Crafting a Blueprint for Success: Recruitment & Onboarding of Internationally Educated Nurses

By Donna Anderson

The Central Texas Organization for Nursing Leaders (CTONL) convenes on a quarterly basis in Austin Texas.   April’s meeting was sponsored by Lone Star Communications and included social networking, a general session, and a presentation titled, “Crafting a Blueprint for Success: Recruitment & Onboarding of Internationally Educated Nurses.”

The evening’s presentation was brought to CTONL by Dr. Marlene Porter PhD, RN, NPD-BC, CEN, CCRN.  Dr Porter is the Nurse Scientist for the Central Texas Region – Baylor Scott & White.  She has been a nurse for 21 years and with BSW – Temple since 2012. Her nursing background is in long term care, ED and Progressive Care settings.   Dr. Porter’s contributions to the profession of nursing include poster, podium presentations at local and national conferences.  She has published work focused on synthesizing the literature on the personal factors that influenced work engagement, as well as a publication examining work engagement, burnout, and well-being in the nursing professional development practitioner. Dr. Porter has disseminated the results of various research studies where she has served as a primary investigator, co-investigator, or project lead.

Scenarios of internationally educated nurses (IENs) who dreamed of providing nursing care in another country were the focus of this CTONL event.   In her presentation, Dr. Porter shared beautiful stories of her own experiences and the experiences of others with the possibilities and the challenges of being in another country in unfamiliar surroundings and resources. 

Data presented outlined facts of nursing complexities as follows:

• 40% of the U.S. population identify as people of color & 19.4 % RN workforce are from minority backgrounds (AACN, 2023).
• In 2021, 38,561 Internationally educated nurses took the NCLEX compared to 63,836 in 2022 (NCSBN, 2022).
• Future of Nursing 2020-2030 focuses on achieving health equity (NASEM, 2021).
• The registered nurse (RN) workforce is expected to grow by 6% over the next decade (US Labor of Statistics, 2023).
• Current projections show 203,200 openings for RNs each year through 2031.
• The Experience Complexity Gap (Virkstis & Rewers, 2019)
• Recruitment of Internationally Educated Nurses (IENs)

CTONL members enjoyed learning of the process for recruiting IENs including:

• Equitable recruiting practices for international educated nurses
• Cultural competence preceptor training
• Diversity, equity, inclusion, and belonging training for nurse leaders
• Pen pal and ambassador programs

Dr. Porter and Dr. Kate Williams DNP, RN, NPD-BC, NEA-BC worked together with their team to create a Transition & Acculturation Program (TAP) as the underpinning for the integration of IENs to the BSW workforce.

Dr. Porter described the phases in submersion of IENs into a new country and culture even when they have previous experience in nursing in their home country or other international healthcare settings. These phases include the honeymoon phase, adjustment phase, adaptation phase, and reentry phase.  Hearing the experiences of these nurses during these phases opened the eyes of nursing leaders to the challenges not often considered when building international recruitment pipelines.  Learning from these experiences and sharing best practices for addressing these challenges was a highlight of the presentation.

A qualitative study was conducted, and the results were shared with CTONL members.   The study findings and evidence-based outcomes have been used to provide new education for leaders who are involved in and contemplating recruitment of internationally educated nurses to address the nursing shortage plaguing healthcare. CTONL thanks Dr. Porter and her team for the incredible amount of work that went into this effort.  

CTONL attendees use this quarterly meeting to enjoy a lite fare, network, and connect with nursing leaders and aspiring nurse leaders on topics and challenges that have common threads across organizations and individual leaders.  If you have an interest in this local connection, please reach out to Beverly Walker at Beverly.walker@bswhealth.org or follow CTONL on Facebook.

References:

American Association of Colleges of Nursing. (2023). Enhancing Diversity in the Nursing Workforce. https://www.aacnnursing.org/news-data/fact-sheets/enhancing-diversity-in-the-nursing-workforce

National Academies of Sciences, Engineering, and Medicine 2021. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. Washington, DC: The National Academies Press. https://doi.org/10.17226/25982.

National Council of State Boards of Nursing (NCSBN). (2021-2022). NCLEX Quarterly Examination Statistics. Volume, Pass Rates & First-time Internationally Educated Candidates’ Countries. https://www.ncsbn.org/public-files/NCLEX_Stats_2022-Q4-FactSheet.pdf

Bureau of Labor Statistics, U.S. Department of Labor. (2023). Occupational Outlook Handbook, Registered Nurses, https://www.bls.gov/ooh/healthcare/registered-nurses.htm

Virkstis, K., Herleth, A., & Rewers, L. (2019). Closing Nursing's Experience-Complexity Gap. The Journal of nursing administration, 49(12), 580–582. https://doi.org/10.1097/NNA.0000000000000818