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Indian nurses ‘on the move’ and how their transnational migration for care work shapes their multigenerational relationships of familial care over time Nikki Dunne PhD Sociology - The University of Edinburgh - 2018 ii Declaration of Original Work I hereby confirm that I have composed this thesis and that this thesis is all my own work. I also declare that this work has not been submitted for any other degree or professional qualification. Nikki Dunne Edinburgh, 30 January 2018 iii iv Table of Contents Abstract ...................................................................................................................... ix Acknowledgements .................................................................................................... xi Abbreviations .......................................................................................................... xiii Chapter 1 Introduction .......................................................................................... 1 1.1 Indian Nurse Migration to the UK: Histories and Geographies .................... 6 Nurse Migration in the Indian Context ............................................................ 6 Nurse Migration in the UK Context ............................................................... 10 1.2 Research Aims, Questions and Objectives .................................................. 16 1.3 Structure of the Thesis ................................................................................. 18 Chapter 2 Conceptualising Nurse Migration: Care Chains, Transnational Care and Imagined Futures .................................................................................... 23 2.1 The Global Care Chain ................................................................................ 27 The Global Nursing Care Chain ..................................................................... 30 Global Nursing Care Chains: Limitations ...................................................... 34 2.2 Care Circulation and Transnational Families .............................................. 38 Transnational Families and the Circulation of Care: A Multidimensional Approach to Care ........................................................................................... 41 The Circulation of Care Over the Life Course: Reciprocities and Asymmetries .................................................................................................. 43 2.3 Temporalities in Transnational Care Worker Migration and Transnational Care: Imaginaries and Care Work .......................................................................... 48 Embedded Imagined Futures ......................................................................... 50 Imagined Futures: Relational, Structural & Emotional Considerations......... 52 2.4 Conclusion ................................................................................................... 57 Chapter 3 Methodology ....................................................................................... 61 3.1 Research Design .......................................................................................... 64 3.2 The Research Process .................................................................................. 66 Who, Where and When? ................................................................................ 66 Negotiating Access......................................................................................... 68 v Location of Research ...................................................................................... 70 3.3 Conducting In-depth Interviews .................................................................. 71 3.4 Transcription and Data Analysis ................................................................. 75 Reflexivity, Ethics and Consent ..................................................................... 77 ‘Uncomfortable Reflexivities’ ........................................................................ 79 3.5 Ethical Considerations ................................................................................. 83 Informed Consent ........................................................................................... 84 Confidentiality and Anonymity ...................................................................... 85 Chapter 4 Becoming a ‘Nurse on the Move’: Relational, gendered and life course migrations ..................................................................................................... 89 4.1 Multi-layered Migrations from Kerala ........................................................ 92 The Entanglement of Nursing and Migration in Kerala ................................. 92 Accounting for Migration: ‘I Migrated to Support my Family’ ..................... 93 Accounting for Migration: The ‘Burdensome’ Daughter .............................. 98 Accounting for Migration: Breadwinning for a ‘Good’ Family Life ........... 102 Accounting for Migration: Self-improvement and ‘Freedom’ from Family 107 4.2 Multi-sited forms of migration from Kerala to Britain.............................. 113 Stepwise Migration ...................................................................................... 113 Family in the Choice of Destinations ........................................................... 116 4.3 Conclusion ................................................................................................. 123 Chapter 5 Negotiating Work and Childcare in the Context of Migration .... 127 5.1 The Phase of Transnational Motherhood................................................... 129 5.2 Negotiating Childcare Between Parents .................................................... 136 5.3 Turning to ‘Father-centred Care’ ............................................................... 138 5.4 Localised Negotiation of Formal and Informal Childcare Resources ....... 145 5.5 Conclusion ................................................................................................. 152 Chapter 6 ‘Everybody is there for me…and I’m always there for them’: Reciprocal Care across Transnational Space ...................................................... 155 6.1 Making Connections Between ‘Here’ and ‘There’: Caring for elderly patients ................................................................................................................. 158 6.2 Maintaining Emotional Bonds Across Distance through ICTs: Reciprocities and Asymmetries .................................................................................................. 162 vi 6.3 Transnational Care and the Changing Geographies of The Visit .............. 171 6.4 Managing Healthcare Issues Across Distance and Separation .................. 178 6.5 Conclusion ................................................................................................. 186 Chapter 7 Imagining Futures while Caring in the Present ............................ 189 7.1 ‘The way they are treating us was not like the way I expected…I hoped for better’: Working in the UK .................................................................................. 192 7.2 Hopes and Aspirations for Family ............................................................. 200 Shifting Patterns of Remittance Sending ..................................................... 200 The ‘Good’ Family as Seen from the ‘Here-and-now’ ................................ 204 7.3 Imagined Mobilities for Care .................................................................... 208 ‘Our families are there, kids are here’: Desires and Obstacles in Aspirations for a Return to India ..................................................................................... 208 Stepwise Migration: Aspirations to Move to Other Nurse Recruiting Countries ...................................................................................................... 213 On the Move Again: The Reproduction of Transnational Circulation on an Intergenerational Scale ................................................................................. 221 7.4 Conclusion ................................................................................................. 222 Chapter 8 Conclusion ......................................................................................... 227 8.1 Findings and Contributions ....................................................................... 228 How do Indian nurses account for their decision to become ‘nurses on the move’? .......................................................................................................... 230 How do Indian migrant nurses maintain and (re)negotiate