U.S. Nurse Labor Market Dynamics are Key to Global Nurse Sufficiency

The United States has the largest professional nurse workforce in the world, numbering almost 3 million people in 2004. As demand for nurses continues to grow, there has been an increase in the number of foreign-educated nurses choosing to work in the United States. In fact, an estimated 8 percent of U.S.-registered nurses are now educated in a foreign country, and approximately 80 percent of these emanate from lower income countries. The country with the highest number of immigrant nurses is the Philippines.

This study considers the effect on the nursing shortage in the United States of nurse immigration and examines ways of resolving the problem without adversely affecting the health care demands of lower-income countries. The study found that once living in the United States, foreign-educated nurses are located primarily in urban areas, are most likely to be employed by hospitals, and more likely to possess a baccalaureate than native-born nurses. In addition, foreign nurses are no more likely to locate in areas of greater need than those born in the United States. Nor are they more likely to be Hispanic or African American, though a greater proportion of them are ethnically diverse.

The authors conclude that increased reliance on immigration to solve the shortage of nurses may adversely affect health care in lower income countries while not solving the problem in this country. Expanding nursing school capacity and finding ways to retain nurses and improve productivity could be more effective than relying on immigrant populations.