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TEMPERAMENTVM ISSN 169-6011

 

 

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A History of Today: Nursing and Globalisation

José Manuel Jover Lorente
Secretario General de la Consejería de Economía y Trabajo de la Junta de Extremadura (España)

Mail Delivery: C/ Juan de la Cierva 38. 06800. Mérida, Badajoz (España)

Manuscript acepted by 7.11.2006

Temperamentvm 2006; 4

 

 

 

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Jover Lorente JM. A History of Today: Nursing and Globalisation. Temperamentvm 2006; 4. In </temperamentum/tn4/t806e.php> Consulted

 

     The consequences of the complex process of relaxation of the boundaries imposed to the free circulation of merchandise and people, known as globalisation, has had an impact on every aspect of our lives, both personal and professional. Nurses are not an exception.
     As a result, many Spanish nurses have decided to work in Portugal, or have felt attracted by the tempting offers of the British National Health System. It is also common the case of those who have devoted some years of their careers to collaborating with Non-Governmental Organisations, in places whose work has made a difference in factors as diverse as the transport systems or the development of communication technologies. In addition, there are more and more people who, in their daily work, must look after people from different cultures. And none of them remains estrange to the yet increasing presence of immigrants, who choose to work as carers of the elderly and the disabled in our society. It would not be excessive to affirm that this and other factors have contributed to make of Nursing, indefectibly, an international profession. We are, without doubt, before the healthcare professionals' own and particular globalisation process.
     Accordingly, the numbers that describe the increasing foreign population in Spain are eloquent enough. Despite the difficulty to accurately establish the number of immigrants presently living in Spain, in January 2006, the National Institute of Statistics  estimated a population of 3.884.000 registered foreigners. That is, more than 8% of the total Spanish population. Taking into account that, in 1996, the number of immigrants did not yet reach 550.000, their total number multiplied by seven over a just decade.
     However, all these data become even more significant when compared to those in 1970s, when it was us, Spaniards, who had to migrate to different countries. In addition, taking into account factors such as the right of every immigrant, who has obtained a residence permit, to bring his family with him, or the scarce and remote perspectives of improvement in their own countries, everything seems to indicate that immigration will continue to increase at a yearly rate of nearly 20%, according to which, by 2050, the 25% of the population resident in Spain will have been born in other countries.
     The nationalities that comprise the foreign population in Spain are not only diverse but changing. In 1999, most of the immigrants living in Spain had come from the European Union (41,1%) and the African continent (23,4%), whereas in 2005, 45% of the immigrants arrived from different Latin-American countries, followed by those coming from East Europe, 19,2%. As a result, we stand before a more than evident globalisation process of the possible patients who will, eventually, be the objects of care of the healthcare professionals.
     The diversification of the patients' culture and nationalities will occur all over the national territory, with different intensity. This migration phenomenon has already taken place all over the Spanish geography: in 1999, the Balearic Islands had a rate of immigrants slightly higher than 4%, whereas in 2005, 11 out of 17 Autonomous Communities had an immigration rate exceeding 4%. The migration flow has mostly impacted on Madrid, the Mediterranean coast (Catalonia, Valencia and Murcia), and the two archipelagos, the Balearic and the Canary Islands. The globalisation of the eventual patients will reach each and every one of us.
     Spain faces the predictable consequences of these changes in the population, in the so called Welfare State, from a solid position: a position that comes from the social agreement, nearly unanimous, about the need to extend the services of the national health system to highly dependent people (putting into practice the newly approved Law of Dependency), and the consolidation of a public health system able to offer one of the world's best coverage, to any person that requires the service.
     The responsibility to provide more and better care, especially in places with a higher demand, will imply an increased social responsibility, both public and private, and will require a spectacular increase in the rate of employment destined to cover these necessities.
     It would not be a complete absurdity to assume that a significant number of jobs, destined to auxiliary healthcare professionals to look after highly dependent patients, will be carried out by immigrants. It must be taken into account that more than 14% of the total of people working in housework services is actually immigrant.
     Our elderly and highly dependent patients will be looked after by people from different cultures, with a different mother tongue, different hygienic habits and other ethical and religious beliefs. And the nurses will have to develop a huge effort as healthcare educators/trainers in the area of care of highly dependent patients. The globalisation effects will reach the intimate family environment, where a significant pedagogical effort will be required.
     However, it is everyone's responsibility to maintain this atmosphere, and the supportive spirit hidden behind it, in order to positively absorb the impact of this migration phenomenon. The role of nurses, in this task, in not small. As they communicate with people with different habits and ideas about the concepts of healthcare, death or disease, they must also open their minds to this differentiation, and increase their reception to the suffering of others. And from this point, where looking after the elderly and highly dependent patients has become one of the main occupations of many immigrants, they must be able to find in the nurses' attitude an excellent point of reference.
     In summary, the fast and intense increase in the number of foreigners living with us, and their condition of nurses and carers, have put the nursing profession in a situation where new challenges and difficulties must be assumed and faced, but also where new opportunities arise for the future benefit of all.

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