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The sustainability of a country's health human resources depends on the supply and mobility of its healthcare workers. Globally, nursing occupies the largest health professional labour group (59%), with a growth of 4.7 million nurses seen from 2013 to 2018, amounting to a nursing workforce of 27.9 million worldwide (WHO 2020a). Despite this increase, it is estimated that the world will need an additional nine million nurses and midwives by 2030 (WHO 2020b). Given these projections, enhanced nurse mobility can be anticipated and expected., (Copyright © 2021 Longwoods Publishing.)

The internal migration of nurses within Canada has had limited study. This paper reports the results of a survey of registered nurses and licensed practical nurses who had migrated between the provinces and territories in Canada. Factors contributing to internal nurse mobility included seeking full-time work, opportunities for career advancement and flexible scheduling options. Few nurses received incentives to move between the provinces/territories to work. A number of challenges with internal migration are identified, including complexities related to licensing and limitations in available job information. Implications for nursing health human resources policy related to nurse retention in Canada are identified and discussed.

Recent years have witnessed the publication of a growing number of studies of nursing which, from a disciplinary perspective, are geographical in their orientation. Conceptually, while the emphasis in much of this research has been focused at the micro scale on the dynamics between nursing and "place," curiously there has been scant attention to geometrical "space," and the basic yet important locational and distributive features of nursing at the macro scale. Noting this gap in the literature, the authors of this paper used a Geographical Information System (GIS) to map the movement of 199 nurses from two Canadian provinces where they were educated - Manitoba and Newfoundland - to the provinces where they currently live and work. While the findings show that nurses who move tend to move to nearby provinces, more generally they illustrate the effectiveness of GIS for managing data and representing findings from workforce studies.

Nurses who are early in their careers make important decisions that begin them on unique career trajectories. One of these decisions may be migration. Little is known about the experiences and career decisions made by early career nurses who were educated in Canada and are working in the United States. Focus groups were conducted with nine nurses to explore and describe their experiences. Utilizing the Learning Theory of Career Counselling as a framework, the analysis highlighted the environmental conditions and learning experiences described by the participants. Two themes were identified: early decisions and ongoing decisions. The career trajectories of these nurses were characterized by decision-making. They made decisions about becoming a nurse, where to work and in what clinical specialty. The learning experiences and environments to which they were exposed influenced their early decisions and continued to influence their ongoing decisions about returning to Canada.

Understanding the experiences of nurses who have moved between the provinces and territories (P/T) in Canada for work provides insight into the role of professional socialization in career decision-making. This paper analyzes some of the qualitative data arising from a survey of nurses from across Canada. The findings provide insight into nurses' professional socialization and demonstrate that early perceptions and expectations of nursing practice can influence future career decisions such as mobility and intent to remain. Participants described how "caring" and direct patient contact were central to their choice of nursing and career satisfaction. As the data reveal, nursing is also regarded as a career that enables mobility to accommodate both family considerations and professional development opportunities. The findings highlight the need for professional socialization strategies and supports that motivate Canadian nurses to continue practising within the profession and the country.

The purpose of this study was to explore how educational opportunities may affect nurses' decision to move within Canada. Thematic analysis of qualitative data obtained from 35 registered nurses and 35 licensed practical nurses highlighted educational opportunities available in Canada and how these influence nurses' decision to move across the country for work. The results indicate that Canadian nurses value continued learning but face several barriers while trying to further their education. Two main themes emerged: support for and access to continuing education. Canadian nurses perceive a lack of support, both financially and in the form of scheduling, for engaging in continuing education. Additionally, the lack of access to accredited continuing education programs was reported. The findings and implications of this study are examined within the context of nurse mobility.

The migration of nurses from Canada to the United States has occurred for decades, although substantial increases have been noted since the 1990s. A survey of 4,295 Canadian-educated nurses in the US identified that this trend in mobility is largely unchanged. Almost half the nurses in this study migrated to the US in search of full-time work, often after unsuccessfully seeking employment here in Canada prior to leaving. Incentives to migrate were provided, although the opportunity for full-time work was often perceived as an incentive to move. While some intent to return is apparent, this is unlikely to occur given the levels of satisfaction with work and the high value attributed to Canadian nurses by US employers. Policy makers and nurse leaders are urged to use these data to formulate strategies aimed at retaining Canada's nurses in this country.

Although the licensed practical nurse (LPN) workforce represents an ever-growing and valuable human resource, very little is known about reasons for practical nurse mobility. The purpose of this study was to describe LPN perspectives regarding motives for inter-provincial/territorial (P/T) movement in Canada. Participants included 200 LPNs from nine P/T, and data were analyzed using a qualitative descriptive approach. Three primary themes were identified regarding motivators for LPN migration, including (a) scope of practice, (b) education and advancement opportunities and (c) professional respect and recognition. Although current economic forces have a strong influence on nurse mobility, these findings emphasize that there are other equally important factors influencing LPNs to move between jurisdictions. As such, policy makers, administrators and researchers should further explore and address these themes in order to strengthen Canada's nursing workforce.

Nurse leaders from a sample of acute care and long-term care sites participating in the Health Outcomes for Better Information and Care program in Ontario provided information on their experiences with HOBIC implementation. In addition, they described strategies to enhance successful implementation of the program. Finally, they discussed the potential future uses they envisioned for healthcare settings from the HOBIC data. Organizational benefits, such as data comparability, effective patient care planning and delivery and enhancement of nurses' technology skills were identified. Challenges that were highlighted included attaining buy-in from staff nurses, integration of HOBIC into existing computer systems and the subsequent computer and information technology challenges related to implementing such a program. Additional education and support for nursing staff and management were suggested as approaches for overcoming barriers. This survey demonstrates interest and commitment to HOBIC from many nurse leaders in Ontario and highlights the value that such a program provides for staff nurses in the planning and implementation of care. Nurse leaders in Ontario are keenly aware of the important potential that HOBIC data can provide for high-quality patient care and have identified key factors that need to be considered with the implementation of such a program.

Background: Hospital restructuring has resulted in nurse managers' having direct responsibility for a greatly expanded number of units and staff. However, very little research has examined the impact of these larger spans of control on nurse and patient outcomes., Objective: This study examined the relationships between leadership style, span of control, nurses' job satisfaction and patient satisfaction, as well as the moderating effect of span of control on the relationship between leadership style and the two outcomes., Methods: The study was conducted at seven teaching and community hospitals with a sample of 51 units, 41 nurse managers, 717 nurses and 680 patients. Data analyses included multiple regression and hierarchical linear modelling., Results: The study findings provided support for the theoretical relationships among leadership style, span of control, nurse job satisfaction and patient satisfaction. In addition, the results showed that higher spans of control decreased the positive effects of transformational and transactional leadership styles on job satisfaction and patient satisfaction, and increased the negative effects of management by exception and laissez-faire leadership styles on job satisfaction., Discussion: Leadership matters, and certain leadership styles, particularly transformational, are better than others. Span of control also matters: the wider the span, the lower the nurses' job satisfaction and patient satisfaction. However, as spans of control increase in size, no leadership style, even transformational, can overcome the negative effects.