Foreign-born nurses provide more “human capital” to long-term care settings than nurses born in the US, according to new research that aimed to better quantify the value of immigrants working in healthcare.
Investigators also found that additional criteria for foreign-educated nurses, such as their ability to speak multiple languages and holding licenses to practice in multiple states, makes for a more well-rounded caregiver. The study was led by a doctoral student at Duke University who emigrated from Jamaica.
“I wanted to show that immigrant nurses often have a wealth of transferable skills, are more mobile and adaptable given their experiences practicing in different long-term care settings,” lead author Roy Thompson, PhD, a postdoctoral fellow in the Missouri University Sinclair School of Nursing, said in a press release. “Immigrant nurses are crucial for diversifying the nursing workforce, as they bring a different cultural lens, a different racial lens, and a different linguistic lens.”
Thompson’s research compared data from the 2018 National Sample Survey of Registered Nurses for foreign- and US-born nurses. The sample consisted of 1,752 US-born RNs and 135 foreign-born RNs. Researchers created composite scores from six nursing education and professional experience variables: the highest nursing qualification achieved, skill-based certifications, years of experience, the number of state licenses, multistate employment, and multilingual ability.
“[Foreign-educated nurses] bring a higher level of human capital to LTC settings, which suggests that they have an increased capacity to provide the needed person-centered care to positively impact care quality and improve outcomes in LTC,” the authors wrote.
Recruiting foreign nurses has long been pushed as one of the solutions to the sector’s workforce crisis, but US immigration policies make it difficult to bring in a sufficient number of immigrants, who already comprise 20% of RNs and 15% of LPNs in nursing homes, according to LeadingAge.
LeadingAge Missouri CEO Bill Bates told McKnight’s Long-Term Care News on Tuesday that one of his association’s members has more than a dozen international RNs scheduled to be added to its workforce. But it is taking the provider 18 to more than 24 months to obtain the necessary work permits despite the individuals already being licensed in the state.
“There is a significant nurse shortage in long-term care, and it’s beyond frustrating [that] visa caps constrain improvement,” Bates said. “Our members report positive results with foreign-born caregivers. In addition to the findings of the MU researcher, our members would say that many times foreign nurses have greater respect for the elderly. Ageism is everywhere, but foreign-born caregivers often come from cultures where elders are revered.”
Most nurses who immigrate to the US come from racial and ethnic groups from the Philippines, Sub-Saharan Africa, and the English Caribbean, Thompson said in the press release. They frequently work in underpaid, entry-level positions, despite the experience they bring with them.
“Previous research shows immigrant nurses experience discrimination, racism, exploitation, inequitable pay, and unfavorable treatment at work,” Thompson said. “While most nursing research focuses on hospitals, clinical research, patient populations and patient health outcomes, nursing homes and long-term care facilities tend to be an understudied, yet overregulated sector.”
The study, “Examining Human Capital Among Foreign and United States Educated Nurses in Long-Term Care” was published in the July edition of the Journal of Nursing Regulation.
The other researchers are Susan G. Silva Ph.D., Michael P. Cary, Jr Ph.D., and Eleanor S. McConnell Ph.D., with the Duke University School of Nursing; Kirsten N. Corazzini Ph.D., dean and professor at the College of Health and Human Services for the University of New Hampshire in Durham, NC; and Thomas R. Konrad Ph.D., professor emeritus at the Cecil G. Sheps Center at the University of North Carolina.
