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Yu Xu and Chanyeong Kwak.(2005).Characteristics of Internationally Educated Nurses in the United States. Nursing Economics 23(5) 233-238
The current shortage of nurses in the US has (again) intensified the efforts to recruit nurses from other countries. Through the years it has brought a sizable number of internationally educated nurses into the US RN workforce. A dearth of in-depth information about this population led the authors to do a follow-up study based on the 2000 National Sample Survey of Registered Nurses (NSSRN) data. Mailings were sent to selected participants, with follow up telephone calls to non-respondents. Minority nurses were over sampled in order to allow more in-depth analysis of this population.
Internationally educated nurses (IEN) was the term used because "foreign educated nurses" conjures images of being "alien" or "unwelcome", and because many of these nurses were already US citizens or legal permanent residents when the study was reviewed. An internationally educated nurse is "operationally defined as a RN with an active license to practice nursing in the United States who obtained his or her basic nursing education in another country".
The study compared the demographics, educational characteristics and employment characteristics between IENs and United States nurses (USNs). The significant results are summarized here.
1. Demographics: The mean age difference was negligible: IENs was 45.0 versus 45.1 for USNs. However, the age distribution showed that there were more IENs in the 30-34 age group, less in the 45-54 age groups, and more on the 55-64 age groups. Both groups show majority of women, although male IENs are slightly higher that USNs (6.2% vs. 5.8%). Seventy-four per cent of IENs were married, comparable to USNs (72.2%). However, the rate of "never married" IENs was higher (13.2% vs. 9.4%) and the percentage of "widowed/divorced/separated" was lower than USNs (12.8% vs. 18.5%). Out of 1,300 IENs in the sample, 38.9% came from the Philippines. Other IENs came from Canada (17.5%), India (10.9%) and the United Kingdom (8.9%), and a negligible percentage from other countries.
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2. Educational Characteristics: A higher rate of IENs was prepared at the baccalaureate level than USNs (38.3% vs. 30 %). This was largely determined by the IENs coming from the Philippines, Canada and United Kingdom. The average age of IENs at graduation from basic nursing programs was younger, their average years of experience were longer (22 years vs.18 years for USNs), and the proportion of IENs with more than 15 years of experience as RNs was significantly higher (70% vs. 54%). Less than 4% of IENs had an education that prepared them for advanced nursing practice.
3. Employment Characteristics: There were more IENs (73.7%) who worked fulltime (73.7% vs.59.1%USNs). Also, IENs worked more hours annually than USNs, thereby reporting higher average gross annual salary than USNs. IENs were employed mainly in hospitals and nursing home/extended care facilities. In the hospitals, the most frequent work units reported by IENs were medical/surgical units, ICUs, and step-down units. A significant proportion of IENs worked as staff nurses (76.7% vs. 61.8% USNs), and less likely in management positions such as administrator/manager/supervisor positions. Other work settings that showed less IENs were ambulatory care (4.8% vs. 10.1% USNs), public/community health (8.2% vs. 13.1% USNs), and education (0.9% vs. 2.3% USNs). There was no difference on perceived job satisfaction although the rate of IENs who left nursing was only half that of USNs (2.3%vs 4.6%).
The above findings bring out unique characteristics of IENs that appeal to US employers. As a group, IENs tend to be younger, unmarried 30-40 year old females with baccalaureate education and more years of experience as RNs. They were more likely to work full time, with more hours (and higher gross income) in direct patient care in hospitals or nursing homes in urban areas, and stayed in nursing longer.
These characteristics show that IENs have a great effect in relieving the US nursing shortage and support international recruitment efforts until such time as a long-term solution to this workforce problem is in place.
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