worse and obstruct initiatives to enhance Nigerian health outcomes. Comprehensive approaches to improving working conditions should be prioritised by boosting pay and benefits to reflect fairness, offering chances for professional steady progression, fortifying the healthcare system, and putting in place measures to keep qualified healthcare professionals in the workforce becomes significant to the improvement of the healthcare system of Nigeria to combat brain drain. Nigeria may enhance its healthcare system and increase its population’s access to high-quality healthcare by reducing brain drain and investing in the nursing workforce.

Keywords: Brain drain, Health care, nursing, working condition

INTRODUCTION

In recent years, there has been an increasing worry about the phenomena of brain drain in the nursing profession and health sector in general, especially in developing nations like Nigeria. This problem is the departure of highly qualified nurses leaving their native nation in search of better possibilities overseas which has left the local healthcare system severely lacking in talent and experience (Oduola, 2023). This brain drain can have detrimental effects on the healthcare industry, such as a lack of qualified workers, more work for already-trained nurses, worse patient care standards, and a diminished ability to provide healthcare (Ojo Omonijo, Dare & Nnedum, Obiajulu & Jude, Ezeokana, 2011). In order to establish effective strategies and policies to alleviate the effects of brain drain in nursing on the Nigerian health sector, it is imperative that the fundamental causes of the phenomenon be investigated and addressed.

Definition of brain drain in nursing

The term “brain drain” in nursing describes the migration of healthcare professionals as it may be (Nurses) from their own country to other countries, typically in search of better pay, prospects, and working environments. In addition to the nurses’ physical departure, the loss of their expertise becomes inevitable, the experience, and knowledge, which could have a major effect on the quality of healthcare delivery on the nation of origin becomes unavailable (Johannes, 2020). There is a difficult gap left by the departure of seasoned nursing experts, which makes it harder to find qualified nurses and puts more pressure on the already overburdened healthcare system (Arianne, 2018).

Importance of nursing in the health sector

Serving as the foundation of healthcare delivery in Nigeria, nursing plays a critical role in the health sector. Direct patient care, assisting physicians and other medical professionals, and monitoring patients’ general wellbeing are the duties of nurses. Because of their training in a range of disciplines, such as maternity, mental health, pediatrics, and critical care, they are essential in meeting the population’s different healthcare demands (Gillian & Blake, 2017). Furthermore, nurses advocate on behalf of patients by encouraging illness prevention, health education, and care coordination. The health industry would find it difficult to handle the challenges and rising demands of providing the Nigerian populace with affordable, high-quality healthcare without a strong nursing staff (Oduola, 2023).

Overview of the nursing profession in Nigeria

Nigeria’s nursing profession employs a trained and diversified staff that makes a substantial contribution to the country’s healthcare system. A range of programs, from diplomas to bachelor’s and master’s degrees, are used to educate and train nurses, guaranteeing a wide range of specialization and skill (Oduola, 2023). They are employed in a variety of healthcare facilities, such as clinics, public health agencies, community health centers, and hospitals. With the use of their skills and knowledge, nurses carry out duties like giving prescriptions, treating patients, conducting health exams, offering emotional support, and helping with surgery. Significant obstacles confront the nursing profession in Nigeria, including a lack of funding, a shortage of employment possibilities, and a lack of support, all of which exacerbate the problem of brain drain (Ojo Omonijo, Dare & Nnedum, Obiajulu & Jude, Ezeokana, 2011). It becomes important to address these challenges and improve the nursing profession’s conditions to retain skilled nurses and ensure the efficient functioning of the health sector in Nigeria.

CAUSES OF BRAIN DRAIN IN NURSING

The nursing profession has experienced a brain drain due to factors such as inadequate pay and benefits, little possibilities for professional progression, and demanding work environments with heavy workloads. When they can earn more money and perks in other professions or nations, nurses can be drawn to those areas (Alex, 2012). Furthermore, nurses may look for possibilities outside of the nursing field due to the lack of opportunities for professional growth and advancement within the field. Nurses may experience burnout and unhappiness due to demanding work environments and heavy workloads, which may lead them to quit their jobs or look for work in other nations with better working circumstances (Luara & Pablo,2015). All of these elements work together to cause the nursing profession’s brain drain, which has an impact on the healthcare industry.

Lack of adequate compensation and benefits: One of the main reasons for brain drain in the nursing field is inadequate pay and benefits. Because of their frequently poor pay and inadequate benefits, nurses are typically dissatisfied and are encouraged to look for work elsewhere (Alex, 2012). Because it adds to the scarcity of qualified nurses in healthcare facilities, this problem has significant ramifications for the health industry. Insufficient pay for nurses has a negative impact on their motivation and job satisfaction, which lowers the standard of patient care. To make up for the lack, the remaining nursing staff might also need to take on more work, which might make the issue worse (Abou hashish, Ebtsam & Bajamal, Eman & Ashour, Heba, 2023). To address this issue and keep qualified nurses in the field, pay and benefit package enhancements are necessary.

Limited career advancement opportunities: restricted options for career progression within the nursing profession might have noteworthy consequences for the healthcare industry. There may be a brain drain in the nursing profession if nurses feel their careers are stagnating and are more inclined to look for possibilities elsewhere (Gozum, Sebahat & Yurcu, Gülseren & Ilgaz, Aysegul & Aybar, D., 2023). Lack of growth possibilities can have a detrimental effect on a nurse’s motivation and job satisfaction, which in turn can influence the standard of patient care. In the event that nurses do not have the opportunity to advance in their careers and assume additional responsibilities, they may lose interest in and willingness to make investments in their professional growth (Alex, 2012). This may lead to a scarcity of qualified nurses at medical facilities, a decline in the standard of patient care, and an increase in the burden of the nursing staff members who are there. As a result, it is imperative that healthcare organizations address this problem by giving chances for ongoing professional development as well as defined career trajectories By doing this, companies may encourage employee retention and guarantee a steady workforce that can efficiently handle the population’s healthcare needs.

Challenging working conditions and high workload: Brain drain is a major problem in the nursing profession because of the demanding work environment and heavy workload. Nurses frequently labor in hard circumstances with high patient-to-nurse ratios, lengthy workdays, and few resources. Burnout, a decline in job satisfaction, and physical and mental tiredness are the results of these conditions (Alex, 2012). The lack of nurses to fill the positions further increases the burden and strain on the nursing staff that is left. In the end, these difficult working circumstances drive nurses to look for chances abroad or quit the field entirely, which has an influence on the quantity and caliber of healthcare services offered in their native nations. In order to address these problems, measures to enhance working conditions must be put in place (Abou hashish, Ebtsam & Bajamal, Eman & Ashour, Heba, 2023). These measures include hiring enough people, providing programs to help employees deal with stress and burnout, and cultivating a positive work atmosphere that values and acknowledges the contributions made by nurses (Gozum, Sebahat & Yurcu, Gülseren & Ilgaz, Aysegul & Aybar, D., 2023).

Inadequate Infrastructure and Resources: Nigeria’s healthcare system suffers issues due to inadequate infrastructure, such as poorly equipped healthcare facilities and a lack of medical supplies and equipment. Nurses may get dissatisfied by their inability to offer adequate treatment as a result of these constraints, prompting many to seek employment in nations with better-equipped healthcare facilities.

Insecurity: Nurses in Nigeria may confront safety and security problems, such as violence, occupational hazards, and instability in specific areas of the nation. A lack of proper security measures and precautions might jeopardize nurses’ well-being and influence their decision to relocate to safer places.

Political and Economic Instability: Political and economic instability in Nigeria can lead to uncertainty and insecurity among healthcare workers, particularly nurses. Instability may take many different forms, including legislative changes, economic downturns, and social unrest, all of which can have an influence on job security and quality of life.

CONSEQUENCES OF BRAIN DRAIN IN NURSING PROFESSION

Brain drain has serious and wide-ranging effects on the nursing profession. First of all, the lack of qualified nurses in medical facilities puts a pressure on the system and jeopardizes patient care. The remaining nursing staff members are also burdened with more work as a result of this shortfall since they must take on more duties. As a result, nurses are overworked and unable to provide every patient the same amount of time and care, which lowers the quality of patient care (Abou hashish, Ebtsam & Bajamal, Eman & Ashour, Heba, 2023). These effects emphasize how urgently the problem of brain drain needs to be addressed. The detrimental impacts of brain drain in the nursing profession can be lessened by putting methods into place such raising possibilities for professional advancement, boosting benefits packages, and enacting laws to enhance working conditions (Gozum, Sebahat & Yurcu, Gülseren & Ilgaz, Aysegul & Aybar, D., 2023). The healthcare industry can guarantee the delivery of high-quality treatment and a thriving nursing workforce by addressing these effects head-on.

Shortage of skilled nurses in healthcare facilities: One urgent problem that results from brain drain in the nursing profession is the lack of qualified nurses in healthcare institutions. The availability and caliber of patient treatment are restricted by this shortage, which has serious ramifications for the healthcare industry (Bhardwaj & Sharma, 2022). The overall standard of patient care may suffer as a result of the remaining nursing staff having to handle more work due to a shortage of qualified nurses. The difficulty is in addressing the elements that lead to brain drain, which include poor pay and benefits, little chances for professional progression, and difficult working circumstances (Johannes, 2020).. It is possible to lessen the effects of brain drain and the scarcity of qualified nurses in healthcare facilities by putting new policies in place to improve working conditions, increasing career development opportunities, and improving compensation and benefits packages, among other measures.

Decreased quality of patient care: One of the main effects of brain drain in the nursing field is a decline in the standard of patient care. There is a scarcity of experienced personnel in healthcare facilities as talented nurses depart for more favorable prospects elsewhere. The remaining nursing staff is overworked as a result of the shortfall, which increases fatigue and the likelihood of mistakes (Bhardwaj & Sharma, 2022). Patients may face delays in receiving care and have less time for individualized attention if there are fewer nurses on duty. The overall quality of patient treatment may suffer due to a lack of experience since there may be a loss of knowledge and skill (Johannes, 2020). Maintaining the industry’s standard of healthcare requires addressing brain drain and its effects on patient care.

Increased workload for remaining nursing staff: The nursing profession is seeing a brain drain, which has led to an increasing burden for the surviving nursing personnel. The current staff is forced to take on more responsibilities and care for more patients because there are fewer nurses available. Due to the need for the remaining nurses to work longer shifts and take on more complicated cases, this has resulted in a noticeable rise in workload. They might so become mentally and physically exhausted, which could result in burnout and a decline in job satisfaction (Merten, 2016). Additionally, because nurses may not have enough time to give each patient the specific attention and care they need, the increasing workload may negatively impact the quality of patient care (Bhardwaj & Sharma, 2022). In order to solve this problem, measures like increasing the number of nurses hired, enhancing staffing ratios, and offering assistance and resources to the current nursing staff should be put into place.

THEORETICAL EXPLANATION

Two theories were adopted to provide the theoretical ground for the discussion. The theories are the human capital and the push-pull theories.

Human Capital Theory: The Human Capital Theory, which emphasizes the investment in education, training, and skill development as important assets that contribute to economic growth and development, can be used to study the brain drain of nurses from Nigeria. This hypothesis provides information about the reasons behind and thought processes behind the decisions made by nurses who migrate, as well as the wider ramifications for the nation’s growth and the healthcare system.

Fundamentally, human capital theory holds that people build up their human capital by investing in job experience, education, and training, which raises their earning potential and productivity. Given the extensive study and training needed to become a registered nurse, these investments are crucial in the case of Nigerian nurses. Nurses may, however, feel that their options for career advancement, financial gain, and overall quality of life are limited in their own nation, leading them to look for work overseas.

People can raise their productivity and earning potential by investing in their education and skill development. Through education and training, people can pick up useful abilities in the nursing field. It might be argued that moving in search of better chances is a logical move that will increase their level of life and make the most of their human capital.

Push-Pull Theory by Heberle (1938): According to the push-pull hypothesis, people are drawn toward a destination country by alluring prospects and driven away from their home country by negative circumstances. The Push-Pull Theory provides a comprehensive framework for understanding the brain drain of nurses in Nigeria, highlighting the push factors driving migration from Nigeria and the pull factors attracting nurses to other countries When it comes to nursing, things like poor working conditions, low pay, little opportunity for professional growth, and a lack of job satisfaction may cause nurses to look for better chances in nations where the nursing profession is more respected, well-paid, career progression, good work-life balance with quality of life, stability, and security.

Strategies to address brain drain in nursing profession

In order to mitigate the detrimental effects on the healthcare industry, nursing brain drain must be addressed. Improving pay and benefit packages is one practical strategy that might aid in luring and keeping qualified nurses. Improving possibilities for career growth is another tactic to encourage nurses to remain in the field and advance their careers (Merten, 2016). In order to lessen the difficulties and heavy workload that nurses experience, it is also critical to have policies in place to enhance working conditions. When all of these tactics are used, the problem of brain drain can be solved and a steady and qualified nursing staff can be guaranteed (Bhardwaj & Sharma, 2022).

Improving compensation and benefits packages: Improving benefits and pay packages is a key tactic in addressing the problem of brain drain in the nursing field. Because of their critical position in the healthcare industry, nurses require competitive pay and benefits in order to draw and keep qualified workers (Johannes, 2020). Not only does adequate compensation show how much their labor is valued, but it also helps employees fulfill their financial demands and feels more satisfied at work. Comprehensive benefit packages that include paid time off, retirement plans, and healthcare can also improve nurses’ general wellbeing and lower their risk of burnout and stress (Gozum, Sebahat & Yurcu, Gülseren & Ilgaz, Aysegul & Aybar, D., 2023). Healthcare companies should foster a culture that recognizes and supports the nursing profession by giving higher pay and benefits first priority. This will increase retention rates and guarantee high-quality patient care.

Enhancing career development opportunities: Improving possibilities for career growth is a critical tactic in addressing the brain drain in the nursing profession. Healthcare companies may encourage nurses to remain in their roles and make contributions to the medical field by giving them promotion and growth chances (Merten, 2016). Nurses can improve their skills and knowledge through career development activities like professional development programs, mentoring, and educational opportunities, which will enable them to take on increasingly demanding positions and responsibilities. This fosters a sense of loyalty for the company in addition to raising engagement and job happiness. Furthermore, providing nurses with possibilities for advancement and clear career trajectories might encourage them to remain in their current roles and pursue their long-term professional objective (Johannes, 2020). The health sector can lessen the consequences of brain drain and guarantee a long-term workforce in the nursing profession by supporting nurses’ career development.

Implementing policies to improve working conditions: One of the most important ways to address the problem of brain drain in the nursing profession is to put rules in place that would enhance working conditions (Gillian &  Blake, 2017). By fostering a positive and encouraging work atmosphere, nurses are more likely to stick with their jobs and make contributions to the medical field. Policies may involve actions like cutting back on excessive workloads, making sure there is enough personnel, and enhancing nurses’ general work-life balance (Merten, 2016). Furthermore, offering tools and assistance for ongoing education and professional development might improve nurses’ chances for career advancement and job satisfaction. Putting these regulations into practice helps nurses individually, but it also improves patient care overall and increases the retention of qualified nurses.

CONCLUSION

To address the causes of brain drain among Nigerian nurses, comprehensive strategies must be implemented that include improving working conditions, increasing remuneration and benefits, providing opportunities for career development, strengthening healthcare infrastructure, ensuring workplace safety and security, and addressing political and economic challenges. Addressing these variables will help Nigeria maintain its nursing workforce and provide access to quality healthcare for its population.

Competing Interest Declaration

There are no competing interests

REFERENCES

1. Abou hashish, Ebtsam & Bajamal, Eman & Ashour, Heba. (2023). Development and Psychometric Properties of the Brain Drain Questionnaire for Nurses. Journal of Nursing Measurement. JNM-2022. 10.1891/JNM-2022-0130.
2. Alex Sager (2012). Brain Drain, Health, and Global Justice. – In Rebecca S. Shah (ed.), The International Migration of Health Workers: Ethics, Rights, and Justice. Palgrave-Macmillan. pp. 103-117.
3. Arianne Shahvisi (2018). Health worker migration and migrant healthcare: Seeking cosmopolitanism in the NHS. Bioethics 32 (6):334-342.
4. Bhardwaj, Bhawana & Sharma, Dipanker. (2022). Migration of skilled professionals across the border: Brain drain or brain gain?. European Management Journal. 10.1016/j.emj.2022.12.011.
5. Gillian Brock & Michael Blake (2017). Guest editors’ introduction: Justice, the brain drain, and Africa: Introduction to a symposium on Debating Brain Drain. South African Journal of Philosophy 36 (1):1-3.
6. Gozum, Sebahat & Yurcu, Gülseren & Ilgaz, Aysegul & Aybar, D. (2023). Factors Affecting Health and Tourism Students’ Perceptions of Brain Drain: A Serial Mediation Model. European Journal of Public Health. 33. 10.1093/eurpub/ckad160.1615
7. Johannes Kniess (2020). Health, migration and human rights. Critical Review of International Social and Political Philosophy 25 (7):920-938.
8. Luara Ferracioli & Pablo De Lora – (2015). Primum Nocere: Medical Brain Drain and the Duty to Stay. – Journal of Medicine and Philosophy 40 (5):601-619.
9. Merten Reglitz (2016).  Medical Brain Drain: Free-Riding, Exploitation, and Global Justice. Moral Philosophy and Politics 3 (1): 67-81.
10. Oduola, Damilola. (2023). Medical Brain Drain and Healthcare Delivery in Africa: Beyond Restrictive Migration Policies. 10.1007/978-3-031-32898-5_13.
11. Ojo Omonijo, Dare & Nnedum, Obiajulu & Jude, Ezeokana. (2011). Understanding the Escalation of Brain Drain in Nigeria From Poor Leadership Point of View. Mediterranean Journal of Social Sciences. 2. 434. 10.5901/mjss.2011.v2n3p434.