Today’s Caribbean Current: Nurse Migration and the Quiet Strain on Caribbean Health Systems
Across the Caribbean, nurses are the backbone of healthcare delivery, from hospitals and clinics to community and public health services. Yet today, nurse migration is quietly reshaping how care is delivered across the region.
Peer-reviewed research shows that nursing vacancy rates in parts of the Caribbean average around 40%, with sustained nurse migration identified as a major contributing factor. This figure reflects more than a workforce challenge; it signals a system under strain.
When experienced nurses leave faster than systems can retain or replace them, the impact is immediate: thinner staffing on wards, longer wait times, rising burnout, and increasing reliance on temporary or agency staff. For patients and families, this isn’t an abstract statistic, it shapes access, continuity, and quality of care.
As vacancies grow, health facilities are forced to do more with less. Remaining nurses carry heavier workloads, often without adequate support. Institutional knowledge and mentorship are lost, and service delivery becomes increasingly fragile, particularly in rural and community settings.
Research consistently links sustained nurse out-migration with:
- Chronic staffing gaps that strain service delivery
- Increased burnout among remaining staff
- Reduced continuity and quality of care
- Higher operating costs due to short-term staffing solutions
These pressures compound over time, making recovery harder and reform more urgent.
Nurse Migration is Not New
Nurse migration itself is not new. Caribbean nurses are highly respected internationally because of their training and professionalism. Movement has long been part of the global health labour market.
What the evidence makes clear is that migration often reflects misalignment between what nurses are asked to give and what systems are able to offer. Limited career progression, wage gaps, chronic understaffing, weak leadership support, and reactive workforce planning all contribute to rising vacancy rates and sustained out-migration.
The central challenge for Caribbean health systems is not whether nurses will move, but how systems function when they do.
Evidence points to strategies that support resilience: clearer career pathways, safer staffing ratios, stronger investment in nurse leadership, regional training and exchange models, and workforce data systems that enable long-term planning rather than crisis response.
When nursing vacancy rates approach 40%, workforce challenges become system challenges. They affect access, quality, cost, and trust, the foundations of healthcare.
Nurse migration is one of the clearest signals shaping Caribbean health systems today. It exposes long-standing weaknesses, but it also points to where reform matters most. This is not about stopping movement. It is about leading through it.
Today’s Caribbean Current highlights emerging pressures shaping health systems across the region. Future pieces will explore how leaders are responding.
Sources
- Rolle Sands, S., Ingraham, K., & Salami, B. (2020). Caribbean nurse migration — a scoping review. Human Resources for Health.
- Pan American Health Organization (PAHO). Health Workers Perception and Migration in the Caribbean Region. 2019.
- World Health Organization (WHO). A Universal Truth: No Health Without a Workforce.
- World Bank. The Nurse Labor and Education Markets in the English-Speaking CARICOM. 2009.
Data note: Vacancy rates vary by country and over time. The estimate of rates averaging around 40% reflects peer-reviewed regional literature where sustained nurse migration is identified as a major contributing factor.
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