Migration from Latin America to Italy and EU: the issue of health professionals

Abstract Introduction The estimated shortage of more than 15 million health and social care professionals, including over 6 million nurses, together with the significant phenomenon of international migration of such professionals, emerged, during COVID-19, with even more evidence. During the pandemic the danger of a collapse of health systems in many areas due to a shortage of staff was manifest. This leads, among other reasons for several professionals to migrate from South America to Italy and Europe. Methods an integrative review analysis (2011-2021), of trend in terms of legislation and policy documents were conducted using health and social database and gray literature. 34 different documents were included in this review. Results Several initiatives have been developed to establish international and/or bilateral obligations among countries in terms; however, this showed to be insufficient. There is confusion in terms of the necessity of harmonizing rules, nursing curricula, monitor systems, and innovative rules for recognition. With covid-19 and the increase in shortage of health professionals, a number of countries decide to reduce the general criteria of recognition. Conclusions It is time to develop specific actions aimed at setting up a passport for public health and health care professionals which allows guaranteeing prior certification and accreditation of skills by independent agencies. There is the need to set up a joint effort/actions among different stakeholders such as Government, Higher Education institutions, International Labor health market actors, and NGOs in the field of migration, labor, and training of public health and health care professionals to better meet health needs worldwide Key messages • it is necessary balancing the rights of individuals to migrate with the potential loss of essential health care services in source countries. • migration and shortage of nurses is a serious ethical issues.


Introduction:
Due to a shortage of health professionals and economic pressure, many German hospitals are required to transform the clinical work environment to increase job satisfaction, but also to attract and retain health professionals. Leadership is a key factor for the successful implementation of organization-wide change. The aim of this study was to identify the attributes and competencies among leaders that are beneficial for implementing and managing hospital-wide transformations.

Methods:
A qualitative study design. In 2020, 18 face-to-face, semistructured interviews were conducted with chief nursing officers, ward managers, nurses and physicians in five German hospitals which have started implementing a hospital-wide transformation (e.g. Magnet Õ or Pathway Õ ). Interviews were recorded and transcribed verbatim. Data were analyzed in Atlas.ti using the content analysis method according to Mayring.

Results:
Results show five beneficial leadership elements to instigate and steer hospital-wide transformation: (1) Charismatic leaders are role models and idealists with well-communicated visions that are grounded in clinical practice and reflect the clinical practitioners.
(2) Mentally strong leaders have courage, stamina, and are resilient. (3) Empowering leaders are highly supportive and increase the intrinsic motivation of employees.
(4) Imparting interprofessional appreciation refers to leaders who cultivate a respectful relationship with persons from other professional groups and recognize their daily performance. (5) Agile leaders are well and quickly accessible for employees and respond situationally to changing demands in everyday work.

Conclusions:
Interviewees described characteristics of hospital leaders as success factors for establishing and maintaining continuous change processes. Charismatic and supportive leaders are critical to transform the hospitals' culture and values. In addition, equitable interprofessional collaboration is of utmost importance.

Key messages:
Charismatic, agile, empowering leaders can have a positive impact on system-wide change processes. The successful transformation of hospitals' work environment needs interprofessional appreciation and the mutual acknowledgement of competences.

Introduction:
The estimated shortage of more than 15 million health and social care professionals, including over 6 million nurses, together with the significant phenomenon of international migration of such professionals, emerged, during COVID-19, with even more evidence. During the pandemic the danger of a collapse of health systems in many areas due to a shortage of staff was manifest. This leads, among other reasons for several professionals to migrate from South America to Italy and Europe.

Results:
Several initiatives have been developed to establish international and/or bilateral obligations among countries in terms; however, this showed to be insufficient. There is confusion in terms of the necessity of harmonizing rules, nursing curricula,

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European Journal of Public Health, Volume 32 Supplement 3, 2022 monitor systems, and innovative rules for recognition. With covid-19 and the increase in shortage of health professionals, a number of countries decide to reduce the general criteria of recognition.

Conclusions:
It is time to develop specific actions aimed at setting up a passport for public health and health care professionals which allows guaranteeing prior certification and accreditation of skills by independent agencies. There is the need to set up a joint effort/actions among different stakeholders such as Government, Higher Education institutions, International Labor health market actors, and NGOs in the field of migration, labor, and training of public health and health care professionals to better meet health needs worldwide