Nurse turnover is a critical issue facing workforce planners across the globe, particularly in light of protracted and continuing workforce shortages. An ageing population coupled with the rise in complex and chronic diseases, have contributed to increased demands placed on the health system and importantly, nurses who themselves are ageing. Costs associated with nurse turnover are attracting more attention, however existing measurements of turnover show inconsistent findings which can be attributed to differences in study design, metrics used to calculate turnover and variations in definitions for turnover. This paper will report the rates and costs of nurse turnover across three States in Australia.

DevOps is a set of principles and practices to improve collaboration between development and IT Operations. Against the backdrop of the growing adoption of DevOps in a variety of software development domains, this paper describes empirical research into factors influencing its implementation. It presents findings of an in-depth exploratory case study that explored DevOps implementation in a New Zealand product development organisation. The study involved interviewing six experienced software engineers who continuously monitored and reflected on the gradual implementation of DevOps principles and practices. For this case study the use of DevOps practices led to significant benefits, including increase in deployment frequency from about 30 releases a month to an average of 120 releases per month, as well as improved natural communication and collaboration between IT development and operations personnel. We found that the support of a number of technological enablers, such as implementing an automation pipeline and cross functional organisational structures, were critical to delivering the expected benefits of DevOps. CCS CONCEPTS• Software creation and its engineering → Software creation and management KEYWORDS DevOps enablers and practices, DevOps benefits and challenges

Given the increasing globalization of labor markets, it is likely that the historically high levels of inflow of internationally recruited nurses to the United Kingdom will continue over the next few years; however the "peak" number reached in 2002/2003 may not be repeated, particularly as large-scale active international recruitment has now been ended, for the short term at least. New English language tests and other revised requirements for international applicants being introduced by the Nurses and Midwives Council from September 2005 may restrict successful applications from some countries and will also probably add to the "bottleneck" of international nurse applicants. Demographic-driven demand for health care, combined with a potential reduction in supply of U.K. nurses as many more reach potential retirement age means that international recruitment is likely to remain on the policy agenda in the longer term, even with further growth in the number of home-based nurses being trained.

This article highlights key trends and issues for the global nursing workforce; it then identifies policy interventions appropriate to the new economic realities in many OECD countries.

Work force planning is absent or restricted in three of the countries. Scope for improved productivity through use of advanced nurse roles exists in all countries.

The international migration of skilled health workers has increased significantly from the 1990s. Many source countries have expressed concern over losses of health workers, resulting in regional Codes of Practice and bilateral Memoranda of Understanding being established since 1999 to achieve more effective, equitable and ethical international migration. The finalisation of a Global Code in 2010 drew attention to continued migration concerns. Codes have three key objectives — protecting rights of migrant workers, adequate workplace support for migrant workers and ensuring that migration flows do not disrupt health services in source countries. There is no agreed definition of ethical international recruitment, and no consensus on the significance and location of harmful recruitment practices. Most codes have covered relatively few regions and exhibit a high degree of generality. Several source countries encourage rather than discourage migration. Migration is a right and occurs in contexts that do not necessarily involve health issues. There are no incentives for recipient countries and agencies to be involved in ethical international recruitment. All codes are voluntary which has restricted their impact. Substantial migration and recruitment have occurred outside their scope, and codes have diverted skilled health workers beyond regulation. The private sector is effectively excluded from codes. Bilateral agreements and memoranda have a greater chance of success, enabling managed migration and return migration, but are more geographically limiting. The most effective constraints to the unregulated flow of skilled health workers are the production of adequate numbers in present recipient countries and provision of improved employment conditions in source countries.

A number of common issues and challenges face every country; however, their impact varies greatly across different countries. A particular concern in relation to nurse migration is its effect on adding to the imbalance in nursing resources that already exists in different regions and different countries. The number of nurses recruited into developed countries has increased significantly during the past decade, particularly from developing countries. Understanding and addressing the impact of migration requires not only examining what pulls nurses into destination countries but also what pushes them from source countries. We must also address the ethical issues involved in international recruitment. We must also not lose sight of nurses currently in the workforce. Effective national policies for recruiting and retaining nurses would reduce the need for recruiting from other countries.

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