Guide to International Direct Hiring for Nurses and HR Professionals
It’s no secret that healthcare facilities in the United States continue to grapple with a critical shortage of qualified nurses. Our recent Nurse and HR Leader Survey underscores the urgency of this issue, with a significant proportion of nursing leaders in teaching hospitals acknowledging a shortage of experienced and specialty nurses for the future.
The need for a long-term workforce plan has never been greater. It serves as a roadmap for hiring the right professionals and placing them in the appropriate roles to meet organizational goals. Putting together a plan for the next 3-5 years can help set up your healthcare organization for success.
An Incredible Health State of US Nursing Report mentions that 88% of nurses acknowledge the detrimental impact of staff shortages. A recent HRSA Nurse Workforce Projection report forecasts that the supply of registered nurses will not meet the demand needed in the future.
Notably, the shortage varies widely from state to state, with locations like Georgia seeing shortages of over 20% by 2030, whereas states like South Dakota will experience a surplus of RNs over the coming years. From 2024 to 2028, the supply of nurses versus the demand need erodes by 4%. By 2036, that erosion escalates to 6%.
As healthcare professionals seek various solutions to address these shortages, international direct hiring stands out as a highly effective strategy to comprise 10-25% of overall workforce planning to diversify your clinical pipelines.
By tapping into a global pool of nursing talent, healthcare facilities can supplement their workforce, mitigate shortages, and ensure they offer their clients the best healthcare.
But what exactly is international direct hiring? How can it benefit you? And what can you do to ensure it’s a success in your organization?
What is international direct hire nursing?
International direct hire nursing refers to the process of recruiting and hiring nurses from other countries for permanent work; they’re your employee on your payroll. This strategy gives healthcare organizations access to a pipeline of highly skilled, highly experienced nurses in a landscape where many other pipelines are dependent on bringing in younger, greener talent.
The IDH solution typically works with a healthcare organization to handle the entire recruitment process, finding the most qualified clinicians to match their needs. They also handle all the immigration and visa requirements, while ensuring the onboarding process runs smoothly so that international nurses successfully integrate into the healthcare organization and local community.
While many IDH partners claim to offer an end-to-end staffing solution, many aren’t truly end-to-end. Take PRS for example, we offer an integrated approach from orientation to onboarding that ensures the success of newly landed international nurses. From legal requirements, licenses, welcoming into the country, support during early days, and community integration, we ensure a smooth process for both the client and nurse.
However, those that will, see the benefits of implementing an IDH strategy as part of their workforce plan.
With the growing attention in international recruiting to supplement the US healthcare workforce, we are committed to ensuring that our recruitment practices are not only effective but also ethical, transparent, and aligned with the highest industry standards. As a Certified Ethical Recruiter (CER), we will continue to show our dedication to fair recruitment practices, setting us apart as a trusted partner for both healthcare organizations Foreign Educated Healthcare Professional (FEHP).
So, what are the benefits of using international direct hire nursing?
International direct hiring offers significant benefits for both hospitals and nurses. From hospitals accessing a global talent pool and closing the skills gaps to nurses experiencing cultural enrichment and competitive compensation, this approach is a win-win for all parties involved.
Benefits for healthcare organizations:
- Access to diverse global talent. Healthcare professionals can access an international pool of skilled professionals to help meet their staffing needs.
- Addresses healthcare professional shortages. Sourcing talent internationally allows hospitals to effectively address many staffing shortages/challenges instead of competing in wage wars.
- Closes skills gaps. If nurses with specific skills and expertise are scarce locally, HR professionals can recruit the right talent internationally to close that gap. Along with closing skill gaps, IDH nurses can help with seniority gaps. Many international nurses are bringing years of experience to the table, paving the way for them to become preceptors and leaders.
- Promotes long-term staffing, stability, and retention. An IDH program is crucial to building a sustainable workforce strategy. It provides a stable, reliable, and experienced long-term staff resource customized to the needs of healthcare providers.
- Simplifies recruitment. The recruitment process improves when using an end-to-end solution backed by expertise to create and maintain a sustainable pipeline of skilled clinicians.
- Diversity is strength. Hiring internationally helps create workplace diversity and promotes innovation by exchanging different ideas and perspectives.
- Improves organizational reputation. Showcasing a commitment to diversity, in turn, helps hospitals become more attractive and inclusive places to work. IDH nurses are also eligible to earn Daisy awards, which can benefit the hospital’s standing and become more appealing to other nurses.
- Higher retention. When a sense of belonging is created, IDH nurses can contribute and help build a robust and stable workforce. That allows healthcare teams to invest in career path development and continued education.
- Improved service quality. More stable workforces lead to better patient outcomes and an improved ability to innovate and expand service offerings.
These compelling benefits can transform healthcare organizations. To achieve those benefits, there are some considerations and challenges to work through.
What are the barriers to implementing an IDH program?
Hurdles may include cultural differences, immigration times and the need for additional support for international nurses to adapt to the new healthcare system.
Interestingly, our survey found that despite 61% of nurses and 86% of HR professionals voicing that they have considered implementing an IDH program to address staffing challenges, the two most common reasons they haven’t pursued this strategy are the length of time and cost to recruit.
This speaks to the importance of partnering with an end-to-end solution that helps you effectively tackle these hurdles. Let’s jump into some of those best practices now.
What are the best practices for implementing an international direct hire nursing program?
Conduct a thorough needs assessment
A thorough needs assessment helps you identify staffing requirements, specialty assignments, retiring workforce, geographic challenges, location expansion, and local nurse graduation rates to align recruitment efforts.
Start by identifying any current staffing gaps:
- What are your current needs in terms of nursing specializations and shifts?
- Are there any specific department requirements?
Continue by evaluating future projections and other considerations:
- What is the scale and rate of your future system growth?
- What is your exposure of shift differentials, bonuses and add-ons
- Turnover: year over year, 3-year trend, and 5-year tren
By proactively planning, you ensure the long-term sustainability of your nursing program along with the quality of your patient care.
Implement comprehensive onboarding and integration
Proper onboarding goes beyond administrative tasks; it is critical to making nurses feel welcome, prepared, and integrated into your hospital—especially as they are effectively uprooting their entire lives. It also improves job satisfaction and promotes retention.
A well-designed onboarding program typically includes:
- Orientation sessions covering organizational culture, policies, and practices
- Cultural integration where you provide resources to help nurses acclimatize to the local culture and workplace. For example, workshops, and interactive sessions that educate nurses about local customers
- Support networks like mentorship programs where experienced nurses support new hires
Ensure compliance and legal preparation
Maintaining compliance with immigration laws and visa requirements is crucial to mitigate legal risks. It ensures your IDH program operates within the confines of the law, safeguarding you against any legal liability and business disruption.
You will also need to file a Prevailing Wage Determination as one of the first steps to implementing an IDH program. The Immigration and Nationality Act requires that the hiring of a foreign worker will not adversely affect the wages and working conditions of U.S. workers comparably employed.
So, research and understand the laws, requirements, and regulations in your host and home countries. If necessary, seek guidance from legal experts in immigration and healthcare to navigate complex legal procedures and documentation. This is a key area where a strong IDH partner can take on the risk and hassle of legal compliance while integrating with your system requirements.
Provide continuous support and development opportunities
Providing ongoing support and development opportunities to your nursing staff demonstrates your commitment to their growth, fosters a supportive work environment, enhances job satisfaction and retention, and ultimately leads to improved patient care.
Offer this support by establishing feedback mechanisms for nurses to share their experiences and challenges. Regular check-in meetings can effectively serve this purpose. Additionally, consider providing continuous learning opportunities, such as training in new technologies, advanced clinical skills, or leadership development.
Partner with the right IDH solution
An IDH solution works with the hospital to find the best talent, handles the legal stuff, and manages the onboarding process. The right IDH partner can streamline the entire recruitment and onboarding process while amplifying the benefits of pursuing an IDH strategy in the first place.
For instance, they’ll have direct access to regions known for producing high-quality nurses and provide an end-to-end service that not only fills staffing gaps quickly but also ensures new nurses are well-prepared, integrated, and supported for improved retention.
More importantly, the right partner will help provide concierge-level services to ensure a sense of belonging and increase retention for the incoming nurses. Healthcare systems should look for partners who are thinking about details like getting nurses set up with stable housing, bank accounts, cell phones, internet, transportation to and from work, and connecting them with local communities. It’s all about going the extra step to ensure success for newly arrived nurses.
Look for a partner that is backed by the experience to build a sustainable IDH program, has a strong reputation, offers comprehensive support, and provides features tailored explicitly to healthcare recruitment. Be wary of vendors who promise turnaround times and guarantees that seem too good to be true or over-promise and under-deliver.
Check that your prospective partner has a proven track record—PRS Global, for example, has placed over 5000 nurses with a 93% retention rate.
The best partner for your international direct hire (IDH) program
Creating an IDH program can be challenging, but it doesn’t have to be with the right partner. PRS Global is your partner for international direct hiring success.
Born out of the desire to create a best-in-class direct hire program for our own healthcare locations, PRS Global provides an end-to-end staffing solution backed by the necessary skills and expertise to ensure your IDH program remains sustainable.
From sourcing and matching appropriate talent to fulfilling immigration requirements, coordinating flights and housing, and welcoming candidates at the airport, we truly do it all.
If you want to learn more about what it may look like to partner with PRS to help your staffing needs, let’s connect.