Many hospitals have turned to international recruitment as a long-term strategy to develop their permanent staff amid the shortage of registered nurses.

While staffing solutions such as travel nursing can fill short-term needs, international staffing focuses on bringing in qualified talent on a contract-to-hire basis, where a worker intends to fill a role long term.

As demand for healthcare professionals continues to exceed supply — intensifying as the baby boomer generation ages and the need for health services increases — health systems continue to struggle with recruitment and retention in a tight labor market.

The US Bureau of Labor Statistics projects that there will be 203,200 openings for registered nurses each year through 2031, which includes nurse retirements and workforce exits. Additionally, the National Council of State Boards of Nursing conducted a survey in April that found approximately 800,000 registered nurses intend to leave the profession by 2027. Developing an international supply channel has been an additional strategy explored by healthcare leaders to fill open positions.

The flow of international nurses entering the US and providing healthcare services has not only helped hospitals to meet patient demand but created a partnership with staffing firms who can provide foreign nurses as part of the workforce. According to Patty Jeffrey, president of the American Association of International Healthcare Recruitment, one in six registered nurses practicing medicine in the US is an immigrant.

Foreign nurses are eligible to enter the US with an EB-3 visa, which has a green card limit of 40,000 per fiscal year. The Covid-19 pandemic created heightened demand that not only exceeded supply but resulted in a backlog of visa applications. According to the National Visa Center’s “Immigrant Visa Backlog Report” from April, more than 390,000 applicants are still pending interviews. The US State Department recently announced its decision not to accept any further visa applications for foreign nurses in 2023. Only those individuals who submitted applications prior to June 1, 2022, are eligible for visa interviews. This decision has been met with concerns around added staffing pressures from many in the industry. According to AAIHR, the processing queue is expected to grow with legal experts anticipating that today’s 10-month timeline will increase dramatically, likely meaning nurses who petition this summer will not be able to enter the US until 2025 at the earliest. According to the American Bar Association, healthcare providers and industry groups have reported that this backlog will exacerbate the current nurse staffing shortage in the US.

The green card freeze could be another blow to hospitals that continue to face recruitment and retention challenges. To meet patient demand, it is likely that health systems will continue to rely on staffing firms for contingent staffing and workforce solutions. To better support health systems, healthcare staffing firms have increased automation and are leveraging technology in order to further develop their talent pools, expand their reach, simplify onboarding tasks, and ultimately, increase speed to hire.

To learn more about strategies and models some staffing platforms are utilizing to acquire talent, create operational efficiencies and develop long term networks, see the “Temporary Staffing Platform Update: 2023” report by SIA.