May 4, 2023

International recruitment won’t solve US nursing shortage

Editor's Note

In this paper, published in Health Affairs on May 4, Tony Yang, ScD, LLM, MPH, endowed professor in health policy at the George Washington School of Nursing, and his coauthors argue that a more comprehensive approach than recruiting internationally educated nurses is needed to address the US nursing shortage.

The authors identify the challenges internationally educated nurses face in the US, including collegiality, burnout, racism, job restrictions, and structural barriers to employment.

To create a more sustainable and equitable nursing workforce, they make the following recommendations:

  • Incentivize healthcare organizations to retain their US nurses, making retention a part of organizational performance benchmarking.
  • Designate nursing as a Science, Technology, Engineering, and Mathematics field.
  • Prioritize recruitment based on population health needs, focusing on those who speak languages other than English.
  • Require organizations that hire international nurses to have transitional education programs to help support them during their first 2 years in the US.
  • Leverage the skills of nurses educated in other countries who live in the US but are unable to become credentialed.
  • Support research efforts on effective nurse retention strategies.

The authors conclude that internationally educated nurses play a vital role in the US healthcare system, but relying heavily on their recruitment to address the nursing shortage is like using a "Band-Aid to stop a hemorrhaging wound." It would be more beneficial to focus on retaining existing nursing staff, while creating more equitable and accessible paths to employment for internationally educated nurses, they say.


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