To what extent EU accession provide an opportunity for the nursing leadership in Croatia and Romania to advance a professional agenda?
: A comparative case study using an ethnographic approach

Student thesis: Doctoral ThesisDoctor of Philosophy


The thesis considers the views and experiences of nurse leaders and policy-makers on the use of EU accession as a policy window to advance a professional agenda in Romania and Croatia.
The research question and objectives are designed to identify the policy context prior EU accession, the processes and mechanisms employed to achieve compliance with Directive 2005/36/EC, the nursing policy agendas and achieved legislative and professional outcomes. They are analytically located within the process of Europeanisation, EU accession policy, leadership, engagement and advocacy literature. The comparative findings are interpreted within this theoretical framework.
The study adopted a qualitative approach using an ethnographic multi-method design involving interviews and documentary analysis of key EU accession primary source reports. My own positional was written into the account in a reflexive manner.
The findings indicate that the nursing leadership used EU accession as a policy window to advance a professional agenda but the extent to which this opportunity was exploited differed in the case studies. Findings indicate the importance of regime specific conditions creating a set of constraints which differed in both cases. The Croatian case shows what could have been achieved through the use of TAIEX capacity building engaging stakeholders in agenda-setting. The Romanian nurse leadership failed to take advantage of the policy window prior to EU accession but the continued advocacy hold the Romanian government post-EU accession to account for its policy decisions. Although the new generation of nurses in Romania and Croatia comply with Directive 2005/36/EC, the nursing workforce which graduated prior to EU accession does not benefit from mutual recognition. It is concluded that the EU mechanisms to process compliance – peer review and capacity building – are not robust enough to strengthen free movement based on mutual recognition.
The research findings contribute towards our understanding of the role of nursing in policy-making and the dynamics that drive policies outcomes. The research adds new knowledge to our understanding of the researched area and helps to position nursing within a broader context of EU enlargement.
Date of Award29 Apr 2014
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorAnne Marie Rafferty (Supervisor), Louise Barriball (Supervisor) & Ruth Young (Supervisor)

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