Workplace Discrimination: A Survey Among Newly Arrived Foreign-Educated Nurses

By Sylvia Foley, AJN senior editor

Table 2. Outcome Metrics by Recruitment Model

Table 2. Outcome Metrics by Recruitment Model

This country has often relied on foreign-educated nurses (FENs) to ease nursing shortages—and  with more shortages predicted for as early as next year, it’s likely we’ll do so again. A positive workplace environment is a known predictor of staff retention; yet little is known about how FENs experience their jobs. To learn more, Patricia Pittman and colleagues surveyed more than 500 FENs. This month’s original research CE, “Perceptions of Employment-Based Discrimination Among Newly Arrived FENs,” reports on their findings. This abstract offers a brief overview.

Objective: To determine whether foreign-educated nurses (FENs) perceived they were treated equitably in the U.S. workplace during the last period of high international recruitment from 2003 to 2007.
Background: With experts predicting that isolated nursing shortages could return as soon as 2015, it is important to examine the lessons learned during the last period of high international recruitment in order to anticipate and address problems that may be endemic to such periods. In this baseline study, we asked FENs who were recruited to work in the United States between 2003 and 2007 about their hourly wages; clinical and cultural orientation to the United States; wages, benefits, and shift or unit assignments; and job satisfaction.
Methods. In 2008, we administered a survey to FENs who were issued VisaScreen certificates by the Commission on Graduates of Foreign Nursing Schools International between 2003 and 2007. We measured four outcomes of interest (hourly wages, job satisfaction, adequacy of orientation, and perceived discrimination) and conducted descriptive and regression analyses to determine if country of education and recruitment model were correlated with the outcomes.
Results: We found that 51% of respondents reported receiving insufficient orientation and 40% reported at least one discriminatory practice with regard to wages, benefits, or shift or unit assignments. FENs educated in low-income countries and those recruited by staffing agencies were significantly more likely than other FENs to report that they receive inequitable treatment compared with their U.S. counterparts.
Conclusions: These findings raise both practical and ethical concerns that should interest those striving to create positive health care workplace environments and to ensure staff retention. Health care leaders should take steps to ensure that FENs are, and perceive that they are, treated equitably.

Calling some of their findings “alarming,” the authors stress the need for employers, recruiters, and nurse advocates to “pay better attention to the real terms and conditions of FENs’ employment, looking carefully at wages, bene­fits, and shift and unit assignments, and working to bolster transitional orientation programs.” To learn more, read the article, which is free online, and listen to our podcast with the lead author. As always, we’d love to hear your stories and thoughts in the comments.

2017-07-27T14:48:52+00:00 January 27th, 2014|nursing perspective, nursing research|3 Comments

About the Author:


  1. Elisa Rodriguez April 15, 2014 at 8:30 pm

    Discrimination is a term that has manifested itself throughout history’s course. It usually includes cases involving people of different gender, religion, ethnicity, etc. Today, discrimination most commonly takes place in one’s own work place. For instance, as stated in the article “Workplace Discrimination: A Survey among Newly Arrived Foreign-Educated Nurses”, foreign-educated nurses (FENs) receive unequal wages, benefits, shifts, and treatment compared to American peers. I agree with the article in the sense that employers should strive to create a more equal environment, where skilled nurses, despite coming from a foreign location, receive the benefits they deserve. This, in turn, creates a more positive and proficient workplace, as opposed to one where most workers are unsatisfied. One should not be judged by where they come from, but how well they complete the task at hand. FENs should be treated justly, seeing as they are just as prepared as their U.S coequals.

  2. S. Lozier, RN April 14, 2014 at 5:10 pm

    I feel that the issue of recruiting foreign-educated nurses from low income is a very controversial topic. I believe that every nurse deserves to be treated equally in the workplace, regardless of how they were hired, or recruited.
    For the nurses who sign on to come to a high-income country such as the U.S., it is usually to gain a greater income and to bring their families over to have a better life and better opportunities. However, I have read many articles that discuss how the departure of these nurses that have been recruited out of their countries, have a huge negative impact on those low-income countries that are already deprived of healthcare professionals for their population.
    Also, here in America I see so many nurses that have such a hard time finding a job, especially the new graduates. For that reason, it would be looked upon unfavorably that those who liv here, and are not getting hired, yet the health organizations are recruiting outside of the country. I think that the problem of nursing shortage should be addressed globally, not just by these countries who can afford to do so, while creating bigger problems to the populations of those who cannot.

  3. Rita Prokopowicz January 28, 2014 at 1:40 am

    Will Polish nurses be allowed to work in the USA?

Comments are moderated before approval, but always welcome.

%d bloggers like this: