Global Hospital & Healthcare Management

Marcia Faller, RN, MSN, joined AMN Healthcare in 1989 as the company’s first Vice President of Nursing. Currently she is Executive Vice President, Operations and Chief Clinical Officer.  Ms. Faller has made presentations on staffing effectiveness, foreign nurse assessment and recruitment as well as quality and competency assessment in the staffing environment. She continues to deliver web, panel, and podium presentations in her areas of expertise and is a proponent of further dedicated research in staffing related topics.

International recruitment impacts every healthcare facility in the United States even if it has never recruited a foreign nurse.  Foreign trained nurses comprise roughly 15% of the newly licensed nurses in the United States, and that number is even higher in certain areas such as California.

Why do nurses choose to migrate? No one really refutes the idea that nurses (or anyone) have the right to migrate in order to improve the life for themselves and their family.  Some of the reasons nurses want to migrate include:

• Unsatisfactory working conditions


• Poor pay – in places like India and the Philippines, nurses make what is equivalent to a few hundred dollars a month working full time or more than full time.


• Lack of resources to work effectively


• Limited career opportunities


• Limited educational opportunities


• Gender and Race discrimination


• Various safety and economic issues – e.g. HIV/AIDS, dangerous work environments, political and/or economic instability

Certain countries such as the Philippines and India have established U.S. curriculum based nursing programs and actually manufacture nurses as an export. In some cases, the government supports programs like this formally because of the money sent back to the country. Planned exportation of human resources can have a positive impact on the country’s economic status.

Some well-known organizations have taken positions on the immigration of nurses to the U.S.   In their position statement on the ethical recruitment of nurses, The International Council of Nurses makes several statements, among them the following:

•   A country should grow their own nurses and retain them
1       Nurses have a right to migrate
2       Denounces unethical recruitment practices such as promises not made in good faith, unfair pay
3       Recognizes the benefits of circular migration – nurses can gain tremendous knowledge and experience from U.S. work that can potentially be taken back and share to improve nursing care in the home country. Unfortunately there are no visas that promote this type of circular practice.
4       The  Government should hold responsibility to regulate migration of RNs

•   USA: limited  number of visas

165 UK:  has imposed restrictions on recruiting nurses from certain countries

Recruiting nurses internationally is not just a partial solution to healthcare staffing planning for the future, it is also a dynamic that will help contribute positively to the increasing diversity here in the US. And as our world becomes more in tune with globalization, circulatory migration of nurses can become a reality.

About AMN Healthcare

AMN Healthcare, through its O’Grady-Peyton International division, has been in the business of recruiting English speaking nurses to the U.S. since 1980. From O’Grady Peyton’s decades of recruitment and placement of international nurses into the United States, we are experienced with the unique needs of the nurses and the proactive steps that an employer should take in order to have a positive experience for the nurse, the hospital and your patients.