Challenges of Adding International Nurses to Your Workforce

In the past few years, the healthcare industry has seen a sharp decline in nurses. This has left leaders looking for creative ways to recruit and fill this void. One idea has been the increased recruitment of international nurses.

The recruitment of international nurses sounds like a great idea and solution. As a leader, you hear the promise of the recruitment of 200-300 experienced nurses who would be available within the year. This brought about hope and excitement that the staffing crisis would soon end. Then reality sets in.

As I became more involved with the process, I quickly learned how unrealistic the original promises and timelines were. Starting with the interviewing process, leaders are selected from the organization to be set up for virtual interviews. Unfortunately, there was little to no opportunity to review resumes or review candidate information before the interviews. The timing of the interview would be at odd times for the individual with the time difference. It may be 2 am for some. Also, the onboarding process began less than a year ago and has turned into more than three years. This presents the problem that most candidates' interviews were done by leaders who would not be the direct leaders. Candidates selected also were slotted for areas they were not familiar with. Examples would be a PACU nurse placed on a mixed acuity floor or a Med Surg nurse placed in a Psychiatric care center. I have seen nurses starting to arrive who were interviewed as far back as 2020. Some individuals use this as an avenue to gain a visa and move on in less than a year. Some are trying to get to other family members or an area they originally wanted to move to. 

Once the nurse arrives, more challenges arrive. They are required to pass certain tests such as an English exam and the state board where they will practice. However, I have found the difference in practice needs to be considered. 

In some areas, the procedures and tasks done by nurses here are done by providers in their home country. Terminology and the way we educate patients has been a struggle as well. This has proven especially problematic as we strive for a more patient-centered care model. The nurses tend to be hesitant and struggle with confidence when explaining care to patients and families and communicating with physicians.

It is not all challenges. Overall, the addition of international nurses into the workforce has been positive. There have been several that have become very successful and excelled in each area. I have promoted some to charge nurses. Most are inquisitive, ask for further education, and put forth full effort to be at their best. I appreciate the comradery they bring and have enjoyed being able to be involved in the process.

The international nurse initiative is a positive move to help increase the workforce. We have added several excellent nurses, and they bring positivity to increasing staff morale. I do think we could improve on the process, beginning with interviews and candidate selection. More time and consideration could be spent placing them where they will have the greatest chance of success. As we learn more from current employees, we can use their experiences to improve our education and onboarding processes.