Heidi Bludau

Over its history, while nursing responsibilities have shifted from primarily hygienic tasks (vocational work) to more medically centered duties (professional work), the work of care remains at the core of the nursing profession. Nurses judge themselves and each other as professionals based on how well they are able to care for the patients in their charge. A professional nurse's ability to care centers on the institutional environment in which she works. Using an ethnographic case study of Czech nurses as migrants, this article explores how the discourse of care work enables nurses to examine their professional identities in different institutional contexts, that of their native Czech Republic and in foreign workplaces. At its foundation, I explore what happens when the institutional setting in which caring is supposed to take place hinders the production of caring practices.

Recruiters are literally and figuratively at the center of transnational healthcare migration. Although most international migrants depend on some type of intermediary to help them find employment and housing abroad, in the past few decades, for-profit mediation has become the main channel of healthcare migration. Using ethnographic case studies from the Czech Republic, this article illustrates how recruiters influence migration trends in three primary ways: creating the migration chain, creating the desire to be part of the chain, and facilitating movement along the chain. Each step necessitates continued brokerage and negotiation of a variety of resources. Throughout, recruiters act as channels and shape the flow of transnational migration.

The Czech Republic is experiencing a growing trend of healthcare worker emigration.  Although some emigrate for long periods of time, many return after a few months or years abroad and re-enter the Czech health system. The nurses’ narratives in this study draw on experiences in Czech, British, and Saudi hospitals to explore the role standardised medical policies, procedures, and protocols play in the development and maintenance of a nurse’s professional identity in the post-socialist context. The author suggests that performance of protocols versus informality of practice in healthcare settings provides a lens through which to view professional identity in post-socialism.  In fields such as healthcare, standards operate as measures of security that create normative rules of governmentality, regulate behaviour, and prevent harm. The nurses in this study describe the majority of Czech hospitals as lacking standard protocols for patient care.  Encountering strict rules of practice in foreign hospitals leads them to evaluate the professionalism and quality of Czech healthcare and their own selves as nurses.  Their assessment is often based on their own ability to effectively perform within the standardised system.  The author’s primary analysis for this presentation will concentrate on the ways that standardization relates to ideas about professionalism and nursing autonomy and status.

As skilled, globally in-demand professionals, nurses are in a unique position to take part in the increased levels of global healthcare worker migration. However, due to the lack of mobility in the past, Czech nurses do not readily conceive of working abroad nor do they have a large network linking them to jobs in foreign countries. Therefore, recruitment firms have arisen as a primary source gateway for nurses and other healthcare workers to enter the global market. These firms, in
turn, hold knowledge regarding what an individual needs in order to be successful in the job market and use this knowledge to create ‘migrant products’ for consumption in the global healthcare industry. In this article, I examine how migrants are created as recruitment firms mediate the work
of imagination. Primarily, this paper will describe the training activities that create successful job candidates for work abroad. Migrants must work not only to imagine themselves as part of a global community but also to position themselves as real members of the same. At the same time, recruitment firms mediate both processes by ensuring that their migrant candidates have appropriate levels of English language skills, medical skills, and the cultural capital necessary to negotiate a foreign healthcare environment.

Globally, pre-packaged and processed food is on the rise.  At the same time, homemade food is becoming less common.  Although this change has been happening for decades, in Eastern Europe producing and cooking food in the home played a large part of daily life during the communist era.  Today, however, even with availability of modern convenience foods, “homemade” food retains its place as the best and healthiest. 
In this paper I explore what happens when “homemade” food is no longer the center of kitchen life in the Czech Republic.  Largely, I consider the gendered aspect of this question.  Women are traditionally both the producers of domestic life and the natural reproducers of the nation, literally and figuratively.  Additionally, Czech ideals of womanhood remain rooted in motherhood, care, and familial domestic support. Therefore, I ask how Czech women negotiate their role of caretakers as food habits change in the post-socialist kitchen.  I suggest that one answer to this question is an increased awareness of food safety concerns, shifting caretaking and domestic support to an increased protection of the family’s health.  This paper focuses on ethnographic research from the Czech Republic but will use examples from Eastern Europe to illustrate the broader context.

Nurse migration is a global phenomenon that is increasingly becoming a major concern in European migration politics.  Old European Union member states, as well as the United States, Australia and Saudi Arabia, are experiencing a deficit in health care professionals and recruit workers from less developed countries to help fill the gap.  Some healthcare institutions recruit nurses directly, while others use recruitment agencies.  These for-profit organizations link employers and nurses, often offering training and immigration services.  Globally, recruitment agencies are a multi-billion dollar business and provide opportunities for exploitation and abuse of migrant nurses; they are not monitored or regulated.  However, recruitment agencies are often the quickest way for nurses to get to their potential employment sites.  Attracted by the opportunity to improve their standards of living, Czech nurses are taking advantage of these international vacancies and moving abroad.  This paper will explore nurse recruitment strategies in relation to gender processes using “Care4U,” a Prague-based international medical staffing agency, as case study.  Because most nurses are women, nurse migration is a gendered event that not only preserves traditional gender roles, but also, I argue, allows women to reconstruct their roles as high-wage earners and major contributors to the family’s welfare.
Recruitment agencies sell themselves on the ability to provide lucrative employment opportunities to their clients, often including various types of skill and language training, as well as immigration navigation services.  Care4U supports its nurse-clients through expert knowledge of the immigration processes and access to training for international nursing exams, including alternative programs and detailed timelines.  I suggest that the company is taking on the paternal role of the old socialist state in caring for all needs of its clients, thereby subordinating its female nurse-clients in the process.  However, the nurses in this program are not merely maintaining the traditional gender role of homemaker with a double burden.  Simply by entering the migration process, Czech nurses are reconstructing their roles as “breadwinners” with potential earnings abroad averaging of two to five times their Czech salaries. Additionally, my ethnographic data will demonstrate that the nurses in Care4U’s program are using the company to serve their professional needs even when they do not agree with are4U’s practices.  This work extends recent research on the empowerment strategies that post-socialist women are utilizing in the labor market.