Immigration and contract problems experienced by foreign-educated nurses

Document Type

Journal Article

Publication Date



Medical Care Research and Review


Volume 69, Issue 3

Inclusive Pages



Contract Services--statistics & numerical data; Emigration and Immigration--statistics & numerical data; Employment--statistics & numerical data; Foreign Professional Personnel--statistics & numerical data; Nurses--supply & distribution; Personnel Selection--ethics; Workforce Issues; Quality Improvement


More than 8% of employed RNs licensed since 2004 in the United States were educated overseas, yet little is known about the conditions of their recruitment or the impact of that experience on health care practice. This study assessed whether the labor rights of foreign-educated nurses were at risk during the latest period of high international recruitment: 2003 to 2007. Using consensus-based standards contained in the Voluntary Code of Ethical Conduct for the Recruitment of Foreign-Educated Health Professionals to the United States, this study found 50% of actively recruited foreign-educated nurses experienced a negative recruitment practice. The study also found that nurses educated in low-income countries and nurses with high contract breach fees, were significantly more likely to report such problems. If, as experts believe may occur, the nursing shortage in the United States returns around 2014, oversight of international recruitment will become critically important to delivering high-quality health care to Americans.


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Peer Reviewed


Open Access