First strand: Semi-structured qualitative interview

In order to collect valid data from the CR, where information on nurses´ migration is not publicly available, I had arranged one-on-one semi-structured interviews with two key informants. Interviews have better response rates than questionnaires, allow for deeper questioning and clarity, but are more costly and have a higher risk of interviewer bias (Polit and Beck, 2004). There were only two participants that I intended to interview, which made it possible to conduct the interviews without exhausting the given resources. Burke and Muller offer practical advice on how to conduct a phone interview, which I used when preparing for the interviews. Semi-structured interviews ensure that all of the topics of interests are covered, while the respondent can still answer freely (Burke and Miller, 2001). The questions for these interviews were developed based on the (mostly English) published literature, as well as on one larger Czech migration study dealing with the migration of the Czech general population (Vavreckova et al., 2006). The questions were critically reviewed by both supervisors with minor amendments.

Both informants had special expertise in this topic that is otherwise not publicly available, and they were able to answer my questions and thus later validate the findings from the other strands.

The interview with the representative of a Czech recruiting agency intended to map the trends in nurse migration from the perspective of a recruiting agency. This Czech-based

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agency specializes in the recruitment of health care professionals predominantly for the Gulf region. It has been operating on the Czech market for about 10 years, and so far it has placed over 500 health care professionals abroad. The agency only places nurses in specialist positions. Examples of the questions for the recruiting agency:

 What have been the numbers of Czech nurses responsible for general care that found a nursing job abroad through your agency annually since 2005?

 Do these nurses need a qualification verification certificate issued by the Czech Register of Health Care Professionals?

 Do you have any evidence that these nurses later return to the CR?

 Do you witness a repeated migration of Czech nurses - after they returned from one placement, do they request a second placement in the same country or in a different country?

 Are the patterns of migration and return migration different and specific if the nurse migrates with her family? Is it common that the nurse migrates with her/his family?

 Do the newly migrating Czech nurses prefer foreign health care facilities with an established network of Czech nurses?

 According to you, is there any evidence that the professional skills of the migrating Czech nurses change while working abroad?

 Did you notice a change in the demand to recruit and import nurses since 2009 as a result of the global financial crisis?

The interview with the representative of the Czech Register of Health Care Professionals intended to identify the scope of data in the register relevant to the migration of Czech nurses and to use this information to assess the trends in migration of Czech nurses. The register was established in 2004 as part of the Czech Ministry of Health. Primarily, it checks the credentials of health care professionals (including nurses responsible for general care) who are consequently allowed to use the title „Registered“ and practice the appropriate profession independently. Upon an applicant’s request, the register also issues a certificate confirming the compatibility of the applicant’s professional qualification with Dir.

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EU/2005/36 and Dir. 2013/55/EC. This certificate is required by authorities in other countries in order to recognize the applicant’s qualifications.

Examples of the questions for the representative of the Czech Register of Health Care Professionals at the Czech Ministry of Health were the following:

 What was the annual number of requests for qualification verification made to the register by nurses responsible for general care that obtained their first nursing qualification in the Czech Republic (or previously the Czechoslovak Socialist Republic)?

 Which age cohorts are requesting the qualification verification the most often?  Do you know the average highest nursing education of the applicants?

 Can an estimate of the international migration of Czech nurses be made based on data other than the number of requests for qualification verification?  Are there countries that do not require the migrating nurse to show the

verification certificate? Do you think some Czech nurses migrate without applying for the verification certificate?

 Can some nurses be counted twice in your statistics?

The interviews took place in March 2013 in Prague in person with the representative of the recruiting agency and over the telephone with the representative of the MoH with her office in Brno. Both interviews lasted approximately one hour. In the case of the interview with the representative of the MoH, I obtained a verbal permission to conduct such an interview from the Head of the Register in November 2012.

Before I started the interview, I thanked the informants for their willingness to answer my questions, checked whether the timing (scheduled via previous email communication) was still convenient, and confirmed that I was permitted to record the interview (Burke and Miller, 2001), and then we signed the informed consent. In the beginning I explained the QMU procedure to support research clarity, accountability and confidentiality to the informant and then proceeded to ask the first question.

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The collection of the information in the semi-structured interview was easy and straightforward. The informants did not have any problems understanding the questions and were willing to share their knowledge with me. This format allowed me to immediately clarify any answers and ask further questions in order to explore the given answer.

I transcribed both interviews verbatim in Czech and prepared a summary in English. The summary of the findings from this strand can be found in Chapter 4. Notes made during each interview were used to check the accuracy of the transcription.