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Recruiting international nurses

Five years ago, South Nassau Communities Hospital in Oceanside, NY, faced a severe nursing shortage and turned to international recruiting to help meet its needs. Yvette Mooney, RN, senior vice president of patient care services, knew nurses were not only in short supply in her local market, they were also in short supply across the U.S., and since healthcare providers recruited in markets other than their own, the national competition for the same shrinking talent pool was exceptionally high.

"The nursing shortage continues to have a crippling impact on the quality of the state's and the nation's healthcare system," says Mooney.

Consequently, Mooney looked abroad for new sources of nursing talent to fill the vacancies. Many recruiting trips later, the program proves to be such a success for South Nassau that the hospital has created an international nurse recruiting and staffing agency that helps other hospitals and healthcare providers in the tri-state New York, New Jersey, and Connecticut area fill their nursing staff vacancies.

An international affair

To initially manage her own facility's nursing issues, Mooney created an in-house recruitment program to engage nurses from India, Puerto Rico, and the Philippines. She made trips to each country, conducting interviews and finding nurses who met the same high standards expected of locally-hired nurses.

Mooney says all internationally-recruited nurses have experience working in large modern hospitals that are equivalent to any major U.S facility, and they have worked as a nurse for at least three years.

All nurses must pass The Commission on Graduates of Foreign Nursing Schools (TCGFNS) test, which assesses the applicant's nursing skills, and a nursing degree is a prerequisite for taking the rigorous test. Foreign nurses must also pass the International English Language Testing System (IELTS), which is a lengthy and comprehensive exam that tests the candidate's English ability.

"The tests are probably the biggest challenge any international nurse has to face," says Mooney. "Their training and education is similar to that offered in the United States, making the tests crucial to completing the immigration process."

Once the foreign nurses arrive in the U.S., they stay in a specially-built housing complex within walking distance of the facility, which South Nassau built to help its new recruits with the relocation process. They also participate in an orientation program at the hospital to help them acclimate to U.S. practices, which mainly consists of cultural and language courses. "They speak perfect English," Mooney clarifies, "but we offer a course in American slang to help them better communicate with patients."

Making a positive change

The success of South Nassau's international recruiting program led to the creation of South Nassau Nursing Solutions (SNNS), a staffing agency dedicated to assisting other hospitals with their international nurse recruitment and placement process.

Although international recruitment poses potential cultural difficulties among staff members, the program has proven successful and helped reduce turnover. When all South Nassau's vacancies were filled by international recruits, the turnover rate reached an all time low. "Turnover breeds turnover," says Mooney. "Nurses have to feel that have enough help to take care of their patients."

According to Mooney, foreign nurses help facilities reduce turnover by providing a permanent staffing solution, rather than relying on short-term fixes such as agency staff. This allows facilities to maintain stable nurse-to-patient ratios.

Experience, experience

SNNS helps other hospitals and healthcare providers by using the same program South Nassau built and perfected to address short- and long-term solutions to nursing staff vacancies.

"We screen every nurse that is hired on behalf of each facility to help ensure a permanent placement," Mooney says. The hiring facility pays the hourly recruitment rate of $63 an hour for the nurse's first month of orientation to U.S. facilities, while South Nassau covers the nurse's insurance, benefits, and salary. After the orientation period, the nurse becomes a permanent member of the hiring facility's staff.

International nurses recruited for other facilities experience the same program as those recruited for South Nassau. Along with their cross-cultural training, they also go through specific on-the-job clinical experiences at South Nassau. As a result, they are culturally adjusted and fully prepared to work in key clinical areas such as the emergency room, operating room, intensive care unit, and critical care unit before they transition to their new facilities.

"The nurses are an experienced, compassionate solution for the many unresolved vacancies at hospitals across the state," says Mooney, who has more than 30 years of patient care and nursing administration experience. "The nurses come to the U.S. with training and qualifications so that hospitals can immediately place them where they are needed."