1 Introduction

According to the Ministry of Economic Affairs and Employment of Finland (2022) the Finnish health and social services sector suffers from a shortage of skilled labour. It is estimated that by the year 2030 there will be need for approximately 20,000 new healthcare workers and an estimated 10% of these is expected to be nurses of foreign background recruited from abroad.

The projected shortage is because Finland has an ageing population with a large proportion of the population approaching retirement age in the coming years. This is expected to cause a burden on the healthcare system as older people tend to have more diverse and long-term health challenges that require continuous care and treatment (YLE news 2022).

In the face of growing demand for healthcare workers, the immigrant nursing students trained in Finnish Universities will play a significant role in addressing the nursing shortage. However, challenges persist that hinder these professionals due to integration barriers such as language proficiency, cultural differences, and workplace discrimination. The aim of this article is to

The objectives of this study are in 3 parts:

1. To examine the relationship between healthcare funding and transition to work life.

2. Identify the key barriers to retention.

3. Assess the benefits of providing funding for immigrant nurse reten-tion programmes.

2 Literature review

The state of the EU (2023) reported that in 2021 that the healthcare spending of Finland reached 10.3% of its GDP in 2021. Since 2017, Finland’s healthcare expenditure has grown and there was a further increase during the first two years of the pandemic.

Budget cuts in many Finnish wellbeing areas have led to austerity measures, which has resulted in less recruitment, replacement, and retention investment in order to meet their saving targets for the year (Yle 2024).

Previous research has shown that many nurses with a migrant background experience difficulties within the healthcare settings for example cultural and linguistic challenges, work-place discrimination, bullying, racial problems, and limited career mobility (Likupe 2015, Kamau et al. 2022). Due to these challenges, migrant nurses have trouble in integrating in healthcare organizations, delivery of care and their overall wellbeing. (Likupe 2015, Kamau et al. 2022) Despite these challenges, different support strategies like integration programmes have proven to be beneficial to immigrant nurses as it improves adaptation time and facilitates a smooth start to work life (Brunton et al., 2019; Holmes & Grech, 2015; Kamau et al., 2022, 2023; Pung & Goh, 2017).

3 Findings and discussion

3.1 Healthcare funding and transitioning to workforce

There are constraints on healthcare budgets in the current economic clime and this is indicative of a difficult economic environment where public resources for health are being squeezed by competing sectors (OECD 2024). Investing in healthcare is a strategic tool to enhance access to universal health coverage and a higher density of nurses leads to noticeably better health outcomes (ICN 2024). Healthcare funding directly impacts the resources available for recruiting, training, and retaining immigrant nurses (Al Achkar et al., 2023). According to the research by (Parviainen et al.,2024) adequate funding ensures that immigrant nurses receive language training, cultural orientation, and professional development opportunities to meet Finnish healthcare standards.

3.2 Barriers to retention

3.2.1 Language barrier

The biggest obstacle faced by Immigrant nurses in the Finnish healthcare sys-tem was determined to be the language skills. Many immigrant nurses noted that learning Finnish took longer than anticipated and learning the language was quite challenging. Furthermore, the immigrant nurses’ inability to communicate fluently in Finnish affected their ability to have other nurses trust in their skills. Poor language skills also affected their ability to participate in daily activities, like team meetings and trainings in the ward. Additionally, they felt excluded when they were unable to understand written procedures, or documents that were distributed in the workplace. (Calenda et al., 2018)

3.2.2 Discrimination

Nurses with immigrant backgrounds face discrimination from coworkers, patients, and supervisors. Additionally, their qualifications are occasionally undervalued. Since they are not hired as registered nurses due to language proficiency, many immigrant nurses are forced to work as practical nurses in homecare, hospitals, and nursing facilities. Despite having the necessary education, they also struggle to obtain long-term employment contracts and opportunities to advance in their careers. (Näre 2013).

3.2.3 Difference in Culture

Cultural difference is a factor that goes hand in hand with language proficiency to facilitate an immigrant’s nurse adaptation and easy integration into a society and culture. Integration can be difficult if there is a lack of cultural aware-ness (Nalungwe 2016). Being culturally competent is crucial for immigrants. Sometimes people don’t understand the differences, but they can be learnt, like how to interact at the workplace. Although developing cultural awareness is extremely challenging, once accomplished, it facilitates effective work, adoption, and successful integration (Nalungwe 2016).

3.3 Benefit of increased funding

Increased funding for retention programmes can be used to mitigate employee turnover, develop enhanced level of employee engagement, dedication, and satisfaction (Timsina 2024). Employers should also give professional growth top priority by emphasizing skill development, putting mentoring programs into place, and offering clearly defined career paths. Together with focused efforts, creating a positive work atmosphere, encouraging a positive work culture, and building strong work relationships are important elements that enhance employee retention (Timsina 2024).

4 Conclusion

Retaining immigrant nursing students depends heavily on healthcare funding. Targeted efforts are needed to address obstacles like discrimination, cultural adjustment, and language competency. Funding must be given top priority by policymakers to develop a skilled and inclusive healthcare staff, which will help the Finnish healthcare system in the long run. In addition, keeping immigrant nurses not only serves the health care system but it ensures there is a cultural diversity at the workplace which could lead to better healthcare experience for patients.

Authors:

Temilola Ajayi, Savonia University of Applied Sciences, Kuopio, Finland.

Okko Tervo, lecturer, Savonia University of Applied Sciences, okko.tervo@savonia.fi

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