A review of nursing workforce policies in five European countries: Denmark, Finland, Ireland, Portugal and United Kingdom*/England.

AIM: Review nursing workforce policies in five European countries: Denmark, Finland, Ireland, Portugal and the United Kingdom*. BACKGROUND: Imbalances in registered nurse (RN) supply and demand is a global, significant and recurring issue that impacts on healthcare systems, organizations, staff and patients. METHOD: Policy Review using resources located by a systematic search of relevant healthcare databases and policies in Danish, English, Finnish and Portuguese over the time period 2003-2007. Content analysis was used to identify themes and compare policies. RESULTS: Common nursing workforce policy themes were identified across the five countries: (1) improving retention through effective human resource management, improving the practice environment and nurses' working lives and (2) improving recruitment through attracting more new recruits and RNs back to practice, and international recruitment. The present study also identified methodological issues relating to data quality and quantity. Lack of an agreed definition and standardized measures of nursing need and shortage makes comparison and evaluation of policy effectiveness and impact difficult. IMPLICATIONS FOR NURSING MANAGEMENT: Healthcare systems and organizations need to identify and implement effective policies that promote the retention of RNs in the workforce, or risk threats to healthcare system sustainability, as well as patient care quality and safety.

Models of initial training and pathways to registration: a selective review of policy in professional regulation.

AIM: To provide a synthesis of literature on international policy concerning professional regulation in nursing and midwifery, with reference to routes of entry into training and pathways to licensure. BACKGROUND: Internationally, there is evidence of multiple points of entry into initial training, multiple divisions of the professional register and multiple pathways to licensure. EVALUATION: Policy documents and commentary articles concerned with models of initial training and pathways to licensure were reviewed. Item selection, quality appraisal and data extraction were undertaken and documentary analysis was performed on all retrieved texts. KEY ISSUES: Case studies of five Western countries indicate no single uniform system of routes of entry into initial training and no overall consensus regarding the optimal model of initial training. CONCLUSIONS: Multiple regulatory systems, with multiple routes of entry into initial training and multiple pathways to licensure pose challenges, in terms of achieving commonly-agreed understandings of practice competence. IMPLICATIONS FOR NURSING MANAGEMENT: The variety of models of initial training present nursing managers with challenges in the recruitment and deployment of personnel trained in many different jurisdictions. Nursing managers need to consider the potential for considerable variation in competency repertoires among nurses trained in generic and specialist initial training models.