Beyond Deskilling: Reframing Skill Disruption Among Internationally Educated Nurses as a Problem of Skill Governance.

Internationally educated nurses are increasingly central to healthcare systems facing persistent workforce shortages, ageing populations, and rising care demands. Yet research continues to show that migration and workforce entry are often accompanied by significant disruption to professional practice. Although these experiences are commonly described through the language of deskilling, post-migration skill change is still often framed as a linear process of adaptation and eventual professional equivalence. In this discursive paper, I argue that linear accounts of post-migration skill adjustment are analytically limited because they obscure how host healthcare systems shape what counts as legitimate nursing competence. I propose instead that deskilling, upskilling, unskilling, and mis-skilling should be understood as overlapping and sometimes contradictory outcomes of how these systems regulate, recognize, and reorganize nursing labor. Drawing on nursing workforce scholarship, professional regulation literature, migration studies, and the sociology of work, I reframe skill disruption as a structural effect of skill governance, shaped by risk management, selective recognition, and the preservation of professional hierarchies. A conceptual model of skill governance is presented to show how prior expertise is filtered through regulatory and organizational processes, producing uneven forms of professional incorporation. This reframing has implications for workforce policy, regulatory practice, and nursing leadership by shifting attention from individual adaptation to system accountability and more equitable forms of workforce integration.