A nurse shortage is especially challenging in the middle of a pandemic, and things aren’t going to get better any time soon. Recent estimates suggest the US will have a shortage of more than a million nurses by 2026. The reasons behind the exodus are many, and often systemic: Nurses feel overworked, underpaid, and find their jobs unfulfilling and risky.
But there is a group of nurses who are actually in no rush to leave their jobs: Those born or educated abroad.
According to a survey conducted by AMN Healthcare, one of the US’s largest healthcare staffing agencies, international nurses working in the US might be experiencing the same hardship of their American counterparts, but don’t find that reason enough to leave their jobs.
The 2021 Survey of International Nurses was sent to 1,500 international nurses in the US who are either employed or formerly employed by O’Grady-Peyton International, a division of AMN Healthcare that focuses on hiring international nurses. About 600 of them completed the survey, which found that although international nurses are more likely to work in high-need and high-stress situations, and have experienced mental health issues and high levels of burnout during covid-19, the vast majority of them are satisfied with their work in the US.
Most international nurses in the US (77%) come from three countries: The Philippines, Jamaica, and India. They are more likely to have higher levels of education than American ones—90% have a bachelor of science in nursing or comparable status, compared to 56% of their local counterparts.
International nurses are typically hired with more experience, therefore tend to work in specialized disciplines and more likely than Americans to be working in high-stress environments, such as intensive care units or emergency rooms.
Further, the vast majority of them (86%) treated covid-19 patients, and more than half (56%) treated multiple covid-19 patients. It shows: One in three experienced mental health issues as a consequence of covid-19, and 81% report feelings of burnout. As of April 2020, foreign nurses were paying a high price for their role in treating covid-19: 24% of the nurses who died with covid-19 were from the Philippines, although only 4% of the workforce is Filipino.
Yet this doesn’t translate into a desire to quit the profession—particularly in the US. Almost 80% of foreign nurses say they are satisfied with their jobs, 81% would want to work in the US again, and only 14% have considered quitting during covid-19, compared to half of American nurses. International nurses qualify to receive permanent residence alongside other categories of specialized workers, so their decision to quit wouldn’t affect their ability to live and work in the US.
Although exact numbers aren’t available, it is estimated that about 8% of the 3 million nurses working in the US are foreigners or foreign-educated. These percentages are expected to increase as more international nurses are recruited to compensate the shortage of American healthcare workers. “[International nurses] are not going to solve our domestic problem—we have a nurse shortage and we have a lack of nurse educators,” says Sinead Carbery, O’Grady-Peyton International’s president.
Yet in the short term, recruiting more international nurses will help fill some of the gaps, particularly as international nurses are far more likely to prefer full-time employment with one healthcare facility than working as travel nurses, despite the more lucrative nature of contract work. According to the survey, only 10% of international nurses accepted a travel assignment.
Currently, says Carbery, the department of state is giving priority to processing green cards for nurses, and there isn’t a shortage of visas available because there are quotas left open by other workers who didn’t end up moving to the US during the pandemic.