Most people don’t realize that American educated nurses are the minority among Manhattan’s hospital bedside staff. In the 2008 National Sample Survey of Registered Nurses [NSSRN] half of all internationally educated nurses [IENs] work in only four states: California, New York, Florida, and Texas. Of the 12% who live in New York, most of them work in a New York City hospital. 50% of all IENs come from the Philippines.
Also, most people are confused about the recent nursing shortage in the U.S. When the real estate bubble popped and the market crashed in 2008, many nurses lost their retirement savings forcing them to remain at the bedside. This quelled the shortage and the need for nurses isn’t expected to rise again until 2020.
Across the nation, new nursing graduates are struggling to find jobs within the profession and many have had to seek employment in other fields. 75,857 students were turned away from U.S. nursing programs in 2011.
So why are hospitals still hiring IENs from overseas when we have new nurses scrambling for jobs here at home?
- Not every American trained nurse has a bachelor’s degree. In fact, only half of all nurses in the United States do. Less than 1/3 of nurses in New York State have a Bachelor’s of Science in Nursing [BSN]. U.S. hospitals are now beginning to hire only BSN degreed nurses (in part to achieve Magnet status) and that puts many American educated nurses at a disadvantage. Nurses from the Philippines and India graduate with a bachelor’s degree as part of their nursing curriculum.
- An IEN with many years of experience will theoretically make fewer mistakes than a new grad. This is good for patient safety while saving the hospital money in lawsuit prevention.
- An IEN with ten years experience and a bachelor’s degree is paid the same entry-level salary as a new grad with no experience.
- The IEN also commits to work full-time for several years in exchange for a work visa. New grads do not sign contracts and most bachelor degreed new grads are estimated to remain at the beside for only 18 months before advancing their education or leaving the profession altogether.
- The costs associated with recruiting and relocating an IEN are less than the training of a new grad. On-boarding a new nurse is extensive and costs a hospital approximately $96,000. Or in some estimates, 0.75 to 2.0 times a nurse’s salary.
Hospitals are businesses and the bottom line rules many decisions that affect hiring nurses. That’s not to say hospital boards don’t have a great deal to consider when hiring IENs. For example, the international brain drain or the impact on the future of nursing in America. Those are discussions for future blog entries. For now, I enjoy my daily dose of pancit and tagalog lessons. Salamat.
Originally published June 25, 2012.