What If the Nursing Shortage Is Not a Recruitment Issue?

Healthcare employers are confronted by an increasing shortage of experienced RNs. Recruiters, Talent Acquisition and HR professionals are using more sophisticated recruitment tactics and technology, investing more resources than ever before and yet desired outcomes are not being achieved. Even worse, most recruitment results in qualified applicants simply moving between employers to cash in on increasing sign-on and other incentives.

Is it possible that the nursing shortage is not a recruitment issue but is a supply and demand issue and that there are more open positions than there are experienced applicants to fill them?

Since the demand for health services is increasing, it follows that the supply of healthcare providers must increase also. However, with colleges facing their own faculty shortages and limited practicum placement sites, they are limited in their ability to increase enrollments which would result in more RN graduates. Further, RNs are currently retiring much faster than projected even three years ago. So now what?

Increasingly U.S. health employers are again looking to international recruitment as an option to recruit experienced RNs and to recruit them in volume. International RN recruitment was a common practice in the early 2000’s. Delays in visa processing times starting in 2007 followed by the great recession of 2008-09 saw many programs scaled back or cancelled. However much has changed in the past 10 years. Today visa processing times have improved dramatically, international nurses can write the NCLEX licensure exam in locations around the world and the global, English speaking healthcare workforce is extremely mobile.

International recruitment can make a meaningful contribution to quality of care and financial performance for organizations that are:
• experiencing increasing times to fill or chronic vacancies,
• paying increasing financial incentives to new recruits,
• experiencing unsustainable levels of contingent staff spending,
• planning facilities or program expansion

There are two approaches to international recruitment. The first is Direct Hire – Permanent Placement, where hired nurses become full-time, permanent staff members of the facility that recruited them. Alternatively, international nurses can be contracted through staffing or travel nurse agencies, in essence, increasing spending on contingent staff.

The reality is that international recruitment is not going to solve short-term, urgent staffing needs. However, with no end in sight to a constant and increasing shortage, planning for medium to longer-term solutions is essential – and international recruitment can significantly contribute to those plans.