Recruitment of Foreign Nurses and the Effect on Healthcare systems

The shortage of trained nurses to cater for the rising populations that need nursing services has been constantly rising globally. Just like in the United States, the world is having a severe shortage of nurses probably due to increasing health problems that may make the services of the nurses outstretched. By the fall of 2000, the United States of America had a shortage of 110,707 nurses.

The figure was estimated that it would have risen to 275,215 nurses by the fall of 2010 and further 808,416 by 2020 (Buchan & Sochalski, 2006).

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Going by these figures, it is evident that there is a crisis that nations must address concerning the issue of shortage of nurses. Various countries have adopted different measures to ensure that the shortage of nurses is addressed although the ability of the poor countries to raise the number of nurses to address is doubted.

To address this issue, the Department of Health and Human Services has resulted to recruit foreign trained nurses especially from poor countries where the nurses find life in the United States better due to advanced facility and job opportunities. However, there have been several ethical issues that have been raised about the practice of recruiting foreign nurses (Buchan & Sochalski, 2006).

The issues revolve around the rights of the nurses as individuals, the effects of brain drain caused by the relocating nurses to the country of origin and whether a developed country like the United States should take advantage of the vulnerability of poor countries by taking their trained nurses while the available nurses in such countries are far below the required average.

According to Brush, Sochalski and Berger, (2008), the issue of recruitment of foreign nurses is both a blessing and a curse. It is a blessing to the nurses who come from the poor countries as well as to the United States of America while it is a curse to the countries that lose their trained man-power due to their financial vulnerability.

The process of recruiting foreign nurses has also been examined based on the added value that it causes to the populations of the United States (Goff & Burke, 2006).

Xu and Kwak, (2007), notes that while the practice of recruiting foreign nurses has helped bridge the growing gap between the required nurse-population and those available to offer services to the growing populations, there should measures to establish whether the foreign trained nurses meet the expected standards to ensure that the American populace is always given the best nursing care.

Questions have also been asked whether the United States of America must import foreign nurses while it has the best capacity to train nurses that are needed by its population. According to Nooney, and Lacey, (2007), it is wrong for the richest nation in the world to deprive poor countries especially those in Africa from their few and expensively trained health personnel while the United States have the ability to train its own nurses.

The main stakeholders that are involved in this arrangement are the government of the United States through the health department, the mother countries where these nurses are educated and trained and the nurses themselves.

As far as the recipient country, which is the United States of America is concerned, its role is seen as predatory and that takes advantage of the vulnerabilities of poor nations that cannot be able to offer the best salaries on a global scale to attract and retain its own human talent. The other stakeholder, the country where the nurses are trained and educated, suffers from the effects of brain drain especially due to the lost talent that takes huge proportions of their budgets.

As far as nurses as individuals are concerned, the main issue that comes to the debate is their human rights and freedom as individuals and as family members. It is generally agreed that every individual has the right to work and live in a place of choice. It would therefore be a violation of basic rights of these nurses if policies to restrict foreign nurse recruitment were to be enacted (Patricia & Amanda, 2010).

Due to the ethical questions raised above, there have been several suggestions that would improve the problem that has been witnessed in health care prompting the importation of foreign nurses into America. Nooney and Lacey, (2007), suggest that the population should be encouraged to enroll for nursing courses and those who choose to do this course given substitutes that would improve the attractiveness of the nursing career.

Another option would be to invite foreign students and training them in the American schools and later qualify them as nurses rather importing nurses that have already been trained by a foreign country that is in deeper need of these nurses than the United States of America. The last option is to continue with the practice of importing nurses from the poorer nations leaving these nations further constrained due to lack of nurses.

Each of the suggested options have their pros and cons. Should the United States of America opt to subsidize the nursing training through incentives to attract enrolment of nursing students, there would be the disadvantage of the time between the start time of the approach and the actual time the nurses qualify to serve the population.

However, this suggestion is beneficial in that it would provide a local solution to a local problem associated with shortage of nurses. Another advantage is that it would result to existence of trained nurses who understand the local problems of the American populations.

The other policy proposal would be to have foreign students being trained and gaining employment in the United States. This proposal is based on the idea that when the students are given their training at the United States, the question of ethics associated with recruitment of foreign nurses into the United States would be solved.

This is because the countries that provide the students would not have spent large amounts of money apart from the money spent on basic education. The advantage of this approach is that like the previous one, the country will get locally trained nurses who clearly understand the requirements of their populations as far as health care is concerned.

Finally, the third policy proposal is to maintain recruitment of foreign nurses from foreign countries. This approach has been criticized on the ground of ethics. The advantages of this approach are that the country saves on training costs that are associated with training nurses.

Another advantage is that the United States’ health workforce gains the required diversity brought about by nurses trained in various parts of the world making the entire workforce to be uniquely equipped with varying human talents. Although each of the outlined approaches may offer feasible solutions to the United States, the most recommendable approach is the one that uses incentives to both foreign and local students to enroll for nursing courses.

This is because such an approach would enable the United States of America forecast on its needs for health staff and adequately prepare in advance. The country will also avoid the ethical questions that are currently being raised concerning the appropriateness of the process of recruiting nurses from countries that need them more yet the United States have the ability to train its own nurses.

In conclusion, it is evident that the issue of health nurses is a pressing one globally. The shortage of nursing professional is not only restricted to the United States of America, but also to other countries of the world.

Due to this shortage, there has been rising need for governments through the departments of public health and human wellness to formulate approaches that would ensure that the deficiency of nurses is checked. It is also important to note that the practice of hiring foreign nurses to the United States has helped solve the shortage of nurses.

However, despite this hiring of foreign nurses into the United States health workforce, the shortage of nurses is far from being addressed and the figures that represent this shortage has been on the rise. Due to this rise in shortage of nurses, it is advisable that the United States adopt a different approach from the one of importing nurses from other countries.


Brush, B., Sochalski, J., & Berger, A. (2008). Imported Care: Recruiting Foreign Nurses to U.S. Health Care Facilities. Health Affairs, 23 (3) 78-87.

Buchan, J. & Sochalski, J. (2006). The Migration of Nurses: Trends and policies. Bulletin of the World Health Organization, 82 (8) 587-594.

Goff, M., & Burke, C. (2006). Cultural Competency and Nursing Care: An Australian perspective. International Nursing Review, 53, 34-40.

Nooney, J. & Lacey, L. (2007). Validating HRSA’s Nurse Supply and Demand Models: A state- level perspective. Nursing Economics, 25 (5) 270-278.

Patricia, P., M. & Amanda, F., J. (2010). U.S. Based Recruitment of Foreign-Educated Nurses: Implications of an Emerging Industry. American Journal of Nursing: 110 (6) pp 38-48. Retrieved on June 6, 2011 from

Xu, Y. & Kwak, C. (2007). Comparative Trend Analysis of Characteristics of Internationally Educated Nurses and U.S. Educated Nurses in the United States. International Council of Nurses.