International nursing mobility: ethical issues and governance challenges

The global shortage of nursing personnel, estimated at approximately 5.8 million professionals, is prompting many highincome countries to resort to international recruitment as a means of rapidly filling care gaps. While this strategy may be effective in the short term, it raises ethical, legal, and organizational issues of considerable complexity. This study examines the phenomenon of international nursing mobility, with a focus on the Italian context, analyzing attraction models, qualification recognition procedures, integration mechanisms, and ethical implications. Through a combined analysis of scientific literature and data from institutional sources, critical issues are identified, including the brain drain from low- and middle-income countries, the heterogeneity of recognition procedures, the risk of waste of skills, and vulnerabilities associated with precarious contractual conditions and discriminatory practices. Based on the findings, the paper proposes a governance approach grounded in transparency, international responsibility, and distributive justice, encompassing structured professional integration pathways, mentoring programs, and the valorization of prior competencies. It also underscores the need to limit the systematic use of emergency derogations from formal recognition procedures, ensuring safe and sustainable care standards. An ethical and inclusive governance of nursing mobility has the potential to transform professional migration into an opportunity for innovation, social cohesion, and social justice, while simultaneously safeguarding the health of populations in both source and destination countries.