Ethical International Nurse Recruitment: The People Equation

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Ethical International Nurse Recruitment The
People Equation

Karen A. Hart, RN, BSN, Senior Vice
President Kate Christmas, RN, Vice
President Bernard Hodes Group, Health Care
Division
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Globalization of Nursing Workforce

• Aging nurse workforce
• Aging populations
• Disparities between supply and demand of nurses
  country to country
• Inconsistent planning for nursing workforce needs
  country to country
• Need for programs such as state nurse workforce
  centers, J J campaign in the U.S.
• Reliance on international recruitment in some
  countries

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Why Migrate?

• Push-Pull
• Economic reasons
• Better standard of living
• Higher wages
• Assist home family
• Political reasons
• Lack of opportunity in home country
• Career advancement
• Formal and continuing education
• Opportunities for career advancement/development

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Ethical Dilemmas

• Impact of migration on developing countries
  health care systems
• Migration adding to shortages in developing
  countries
• Reception/integration of nurses by colleagues in
  host country
• Underutilization-nurses working in assistive
  roles in some host countries
• Discrimination

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21st Century International Nurse
Recruitment

• Migration patterns
• Multiple points of migration-home country to UK
  or Saudi Arabia, then to Canada, then to U.S.
• U.S.
• Previously-Nurses from Ireland, UK, Philippines,
  Canada, Caribbean, Africa, Australia
• Current-Nurses from Philippines, India, South
  Korea, Canada, Cuba
• Canada
• Current-Nurses from Philippines, UK, U.S. (top
  three)

NCLEX Stats 2006 Exam Takers
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21st Century International Nurse Recruitment

• Life after 9/11/01
• New immigration constraints
• Licensure issues
• Language issues
• Comparable skills/competency issues
• Nursing roles/ skills needed/expectations vary
  country to country
• Cultural issues

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Developing a Nursing Workforce Plan

• Internal workforce demographics
• Organizational growth-new products/services
• Reduction in products/services
• Turnover
• External factors
• University graduates output
• Economic factors
• Community demographics
• Relocations in and out
• International just a small slice of the overall
  pie

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Developing an Ethical International Nurse
Recruitment Plan

• Choose from countries not at risk
• Is language going to be an issue?
• Is there a built-in community for nurses from
  targeted countries in your area/region to ease
  assimilation?
• Is there a welcoming culture among current staff?

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Developing an Ethical International Nurse
Recruitment Plan

• Enough similarities to help retain new recruits?
• Climate
• Leisure and sports
• Activities
• Religious institutions
• Social activities
• Educational opportunities
• Cultural congruencies?

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Choices in International Recruitment

• Established and reputable job fairs
• Personal trips to countries/personal interviews
• Selecting an international recruitment firm
• Pros and cons for each method

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Selecting an Ethical International Recruitment
Partner

• Look for the track record
• Check recent references
• With RNs placed
• With hospital systems
• Cautionary tales

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Ethical Recruitment

• Deal with companies that give back
• Primary differences between give and take versus
  making money on shortages
• Work with out migration countries
• Residencies, exchanges, college programs,
  scholarships

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Support RNs Who Come

• Social and clinical mentors
• Treats from home
• Accent neutralization classes
• Support for the entire family
• Subsidize housing, relocation
• Scheduled time to adjust
• Follow up

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Dialogue With Global Colleagues

• Set up residencies, exchange programs across
  borders
• Support RN education in underdeveloped countries
• Establish programs to increase interest in
  nursing careers, graduations
• State nurse workforce centers
• Campaigns like J J

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Dialogue With Global Colleagues

• Work with developing, other countries on programs
  to retain both new graduates and experienced
  nurses
• Long-term encourage ability for migration back
  to originating countries

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Dialogue With Global Colleagues

• Where/how does the dialogue begin?
• International Center for Human Resources in
  Nursing (ICHRN)
• International Centre on Nurse Migration
• Working meetings
• Informal dialogue

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The world needs dreamers and the world needs
doers. But above all, the world needs dreamers
who do. - Sarah Ban Breathnach