The development and challenges of an international nursing workforce

Abstract

April 2007 International recruitment of nurses to fill the staffing ranks of US hospitals is at an all-time high. According to Buerhaus,1 employment of foreign-born RNs accounts for nearly one-third of the total growth of RN employment in the US labor market during the years 2002-2003. This adds yet another challenge for chief nursing executives and their management staff, compounding the issues of communication and patient safety. Given that the US nursing schools are unlikely to be able to meet the US health care industry’s demand for registered nurses,1 it seems a safe assumption that international recruitment will continue. As a result, the nursing workforce is likely to be more globally diverse than ever in coming years. The International University of Nursing (IUON) is located in the West Indies on the Caribbean island of St. Christopher-Nevis (St. Kitts). A former British Colony, St. Kitts was chosen by entrepreneur Robert Ross as the site of a private nursing school for educating an international student body for both the US market and the students’ countries of origin. In 2006, the student body of the university comprised 178 students. Of them, 49% are American and 51% are from 19 other countries. The IUON experience of educating nursing students with such diversity may offer some insights to hospital administrators regarding the challenges and the opportunities for welcoming these graduates into the US health care system. OUR EXPERIENCE OVERALL Since opening its doors in May 2005, the overall impression of the student applicants is one of strong motivation to become a professional nurse. Students must leave their home country and move to a new country with different cultural norms and, for some, a different language of conversation. Students must overcome visa issues, generate financial resources to cover private school tuition and living costs, and navigate a detailed process for admission to both the school and the island of St. Kitts. While St. Kitts is a Caribbean island of great natural beauty—with clear Caribbean waters, beaches, and a balmy year-round temperature—living in a foreign country, no matter how beautiful, has its adjustments. Students live among the locals rather than in dorms and must figure out how to take responsibility for transportation and food and the all-important cellular telephone. While the university has a housing department and extensive student services, there are still the usual difficulties with roommates and finding the ethic cuisine of home. The students come from diverse countries, as well as diverse socioeconomic backgrounds within each country. Ages range from 18 to 46, with a majority in their early 20s. For approximately 20%, nursing is a second career choice. The program was originally designed as a six-semester associate degree in nursing, with the students spending the first three semesters on St. Kitts, then transferring to a partner associate degree program in the United States. The Development and Challenges of an International Nursing Workforce