Beyond Deskilling: Reframing Skill Disruption Among Internationally Educated Nurses as a Problem of Skill Governance

Area of Science:

• Nursing
• Sociology of Work
• Migration Studies

Background:

• Internationally educated nurses are vital for healthcare systems facing shortages and increased demand.
• Migration and workforce entry often lead to significant professional practice disruption for these nurses.
• Existing research frames post-migration skill change linearly, obscuring systemic influences.

Purpose of the Study:

• To challenge linear accounts of post-migration skill adjustment.
• To propose that skill disruption is shaped by host healthcare systems' regulation of nursing labor.
• To reframe skill disruption as a structural effect of skill governance.

Main Methods:

• Discursive analysis drawing on nursing workforce scholarship, professional regulation literature, migration studies, and sociology of work.
• Development of a conceptual model of skill governance.
• Analysis of how regulatory and organizational processes filter prior expertise.

Main Results:

• Linear adaptation models are analytically limited in explaining skill changes for internationally educated nurses.
• Deskilling, upskilling, unskilling, and mis-skilling are outcomes of how systems regulate, recognize, and reorganize nursing labor.
• Skill governance, risk management, selective recognition, and professional hierarchies shape professional incorporation.

Conclusions:

• Skill disruption is a structural effect of skill governance, not just individual adaptation.
• Host healthcare systems significantly influence what constitutes legitimate nursing competence.
• Reframing skill disruption calls for system accountability and equitable workforce integration policies.