While some students think that "brain drain" refers to the way they feel after finals week, the term has a much more devastating meaning for Penn Nursing doctoral student Lusine Poghosyan.
Although Poghosyan, an Armenian native, is currently studying in Philadelphia, she will soon journey back to her home country, where she will be the first nurse in Armenia with a Ph.D.
There, she hopes to improve health care and reverse the effects of brain drain, which results from the efforts of developed countries, like the United States, to combat their own nursing shortages by recruiting nurses from developing countries. Many nations tapped for nurses, such as Armenia, are crippled by the nursing brain drain because they lack qualified staff.
"I'm so interested to be involved in reforms in nursing ... to help Armenia move forward," Poghosyan said.
After graduating from Penn, Poghosyan will teach more advanced nursing education programs than Armenia traditionally offers. She also hopes to start an administrative career in health care to strengthen her influence on the Armenian nursing community.
Her priority is "to go back, work and enjoy my life there. I'm working towards meeting that goal," she said.
"I care a lot about [Armenia] and the people in it, and that is where I think I can be helpful. I have friends and family there, and that is my place," Poghosyan said.
Linda Aiken, a registered nurse and the director of the Center for Health Outcomes and Policy Research, cited two causes for the brain drain in developing countries.
One is that "developed countries like the U.S. are not producing as many nurses as they need, and probably not using nurses effectively," Aiken said.
Secondly, she said that "nursing has been underdeveloped in many parts of world."
Several push-and-pull factors draw international students from their home countries into the United States, perpetuating the global nursing shortage.
According to Aiken, factors that drive people from their home countries include a lack of jobs for existing nurses due to a poor economy, a poorly resourced health care system and unsafe working conditions.
Poghosyan said that there is a high rate of unemployment in Armenia.
She also added that Armenia conducts no nursing research and that no nurses in Armenia attain respectable administrative positions. Because many Armenian nurses receive only a minimal amount of training, hospitals there lack quality healthcare.
According to Poghosyan, nurses in Armenia perform more technical and menial tasks. Physicians, not nurses, handle family and patient education, if they pay attention to it at all.
"I'd say this is not a positive effect," Poghosyan said. "It's not fair that [nurses in Armenia] do not have a voice in their own work."
Aiken said factors that draw nurses to the United States include high salaries, higher standards of living, respect for professional nurses, excellent health care and the opportunities to expand education and training.
Salimah Meghani, a doctoral student in the Nursing School and a Pakistani native, said that a nurse on average makes "$200 a month" in her home country. The same job in the United States can earn a nurse up to "$3,400 in one month," Meghani said.
According to Aiken, one issue of high concern is the migration of nurses from Africa to the United States, which has hindered the progress of the fight against AIDS.
"The single biggest reason why we haven't made more advances in AIDS [in Africa] ... has been because of shortage," Aiken said.
In Botswana, for instance, AIDS victims could not receive antiretroviral therapy due to a shortage of health personnel.
In order to balance the global health care work force, Aiken advised that developed countries simultaneously step up their domestic supply of nurses and invest in nursing education around the world.
"The U.S. is using nurses trained abroad because they don't want to invest money in training," Aiken said. "Until [developed countries] develop health research policies that enable them to train enough doctors and nurses to meet their own needs, the shortage will never be eliminated."
Additionally, nations short on nurses need immediate relief from countries like the United States.
Leaders in health care should "invest in education in [developing] countries so they have a bigger infrastructure for education and discover other ways ... to retain nurses," Aiken said.
Aiken also added that the United States should use its resources to educate foreign nurses on its own soil and then encourage them to return to their home countries.
Poghosyan, unlike many foreign nurses, has decided to return to her home country. But what does she think about those who do not return?
"I can't judge those people, because I used to work with people who did not have jobs, Poghosyan said. "I know how hard it is."
She also added that if health care systems fail to provide employment, nurses have a right to find the best way to live.
As a solution, Poghosyan feels that all countries "should think about the nurses in their own country and create an environment so these people will develop themselves and their own careers."
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