Self-revocation of nurse licences in Finland - nursing response to deteriorating workplace and patient safety: Implications for future nursing action.

Aim: To communicate trends in nurse licence revocation in Finland and examine policies and legislation that have implications for future nursing responses to workplace hazards.

Background: The causes of the shortage of nurses working in Finland are multifactorial and complex. Nurses are joining trade unions and taking industrial action in response to the devaluation of their profession and the underpayment of nurses during the pandemic. The Health Care Professions Act in Finland allows nurses to apply voluntarily to withdraw or revoke their licence using online digital tools - and many are doing so as a last resort.

Discussion: A declining nursing workforce is anticipated, with retiree trends increasing while nurse recruitment decreases over the next few decades. Nurses' remuneration and working conditions have suffered during the pandemic, and industrial actions organised by trade unions that include nurses have advocated for the policy and decision-making process to improve, but with mixed results. The process of how legislation enables licence revocation in Finland is essential to understanding this new phenomenon.

Conclusion: Advocacy for nurses, who are disadvantaged within the current pandemic emergency response policy environment, is needed across every nursing context and every career stage. Without support, nurses confronted with precarious working conditions are more likely to draw attention to their plight by using recent legislation to revoke their nursing licences voluntarily. A revocation may be temporary or permanent. Nurses need advocates and mentors to address attrition issues around the voluntary withdrawal of licences. The situation in Finland offers trade unions and nursing associations an opportunity to validate their existence in society.

Implications For Nursing Practice: Public displays of distress about the political undervaluing of the nursing profession discourage applications to study nursing and pursue a nursing career or remain in the nursing profession. International experience tells us that when proficient nurses exit the profession, the level of patient safety and health benefits and national productivity suffer.

Implications For Nursing Policy: Finland's Nursing Act is an aspect of policy that needs exploring and the basis for amending policies to enable collective bargaining agreements to protect the rights and future of nurses. Reactive policies for recruiting foreign nurses to bolster a failed domestic nursing workforce policy have their own problems. These policy issues reflect the problems facing nurses worldwide.