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The purpose of this paper is to identify the extent to which immigrant nurses have integrated within the Maltese healthcare system.

This research consisted of a qualitative case study approach which was conducted within Malta’s four public entities in the secondary care sector. In this case study, data were collected through 34 semi-structured interviews with ten nursing managers, 12 Maltese nurses and 12 immigrant nurses. The data were analysed using content analysis. Data were collected between June 2015 and July 2015.

Four themes emerged from the data. These were: human resources management, language barrier, cultural differences and discrimination. The recruitment of nurses to Malta from other countries translated into several positive and favourable outcomes, such as the sharing of knowledge. However, a number of negative and unfavourable outcomes are also indicated in the data including language barrier and discrimination.

This paper presents a discussion of the issues experienced within a healthcare system in relation to the mobility of nurses. Increasingly, the nursing workforce across the globe comprises of professionals from various nationality, origin, training, culture and professional ethos. The findings are presented in an effort to inform policy makers, management and administrative structures regarding the issues pertaining to the prevalent growing reality of mobility in nurse populations.

This research study provides a unique contribution to the literature regarding the phenomenon of nurse mobility because it embraces the integration of nurses as a two-way process. Since data was collected from immigrant nurses as well as from local nurses and nursing managers, this study hopes to offer a different point of view from previous studies which largely focused on the views of immigrant nurses only.

The contributions in this CDI special issue present research findings that have been generated in the course of the research project, Vocational Identity, Flexibility and Mobility in the European Labour Market, funded under the 5^th EU Framework Programme. Investigating identity formation processes at work, the guiding research question focused on what individuals identify with in their work context when they are challenged to respond to increasing demands for flexibility, mobility, changing work settings and shifting skill requirements. Project partners from seven European countries (Czech Republic, Estonia, France, Germany, Greece, Spain and the UK) interviewed more than 500 employees at intermediate skills level and over 100 managers and representatives of human resources departments about how employees cope with changes at work and how this might affect their work identity, work attitude and career orientation. This paper gives an overview of the background, research questions, basic theoretical considerations, methodology and general findings of this project. It serves as a general introduction to the other five papers presented in this issue which are all based on a common approach and understanding of the research carried out.

Six empirical studies of nurse migration motivations and intentions were identified for review. The review revealed that motivations and intentions varied by country of origin and by individual nurses. Nurses from more developed countries migrated for personal reasons, while nurses from less developed countries migrated for economic, professional and family reasons. Country‐level studies are needed in resource‐poor countries to inform health system policies and workforce development. These policies must simultaneously protect the right of the individual nurse to migrate and create conditions conducive to retention of nurses. Additional research is needed to understand the decision‐making processes related to migration and the experiences of individual nurses who migrate to more developed countries.

Based on the nursing occupation within the UK and The Netherlands' health sectors, which are both highly regulated with policies to increase inclusiveness, the purpose of this paper is to investigate the interplay between employment conditions and policy measures at sectoral level, in order to identify how these both facilitate and limit employment participation for disabled workers.

The research was exploratory in character using qualitative and comparative methods within a case study approach. It draws on statistical data, document analysis, focus group discussion and interviews with key actors in the health sectors in both countries.

Whether the social or medical model predominates, their combined use encourages the employment of disabled persons in the health sector. Arguably the social model, focusing on structural changes, can be seen as more enabling. The Dutch comparison shows that encouraging a sector‐specific approach, with increased social partnership dialogue, facilitates the implementation of the social model, resulting in sectorally‐appropriate enabling measures.

This research highlights the need for a sector‐specific approach to disability policy, with development of sectoral monitoring data and evaluation of impact by the social partners.

While previous academic research focused on the aggregated (national) level only, this research investigates the interplay between training, employment, working conditions and policy measures at sectoral and occupational levels, with a view to identifying their influence on employment opportunities for persons with disabilities.

This paper reports on a comparative qualitative study across four European countries which explored the formation of work identity amongst nurses and other professionals in the field of health care. Within this sector, it identifies trends towards a more flexible, more highly skilled and more mobile workforce. Conversely, however, it is becoming difficult to recruit and retain staff due to increasing workload, decreasing job satisfaction and comparatively low pay. Occupational identity is theorised as a multi‐dimensional phenomenon, with structural, social and individual‐psychological components. A number of emerging common themes across the three dimensions and across the four national settings include structural conflicts between cost efficiency and quality of care, and individual conflicts between the core activity of caring for patients and the increasing demands of administration and other peripheral work. The study identifies a number of strategies used by nurses to balance these conflicting demands. Overall, the professional identity of nurses remains strong, but it is important for policy makers to be aware of the potential negative effects, in terms of staff turnover, mobility and job (dis)satisfaction, of the current state of the health care sector.

Attention has been increasingly devoted to the development of methods for assessing the quality of care in long‐term care (LTC) facilities, especially for government surveillance. A study is described which used the tracer method to provide data on the quality of care in Israeli LTC institutions. Advantages of the tracer method include its incorporation of structural, process and outcome measures and its focus on a number of representative tracer conditions. The study tested the ability of the tracer method to provide data on the quality of care, and facilitated adoption of this methodology by the government for their annual inspections.

Despite the new ‘needs driven’ criteria for public funded admission to nursing homes, there remains concern that older people are entering such care inappropriately. However, neither previous research or policy makers have sub‐divided such inappropriate entries into their constituent groups: those who are inappropriate because they are too independent and those who are inappropriate because they are too dependent. The aims of this study were to determine the extent of inappropriate nursing home admission amongst older people in nursing homes in six areas of England and Wales between 1995‐96. This was done through a retrospective case‐note review using a structured data‐collection pro forma. Although the study found no evidence of extensive inappropriate placement, extrapolation of these data suggests that 6,750 of those admitted to nursing care could have coped in a more independent environment. The inappropriately admitted group were more likely to have lived alone, be female, elderly and not to have seen a geriatrician. It is concluded that the most effective way to prevent such admissions would be to ensure the involvement of specialist geriatricians in the multidisciplinary team involved in admission decisions.

Given that the incidence of coronavirus disease 2019 (COVID-19) varies greatly between countries, it becomes relevant to explore self-initiated expatriate (SIE) health workers' perceptions of home vs host country safety during a global pandemic. Thus, the paper aims to study the effects of COVID-19 on the expatriation experience of Spanish SIE nurses in Germany, focussing on perceptions of home and host country safety as push/pull forces on their intentions to repatriate or stay.

Semi-structured interviews (n = 10) were conducted with Spanish SIE nurses in Germany between April/June 2020 followed by instant messaging interactions with the same participants in October/November 2020. Data analysis was assisted by NVivo software.

Overloaded by information from social networks about the impact of COVID-19 in Spain compared with the situation in Germany, Spanish SIE nurses had exacerbated feelings of stress, and some reported having experienced guilt for not being in their home country. Nevertheless, the contrasting impact and management of the crisis and its relative effect on health workers and the larger society in Spain and Germany reinforced the nurses' intention to stay in Germany.

The research offers insights to organisations and public authorities involved with providing support to SIEs during crises, highlighting the implications of SIEs' social networks and dual allegiance to home and host countries during a global health emergency.

The study contributes to the growing literature on SIEs, whilst adding to the research on expatriates' well-being and safety during crises.

With the ageing global population the demand for nursing jobs and the requirements for complex care provision are increasing. In consequence, nursing professionals need to be ready to adapt, obtain variety of skills and engage in career self-management. The purpose of this paper is to investigate individual, micro-level, resources and behaviors that can facilitate matching processes between nursing professionals and their jobs.

A survey-based study was conducted among 314 part-time and full-time nursing professionals in Hungary.

Consistent with the career construction theory, this study offers evidence on career adaptability as a self-regulatory resource that might stimulate nurses’ adaptation outcomes. Specifically, it demonstrates positive relationships between adaptive readiness (proactive personality and conscientiousness), career adaptability, adapting behaviors (career planning and proactive skill development) and adaptation outcomes (employability and in-role performance).

The cross-sectional design limits causal inference. Relatively small sample of full-time professionals for whom supervisory-ratings were obtained yields the need of further replication.

Stimulating development of nurses’ career adaptability, career planning, and proactive skill development can contribute to sustainable career management. It can facilitate the alignment of nurses to performance requirements of their current jobs, preventing individual person-job mismatch.

Zooming into the context of nursing professionals in Hungary, the study elucidates the understudied link between adaptivity and adapting responses and answers the call for more research that employs other-ratings of adaptation outcomes. It demonstrates the value of career adaptability resources for nurses’ employability and in-role performance.