Report Explores International Nurses’ Experiences in US

Report Explores International Nurses’ Experiences in US

As a predicted nursing shortage continues to impact healthcare options across the nation, a recent survey by O’Grady Peyton revealed some information about international nurses working in the United States.

The report by O’Grady Peyton, a US healthcare staffing agency with a focus on international nursing, explores some of the roles thousands of international nurses fill while also showing some of their experiences working as an international nurse.

With a respondent size of nearly 600 nurses, the 2021 Survey Of International Nurses revealed that a higher proportion of international nurses are working in roles that are traditionally challenging and high stress. For instance, international nurses work  in emergency departments (8 percent vs. 5 percent of all nurses), psychiatric units (11 percent vs. 4 percent of all nurses), and in intensive care units (19 percent vs. 15 percent).

The report’s findings state that approximately 300,000 nurses (about 8 percent of the nurses providing care) in the United States are internationally trained. Of those numbers, these nurses also hold high rates of education with 90 percent of the respondents having attained a bachelor’s degree in nursing or higher (12 percent hold a master’s degree in nursing and 1 percent have a DNP degree). In comparison, the latest statistics from 2019 indicate that about 56 percent of nurses hold a BSN or higher, so the numbers may have increased slightly.

The survey results show the majority of the nurses surveyed come from the Philippines, Jamaica, and India, with a slightly smaller percentage coming from Africa. Overall, international nurses have considerable experience working in the field before coming to the US with nearly 9 out of 10 international nurses having at least 10 years of nursing experience and 49 percent reporting 20 or more years of nursing experience.

As these nurses have worked in the US, they have managed the care of COVID patients and have helped fill the extreme pressure on nursing staff everywhere. Eighty-six percent of the respondents have provided care for patients with COVID and more than half have treated multiple COVID patients. The resulting physical and emotional stress, as with all nurses, is having an impact. One third of the respondents said their mental health was affected by the pandemic and that the greatest stress comes from treating such severely ill patients. There is also significant stress from the anxiety around contracting COVID-19 themselves (17 percent said they have contracted the virus).

The international nurse respondents said they overwhelmingly felt accepted by their patients and colleagues, with more than 8 in 10 reporting that positive acceptance. The results weren’t as strong for other areas–only 56 percent felt that their pay was on par with what US nurses make. And just over a third conveyed experiencing discrimination often or many times based on their country of origin or ethnicity, the report stated.

Experiencing burnout is nothing new for nurses, but the pandemic has certainly made the stressors on nurses worse. The survey reports high levels of international nurses feeling some level of burnout (81 percent), but that despite the strain of the job, 8 in 10 of the respondents said they would work in the US if given the choice to do it over again.

Read the full report for more information on international nurses working in the United States today.

Successfully Integrating International Nurses into Your Staff

Successfully Integrating International Nurses into Your Staff

Eight nurse leaders from across the country gathered to participate at the Avant Healthcare Professionals CNO Roundtable to share their thoughts on the challenges, solutions, and opportunities that they face.

Benefits of Diversity

Diversity in staffing is known to produce higher quality work and increase productivity, overall. More importantly, diversity makes your recruitment and retention efforts easier, according to a Glassdoor study. Two-thirds of the respondents in the study said that a diverse workforce is an important factor when evaluating companies and job offers. The Glassdoor study also found that 57% of people surveyed think their company should be doing more to increase diversity in its workforce.

For health care staffing, diversity is highly desired as it has a direct impact on care delivery. International health care professionals are more equipped to care for minority patients as they understand diverse backgrounds and can better communicate bedside shift reports to them, according to an American Nurses Association study.

In this article, Avant Healthcare Professionals Founder and CEO Shari Dingle Costantini and Vice President of Clinical Operations Jennifer David asked CNOs how they successfully integrate international RNs into their staff. Below are the suggestions.

Address Staff and Peers

It’s essential to inform your staff that an international nurse will be joining the team. Take the chance to educate your staff on the nurse’s culture and background pre-arrival of the new nurse.

Some countries’ medical terms do not translate accurately in English. Procedures may also vary depending on the country, so educating your staff on the clinical differences is a must. Your staff will be understanding and more willing to help when they are aware of these differences.

Assigning an ethnically diverse preceptor for the new nurse is also very helpful in the onboarding process. If this is the first international nurse on your staff, designate nurse leader support for the international nurse so that they have a “go to person” to depend on when needed.

“We have had a lot of success with international nurses as part of our staffing solution. Understanding what environment these nurses come from and then acclimating them to our environment has been key for our retention program. Our other international nurses also help with that transition in prefacing them.”
– Caroline Stewart, CNO, Citrus Memorial Hospital

Address Patients

The patient experience is the most important aspect of care. Hospital leadership should encourage unit managers and charge nurses to educate patients and the patients’ families on their international nurse’s education, preparation, and experience. Therefore, it’s crucial that the patient understands that they are receiving the best care they can get no matter who their nurse is.

Eliminating patients’ requests in nurse changes will reinforce that the international nurse is a part of the team and will make the patient feel more comfortable about their care.

Address the Community

Whether you live in a diverse community or not, discussing the need for international nurses is important. Reach out to key influencers in the community such as the mayor, the Chamber of Commerce, the Rotary Club, local reporters, etc. Inform them of the nursing shortage and explain how international nurses bring value to the community. The goal is to have political backing for a care environment that welcomes diversity.

One of our partners at Great Plains Regional Medical Center met with the mayor and the school board to introduce diversity education to the North Platte, NE community. These meetings serve as a catalyst to successfully integrate internationals into the hospital as well as the community.

Most importantly, the school board should be aware of international families in the community and be prepared on how to integrate these students pre-arrival. Bullying can be an issue in grade schools, which is why the school board should be involved in these meetings.

Overall Goal

Involving your staff, patients, and the community in diversity education serves to create a welcoming home for international nurses and internationals, in general. These nurses are looking to be a part of the community as permanent residents. The overall goal is to improve patient care with a staff that better represents the population. Diversifying your community can start with the health care system. Considering international nurses at your hospital is a great start.

About Avant Healthcare Professionals

Avant Healthcare Professionals ( is the premier staffing specialist for internationally educated registered nurses, physical therapists and occupational therapists. Avant helps clients improve the continuity of their care, fill hard-to-find specialties, and increase patient satisfaction, revenue and HCAHPS scores. Avant is a Joint Commission accredited staffing agency and founding member of the American Association of International Healthcare Recruitment (AAIHR).

Originally published on February 7, 2018 at