Discrimination against foreign nurses in Finland
Deborah Ahonen, Degree Programme: BS nursing student, Novia UAS
Anita Wikberg, RN, RM, PhD, Senior lecturer, Novia UAS
Bringing foreigners to work as nurses in Finland has been a hot topic for many years. Thousands of immigrants have been coming to Finland throughout the decades, yet many of them remain unemployed. Many of the immigrants are highly educated, want to work, and get integrated into Finnish society. Unemployment is not only a problem among first-generation immigrants but second-generation immigrants face discrimination as well. Research has been done in the European Union and Finland about discrimation foreign workers face from the recruitment process to working life. Especially, discrimination based on ethnicity is high in Finland compared to other EU countries. In Finland, immigrant nurses' employment rate is lower, it is difficult to get a permanent work contract, and progressing in the career is more difficult compared to native Finnish people. Immigrant nurses’ qualifications are undervalued by employees, work colleagues, and patients. On top of that, the work is onerous and the payment is poor, which leads to nurses having a lot of stress, exhaustion, and low motivation to work. Some of the foreign nurses get frustrated because of the conditions and opt to move to other countries to work. This is a huge loss to Finland since Finland is suffering from nurse shortages and educating nurses in Finland is expensive for the government. Most of the nurses have been educated in Finland and other countries end up benefiting instead.
Around 30 000 immigrants come to Finland each year (Clausnitzer,2021). All these people want to feel welcomed in Finland and integrate into Finnish society. Bringing immigrant workers to Finland has been a hot topic for several years but how are we helping already existing immigrants in Finland to get employed?
Working is an extremely important part of immigrants' repatriation and integration. It is a way for them to get into the society, make connections and learn the culture. Yet unemployment is three times higher among immigrants compared to Finnish people. First-generation immigrants, especially, suffer from being unemployed but it is also a problem among second-generation immigrants, who are born in Finland and know the language. Unemployment is not the only problem, since immigrants who have a job face discrimination in their workplaces as well (Larja, Warius, Sunbäck, Liebkind, Kandolin and Jasinskaja-Lahti, 2012).
Foreign registered nurses face discrimination from their supervisors, work colleagues, and patients. Their qualifications and abilities are undervalued by all parties. Many of the registered nurses are working as practical nurses in nursing homes because they do not get hired as registered nurses. They are used to do the “dirty work” and fired after there is no need for them anymore. They do not get permanent work contracts easily or have the same chances to go forward in their career, even if they have the required education (Näre, 2013).
Unfortunately, I have personally witnessed this happening to people I know. My foreign friends who are nurses or have another profession have difficulty finding a job, especially a permanent one in their field. Many of these people I know have worked in the health care sector in their home countries, are top students, and do this work with a big heart. I have seen my friends become frustrated for not receiving any calls for job interviews despite all the applications. Even if they get the chance to go to an interview, they turn out to be rather awkward when a foreigner walks into the room. According to 2020 Statistics Finland/ Population Structure; for decades, immigrants have been coming to Finland in increasing numbers. This does not automatically lead to multicultural workplaces though.
Inequity in the Job Market
The Ministry of Employment and the Economy did research in 2012 about discrimination in the Finnish labour market. People coming from countries with a high number of fleeing refugees and African countries face long-term unemployment the most. The salary between Finnish people and immigrants also varies. White immigrants do not face discrimination in work market or workplaces as much as people of colour. According to the research, Somalians and Finnish Romani people face the highest discrimination in job recruitment. People are even changing their names to have a better chance of getting a job (Larja, Warius, Sunbäck, Liebkind, Kandolin and Jasinskaja-Lahti).
The Ministry of Employment and the Economy compared their results to the 2009 Eurobarometer research. The research was done about discrimination in EU countries. Ethnic discrimination was the highest form of discrimination faced by people. In Finland, most of the people thought ethnic discrimination is common Finland, but 34% thought the discrimination is based on language skills rather than ethnic background. In the research, two people with the same qualities but different ethnic backgrounds were applying for the same job. The first factor employers looked at in the applicants was their appearance, the second was age, and the third was their ethnic background. In Finland, skin colour was more likely to affect a person's chance to get employed compared to the average among EU countries.
During the past two years, few places in Finland have started to promote anonymous job applications which will not show the gender, age nor ethnicity of the applicants. Employers will choose the people who will be interviewed based on their qualifications (Salminen, 2020).
The anonymous job applications unfortunately help people only to get into the job interviews, but too often that is the end of the story. According to an article from YLE, Päivi Laakso, who works as occupational safety inspector in the Southern Finland regional supervisory agency, says that immigrants with foreign names or strong accents might not even get into job interviews. Even if the person applying for a job is qualified for the work, it can come down to one phone call which reveals the ethnic background of the person and causes them not to be wanted for the interview anymore.
In Finland, there has been a shortage of nurses for several years which would make one think that nurses with immigrant backgrounds would have a great chance in the job market. Yet the employment rate among immigrant nurses is only 61% when among Finnish nurses, it is as high as 96% (Koivuniemi, 2012).
Tehy, which is the biggest union in Finland for Health and Social Care and Early Childhood Education and Care Professionals, did research in 2012 about nurses with immigrant backgrounds in Finland. They found out that immigrants do not have the same possibilities in the job market or progressing in their career compared to Finnish people. Even though in the eyes of the employees, the foreign nurses are seen as loyal and flexible workers with great work ethic. The flexibility usually comes from experienced discrimination and the vulnerable position faced by foreign nurses. Employers abuse the vulnerability of the nurses to use them as labour. Most nurses with immigrant backgrounds are working as assistants or practical nurses, even if they have higher education. Immigrants are rarely seen in higher positions, which requires management or leadership. It is rather common for them to be working mostly in elderly care. Elderly care in Finland has been in crisis for several years because of a shortage of practical nurses, so it is understandable that it is easier to receive a job from there. The work is demanding taking into consideration that many patients have several diagnoses; can be aggressive and for each nurse, there are too many patients to take care of. The working conditions are onerous, and the payment is poor, which leads to nurses having a lot of stress, exhaustion, and low motivation to work. (Jokinen, 2021)
On top of the above mentioned, immigrants are faced with assumptions regarding their competences. These assumptions come mostly from their language skills. Language skills are extremely important when working with patients to avoid misunderstandings and mistakes related to care. In more demanding work, the employers prefer to have someone who is a fluent Finnish speaker instead of someone with an accent. The requirement to have fluent Finnish usually translates to a requirement of certain ethnicity because only native Finnish speakers can speak Finnish without foreign accent. This does not mean the person with the accent wouldn’t have great language skills. Employers also use this as a reason to discriminate against workers with a foreign background. Employers are seen to use foreign nurses as labourers, but do not take them easily as permanent workers, so they can get rid of the nurses when they are not needed anymore (Näre, 2013).
Discrimination in workplaces
According to research done by Tehy in 2012, 14% of foreign nurses have experienced discrimination from their superiors, 25% from co-workers, 26% from patients. Nurses with African background experience the most discrimination. Here, we can also see the similarities between Tehy research and The Ministry of Employment and the Economy research about the discrimination in Finland based on skin colour. In Tehy research, one surprising reason for difficult integration in workplaces was that work communities do not have skills to have a multicultural work environment. (Koivuniemi)
Finnish institute for health and welfare (THL) did research in 2013, about the foreign nurses and doctors experiences working in Finland. Nurses, who shared their personal experiences from work, tell that their supervisors have made them work more. These nurses have complied because they have not been aware of their rights or because of their culture, they had difficulty saying no, when asked to work extra shifts. Co-workers do not trust their abilities to do different tasks. Sometimes their help is appreciated but otherwise, they are treated like air. (Aalto, Elovainio, Heponiemi., Hietapakka, Kuusio and Lämsä)
Patients have been racist towards the immigrant nurses in the way they behave and speak to the nurses. For example, patients refuse to be taken care of by people of colour and demand a white nurse to take care of them. Even the patients have not trusted the nurse's qualification to do their job. Employees have been told to just not care about the things they are facing. Even employers say that they cannot do anything about patients' attitudes towards immigrants, so they are left to suffer alone.
As Finland is becoming more multicultural, you can see the same trend in patients. There is an increasing number of patients who need an interpreter to communicate with the doctor or nurses in their own language. Nurses who know many languages come in handy with these patients, but according to the THL research, 65% of them do not get any pay for multitasking as an interpreter. They only get a warm thank you from the extremely thankful patients who can communicate in their mother tongue.
Every person should be treated equally no matter what their background is. Respect and human rights belong to everybody, and nobody should experience discrimination or racism. Even though there is an existing system for anonymous job applications, it should be introduced more broadly around Finland and further developed in favour of the most qualified worker. This said, employers should hire people based on their qualifications – not their ethnicity. All professionals should also have the same chance to move forward in their careers and receive higher positions that require management or leadership if they are qualified for it.
If employers, work colleagues, and patients do not want to recognize the problem with discrimination, it is difficult to make a change. Foreign nurses should receive more information about their rights, so they can stand up for themselves and not be used unethically as labour. Working in multicultural teams is taught as a subject in vocational and university level education which is a great way to bring more awareness for future employers and employees. Courses which teach working in multicultural teams, should be introduced to workplaces as well. This way it would be possible to teach nurses who have been working in the field for several years, how to work in a multicultural environment, taking into consideration immigrant work colleagues as well as the patients.
Finland needs nurses and as mentioned earlier, bringing immigrant workers to Finland has been a hot topic for several years. Finland should keep the current immigrants and their offspring in Finland and focus on helping them to get integrated into the society and work environments. Many foreigners are leaving to work in other countries after studying in Finland because they cannot find a job that they are qualified for. Many people do not want to work as an assistant or practical nurse after graduating as a registered nurse or work as a registered nurse after doing a master's or even doctoral degree.
The payment has its own impact as well, nurses' salary in Finland is much lower compared to several European countries. Also, the nurse's salary in Finland is the lowest among Nordic countries. The average annual salary in Finland for registered nurses is roughly 30 000 euros (Sarell, 2020). The annual income for example in Luxembourg varies between 51 000 and 107 000 euros, in Ireland, the salary is roughly 51 000 euros and in Norway 44 500 euros (Gaines, 2018). Finland should be able to offer a salary that is at least somewhat comparable with other Nordic countries' salaries.
Training one nurse in Finland costs around 28 000 euros to the government (Taloussanomat, 2015). This means Finland is paying a huge sum of money to educate all these nurses who end up leaving despite the shortage in nurses. Other countries end up benefiting from this fact since they receive well educated nurses for free. If the countries the nurses are moving to are more foreign friendly, it is a win-win situation for the nurses. Finland has a lot of great things to offer which would make an immigrant want to stay here. But it is time for Finland to wake up to these conditions faced by the nurses.
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