Healthcare organizations have made measurable progress in stabilizing their workforce, but stability today looks different than it did just a few years ago. Open roles may be closing faster, yet many teams still feel the strain of uneven experience, ongoing turnover, and inconsistent team performance.
During The Experience Equation webinar, one theme stood out: workforce strategy is no longer just about supply. It’s about how experience is distributed across teams, how nurses are supported, and how organizations design environments where people can contribute over time.
This shift matters. The U.S. is projected to see 189,100 registered nurse openings annually in the coming years, driven by retirements and workforce gaps.1
Sinai Hospital in Baltimore offers a concrete example. Over the past several years, they have built international nurse recruitment into the fabric of their workforce strategy—and the results show up in retention, team stability, and how nurses like Grace have grown within the organization.
"International nurse recruiting is not a short-term strategy. It is a play for long-term stability.”
— Amanda Shrout, CNO, Sinai Hospital
Watch The Experience Equation to see what intentional integration looks like at every level.
Experience mix is often treated as a scheduling concern, something managed shift by shift. The webinar reframed it as a strategic priority that requires leadership attention at every level—from the unit to the board.
How teams are composed has a direct impact on outcomes. Research has shown that for each patient added to a nurse’s workload, the likelihood of patient mortality increases by seven percent.2
Experienced nurses bring judgment, confidence, and the ability to stabilize high-pressure situations. They also shape how less experienced nurses develop through mentorship, modeling, and day-to-day collaboration.
At the same time, balance is critical. Teams need a mix that allows experienced nurses to guide and support newer colleagues without carrying disproportionate load.
One question that comes up consistently for nurse leaders is how to communicate this strategy upward. During the webinar, Amanda described bringing international hiring into every board conversation on recruitment and retention—framing it not as a workaround but as the long-term play. That clarity at the top is what allows the strategy to hold across leadership layers.
Workforce strategy takes shape at the unit level, and nurse managers are the ones who execute it. Managers account for up to 70 percent of the variance in team engagement, which means how well they are supported directly shapes team outcomes.3
Megan Schwartz, nurse manager at Sinai's B6 unit, described this during the webinar. On her unit, staffing decisions are intentional: assigning patients based on acuity and skill mix, pairing experienced and newer nurses, and maintaining visible leadership presence so nurses know support is available. Sinai also modified orientation for internationally educated nurses—not rebuilding it from scratch, but focusing on what experienced nurses actually need: the EMR system, equipment, and unit-specific protocols. Through a competency-based model called TSAM, nurses like Grace ramped up faster and felt more confident from day one because orientation reflected their experience level rather than treating them like new graduates.
Regular check-ins, structured introductions, and accessible leadership help internationally educated nurses build confidence early. When managers are aligned with the workforce strategy and given the tools to execute it, teams function more cohesively and nurses are more likely to stay.
Recruitment brings nurses into the organization, but integration determines whether they stay, engage, and contribute fully. One of the most common questions from the webinar audience was about orientation—specifically, how to approach it for nurses who arrive with years of clinical experience already. Belonging drives the answer: employees who feel connected to their organization are more likely to stay, engage, and grow.4
Integration begins earlier than many organizations expect. For internationally educated nurses navigating long timelines before arrival, pre-arrival communication and early engagement with leadership build trust and create a sense of belonging that carries into their first days on site.
Competency-based approaches let nurses demonstrate what they already know while focusing on what's new—the EMR, equipment, and unit-specific protocols. This reduces frustration and accelerates the transition to independent practice.
Grace, an international nurse placed by PRS Global, is a direct example of what this produces. Now choosing to stay beyond her third year at Sinai, she has advanced through the clinical ladder, serves as a charge nurse, preceptors newer nurses, and participates in shared governance.
The structures Sinai built—buddy systems, preceptor consistency, committee involvement, professional development pathways, and monthly connection sessions during the immigration process—made that trajectory possible.
Integration doesn't end after the first few weeks. Organizations that sustain workforce stability continue to invest in the experience through listening sessions, leadership visibility, and ongoing support. Grace’s story didn’t begin on day one, and it didn’t peak there either.
The Experience Equation made clear that workforce stability isn't built through hiring alone. It's built through the experience nurses have when they arrive, the integration structures that surround them, and the long-term investment organizations make in their growth.
PRS Global supports that full arc: from pre-arrival Nurse Connect sessions that begin building belonging during the immigration process, to on-the-ground arrival support, to partnerships that help hospital leaders design integration programs aligned to their workforce strategy.
Watch the recording or contact PRS Global today to talk through what intentional team design could look like for your organization.
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