A growing exodus of nursing professionals from Trinidad and Tobago is being driven by uncompetitive pay, blocked career advancement, and unsafe working conditions, according to first-hand accounts from three nurses who have recently relocated for jobs in the United States and United Kingdom. All three secured their overseas roles through international recruitment agencies, a pathway they describe as more cost-effective and streamlined than other hiring channels.
Darius Mollineau, a former psychiatric nurse with Trinidad’s North West Regional Health Authority (NWRHA), left for the United Kingdom in 2021, citing a complete lack of upward professional mobility as his core motivation. Before departing, Mollineau had completed specialized training to work as a District Health Visitor and served in an acting capacity in the role for three full years. Only after he made the decision to migrate was the permanent position offered to another candidate, a missed opportunity Mollineau calls disheartening.
What disturbed him most, he says, is the widespread culture of extended acting appointments across Trinidad’s public health system, where some staff wait as long as nine years to have their positions made permanent. “I was like, I’m not going to be stuck in that holding pattern for that long. Even now it’s not my turn, I don’t want to be that person five, six years from now still stuck in an acting role,” he explained.
Today, Mollineau works at a hospital near Birmingham, England, where he has risen to a management role in just three years – a progression he says would be unheard of in his home country. He credits the foundational training he received at NWRHA for his success, but notes that the UK healthcare system offers far clearer pathways to transition into specialized roles such as nursing assessor or prescriber, with opportunities that are far more accessible for frontline staff.
When asked if he would ever consider returning to Trinidad and Tobago, Mollineau says he is open to the idea – but only after major systemic changes are made. Most urgently, he points out that nurses in the country are still being paid according to a 2013 salary scale, a frozen pay structure that has not been addressed in the five years since he left. “If salaries are adjusted to what nurses actually deserve, that would be a real incentive to come back,” he said. Though he has experienced repeated racism during his time working in the UK, he says his significantly higher pay offsets the disrespect he has encountered. He added that nurses in Trinidad are also undervalued by patients and hospital visitors, on top of being drastically underpaid. Beyond salary, Mollineau says expanded investment in ongoing professional development is a non-negotiable requirement for him to return home, noting that UK nurses are required to complete regular updated clinical training every three years to maintain their practice, a standard that is not enforced locally.
For Marcia Baptiste, a 17-year veteran nurse who worked with Trinidad’s South West Regional Health Authority (SWRHA) before moving to a New York City hospital in 2023, the decision to migrate came down to a search for financial stability and faster professional growth. “Back home, you get your pay check and it’s gone before you know it. I was looking for more long-term financial security, and moving here has really turned that around for me,” she explained.
Beyond higher wages, Baptiste says overall working conditions are far better in New York, though she does note one downside: a 30-minute lunch break, compared to the one-hour break she received at SWRHA. She acknowledges that nurses in New York still face systemic challenges – pointing to the January 2024 strike of 15,000 nurses across three city hospitals, who walked out demanding safer staff-to-patient ratios, improved benefits, and protections from workplace violence. But even with those shared challenges, she says professional advancement is far less bureaucratic in the U.S. “Back in Trinidad, you have to cut through endless red tape to move up. Here, once you have the required certification, you can climb the ladder very quickly,” she said.
As a single parent of two, Baptiste admits the transition to the U.S. was difficult at first, and she has faced implicit bias from patients who have questioned her competence based on her skin tone. She draws a parallel between this anti-Black bias abroad and the widespread stigma and undervaluing of nurses that is common in Trinidad. Baptiste, who plans to earn a specialized certification in chemotherapy administration – a program that is partially funded by her New York hospital – says the scope of nursing practice is also far broader in the U.S. than in her home country. “Back home, nurses rely on doctors for almost every decision. Here, we have real autonomy. If you’re certified to do a procedure, you do it, and the hospital will invest in training you to get that certification,” she explained. In the U.S., advanced practice registered nurses like nurse practitioners can diagnose conditions, order diagnostic tests, and prescribe medication, with many practice areas operating as nurse-led care models where patients only see a doctor for complex emergency cases.
Like Mollineau, Baptiste says she would consider returning to Trinidad eventually, and wants to come back to work in a management role after gaining international experience. But she echoes the concern that inadequate pay that does not match advanced skills and specializations would keep her away. While she does not support the long-term brain drain of Trinidad’s nursing workforce, she encourages young local nurses to gain international experience before returning home to share their new skills and knowledge.
The third nurse, a former employee of the North Central Regional Health Authority (NCRHA) who requested anonymity to protect her family back home, left Trinidad one year after graduating from the University of the Southern Caribbean in 2019, and has since worked in the UK and is currently seeking a permanent role in the southwest U.S. She cites systemic nepotism and favoritism as the core drivers of her decision to leave, explaining that hiring for permanent roles at regional health authorities is not based on qualifications, but personal connections. “Whether you have a bachelor’s degree versus an associate degree doesn’t make a difference. The only thing that matters is who you know,” she said.
She also describes a contradictory cycle where hospital management constantly complains about understaffing, yet claims there are no open permanent positions. After months of waiting, she was only offered a 10-month fixed-term contract. As a new graduate nurse, she describes her early experience on the job as dangerously overwhelming, with no formal mentorship or support system for early-career staff. In her first few days working on a cardiac ward, she was assigned to work night shifts completely alone after just three days of on-the-job experience, a situation she found terrifying as a new nurse. “Back here in the U.S. and UK, each nurse is responsible for four to six patients maximum. Back there, I was expected to cover an entire ward alone with no support,” she explained. That experience led her to resign from the position and pursue work abroad.
Unlike the other two nurses, she has no plans to return to Trinidad, with rising crime being another major factor in her decision to stay overseas. She notes that advanced education opportunities for nurses are also far more accessible abroad: next year, she will begin a nurse practitioner graduate program, a path she says would not have been possible for her in Trinidad, where management is rarely supportive of staff pursuing master’s or doctoral level training. She encourages other Trinidadian nurses to take the opportunity to work abroad, calling it one of the most life-changing and career-enhancing steps they can take.
