Who cares? Indian nurses ‘on the move’ and how their transnational migration for care work shapes their multigenerational relationships of familial care over time

Abstract

This thesis explores how migration for care work shapes Indian nurses’ multigenerational relationships of familial care over time. Using qualitative research methods, it interrogates the intertwining of economic and non-economic factors underpinning the entry and continued participation of this group of women and men in the nursing field and international nursing labour markets. The thesis is broadly informed by a relational approach to care. More specifically, the thesis draws on feminist theories on care as a lens for analysing the migration of nurses from poorer regions to wealthier regions, as well as a transnational care framework to analyse the care relations that nurses maintain and sustain in the context of their migration. In paying attention to changes over the life course and participants’ constructions of their future, a focus on the temporal adds to existing frameworks for theorising.

Through an analysis of the nurses’ personal accounts, this project examines the connections between undertaking the care of patients in British hospitals and nursing homes at the same time as caring for their own families, both in India and the UK.

Drawing on in-depth qualitative interviews with 25 Indian women and men working as nurses and carers in the UK, the thesis demonstrates how nurse migration is underpinned by 1) the structural and gendered inequalities that drive migration and caregiving, as well as 2) the moral values that sustain multigenerational care between family members that 3) change over time. Firstly, the thesis highlights how the socioeconomic conditions in India, the structural demands for nurses in the British health care system, gender and racial hierarchies within the nursing field, and the colonial relationship between India and the UK create the conditions that have enabled Indian nurses to enter the British labour market. This reveals how a complex array of intersecting policy contexts on labour, migration and healthcare shape the practices of reciprocal care in the nurses’ resident and transnational families. The transnational care practices that emerge out of these contexts are entangled with the nurses’ insertion into the global labour market. Secondly, the thesis reveals how multidirectional and asymmetrical reciprocal care relationships between nurses and their families also underpin this form of migration. The analysis finds that culturally informed values regarding care for family is a central factor in stimulating and reproducing nurse migration. The nurses’ consistently present accounts of decision-making regarding past and imagined future migrations and work in terms of caregiving and care-receiving, with familial care duties and obligations frequently mapping onto the migration opportunities engendered by nursing. This care in turn circulates between different family members, in different locations, to differing degrees, over the life course. Lastly, by drawing attention to the changes that occur over personal, migration and family life courses, temporality is identified as a central dimension of nurse migration and transnational family life. Aspirations and hopes reveal the importance of imagined futures for reproducing nurse migration and transnational family care.

Focusing on this complex intersection through the personal accounts of the nurses, I argue in this thesis that migration for care work both shapes and is shaped by multigenerational relationships of familial care over time. In doing so, the analysis draws attention to the mediating factors that impact upon the ways in which this care has been exchanged over time, paying special attention to (re)negotiations of childcare and eldercare over time. By focusing on the creative and innovative ways in which the nurses navigate the obstacles to caring for family in the context of migration, the thesis contributes to the growing body of literature that questions representations of victimhood often imposed on migrant women from the global south. Examining the family care dimension of nurse migration and its changes over the life course is essential for better understanding the broader dynamics of the overseas nursing workforce and the factors influencing their arrival, settlement or departure from the UK, as well as how family relationships shape and are shaped by international migration for care work. Overall, the thesis contributes to the empirical basis for a revaluing of care that takes place within and across borders.