Quality of Care and Foreign Nurses

Importing foreign trained nurses is no new phenomenon, America has been importing nurses for over fifty years since 1965, according to B.L. Brush and A.M. Berger, "Sending for Nurses: Foreign Nurse Migration, 1965–2002" Nurses Announcements Archive Article

I would like to examine evidence to see if foreign trained nurses have an impact on quality of care and wages.

There are numerous articles on importing foreign trained nurses and this article provides links to some interesting information.

Imported Care: Recruiting Foreign Nurses To U.S. Health Care Facilities

This article states that...

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Quality issues. Little is known about whether the quality of nursing care differs between foreign- and U.S.-trained nurses. While the certification process assures competency in educational training and language, differential quality of clinical care has not been assessed. Quality of care could be affected by, among other things, poor orientation and training of new foreign nurses who are assimilating into the U.S. health care system. The development and evaluation of more comprehensive orientation and training activities are warranted and have been recommended by the AHA.50 An assessment of the quality of care and patient outcomes is likewise needed and should include an appraisal of the cultural competence foreign nurses bring to patient care.

From my own perspective I was given 2 weeks orientation and sent on my way as a foreign trained nurse I felt I was flying by the seat of my pants. Initially I was promised an eight week orientation but after 2 weeks I was on my own. Fortunately I received good reviews I was a very experienced nurse and could competently carry out my duties, I learnt by my mistakes and I avidly learnt by other peoples mistakes, making a mental note not to do anything which somebody else was reprimanded for. My mistakes were confined to paperwork, Dr's orders and learning what not to say.

However are others who are recruited so well informed and experienced in nursing. I have my concerns about orientation and the impact it can have on quality of care.

In the UK recruitment of nurses was obtained from India, Pakistan and African countries their orientation amounted to 6 months orientation, where they achieved a 'book' full of objectives before they were allowed to work as an RN-this obviously has cost implications. They were paid at a lower grade until their objectives had been achieved thus ensuring the nurses were fully familiar with nursing practices in the UK.

It is doubtful anything like this would be implemented in the US because of the cost implications this would involve. (work in progress)