Analysis | By G Hatfield | G Hatfield is the CNO editor for HealthLeaders
International recruiting begins with strong communication and partnerships, according to this nurse educator.
KEY TAKEAWAYS
International nurses bring new cultural perspectives to the workforce that can improve care for diverse populations. CNOs should strategically plan for short- and long-term workforce needs when developing a recruitment plan. Health systems can build a sustainable, diverse, and skilled workforce by balancing local and international recruitment.
CNOs are searching everywhere for nurses at all stages of their careers to help fill the critical workforce gaps left by the nursing shortage.
International recruitment can be a solution, if it is done mindfully and strategically.
In 2022, about one in six registered nurses (RN) were immigrants, and 32% of hospitals accounting for nearly half of all hospital beds say they hired foreign-educated RNs, according to KFF. According to Dr. Yolanda VanRiel, the department chair of nursing at North Carolina Central University, there are many benefits to recruiting nurses internationally, as well as some challenges.
Why international recruiting?
First and foremost, internationally recruited nurses help fill staffing gaps, both in the short and long term. Nurses from different countries also enhance diversity in the workplace, VanRiel explained.
“They bring unique cultural perspectives that can improve the care for diverse populations,” VanRiel said. “They might bring a different viewpoint, a different healthcare perspective or approach, and it might lead to some new ideas, practices, and efficiencies in patient care.”
International nurses will also go into rural and underserved communities, according to VanRiel.
“They’ll go into areas that are underserved, such as rural areas,” VanRiel said, “whereas I knew nurses, [where] they graduated and…they want to go straight to the big city areas.”
Why not?
One pitfall to international recruiting is that it can take talent away from other communities, VanRiel explained.
“We don’t want to ‘brain drain,’ a phenomenon where we have those highly skilled nurses from the lower income countries that come to wealthier nations,” VanRiel said, “and so we don’t want to leave that home country where they’re also in a staffing shortage.”
The World Health Organization (WHO) released additional guidance earlier this year, titled Bilateral Agreements on Health Worker Migration and Mobility, which serve as a tool for improving the development, negotiation, implementation, monitoring, and evaluation of international health worker agreements in alignment with the WHO Global Code of Practice on the International Recruitment of Health Personnel.
CNOs should follow these guidelines to ensure that they are not taking nurses from other communities and leaving them with less or no healthcare resources.
Language barriers and cultural differences can be a challenge, according to VanRiel. There can also be differences in credentialing and licensing, and some differences in education.
“It might be that they might not get their license in time,” VanRiel said. “Also, if they’re coming here, maybe they didn’t have some education that we offer here.”
International partnerships
To streamline pipelines into the nursing industry, health systems should partner with international organizations and educational institutions to come up with a customized training program, VanRiel said.
“It might be that you say, ‘okay, you can bring your students here for a little while or we can bring faculty members there’,” VanRiel said. “There are all sorts of ways that you can develop those partnerships, and I think…that might be a good way to do it because then you are influencing what’s being taught there and bringing that [here].”
VanRiel also recommended partnering with organizations in the United States as well. Some organizations do mission trips, and CNOs can partner with an organization’s Office of International Affairs if they have them to get aligned with the correct programs.
“That’s one of the good things that we’re starting to actually look at,” VanRiel said, “as [we try to get] more students to [have] that global experience.”
Finding the balance
It’s critical that CNOs strike a balance between recruiting from local and international sources, which according to VanRiel, includes developing a local talent pipeline, adhering to ethical recruitment practices, and fostering diversity and inclusion.
“You [have] to strategically plan for both the short-term and long-term workforce needs,” VanRiel said, “so I think by maintaining a healthy balance between local universities or international recruitment, health systems can build a sustainable, diverse, skilled workforce.”
CNOs should also invest time in creating cross-cultural communication workshops, according to VanRiel, and work with both the universities and hospitals in the international community to determine what their needs are.
“You’re not competing, everybody is feeling the pinch with staffing,” VanRiel said. “Talking with that other health care system is one of the best things you can do to establish that relationship.”
