Direct-hire international nurses could offer sustainable solution to US shortage

Editor's Note

Direct-hire international recruitment can be a viable long-term strategy to stabilize staffing and improve care delivery amid a worsening shortage of registered nurses (RNs), according to a May 20 article in Daily Nurse.

To make the case, the article extensively quotes Ron Hoppe, CEO of WorldWide HealthStaff Solutions (WWHS). He argues that international hiring does not undercut domestic workers, but rather fills a gap that cannot be bridged by retention efforts alone. In fact, he says international hiring is one of the few available levers to increase the actual number of RNs in the workforce.

 According to the article, the crisis is largely a supply issue, not merely a recruitment challenge.  By 2030, the US could face a deficit of up to 125,000 full-time RNs. Meanwhile, US nursing schools are not graduating enough new professionals to offset a wave of retirements, while aging populations and expanded healthcare coverage continue to increase demand. 

Contrary to persistent misconceptions, internationally educated nurses must meet rigorous standards, including English proficiency, NCLEX certification, and state licensure, Hoppe told Daily Nurse. Many come through the EB-3 visa program, which grants permanent residency and integrates nurses into care teams as long-term staff, not temporary labor. Hoppe also noted that employers can save $40–$60 per hour per nurse compared to contract staffing.  

For organizations considering the shift, Hoppe advises early planning and cultural investment. Supportive onboarding and partnerships with experienced recruiters are key to successful integration. While the EB-3 process can take 12 to 30 months, he notes that starting steps like prevailing wage certification come at no cost and prepare systems for future staffing needs.

Other detail and context in the article sheds light on WWHS’s recruiting practices and the need to advocate for immigration reform as international competition for nurses intensifies.