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.


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