The grand tour for hiring

Foreign nurses fill gap

Paula Bradney, RN, director of recruitment staffing at Banner Health System in Mesa, AZ, has been to Europe, Canada, Africa, the Middle East, and Asia. But those weren’t vacation trips. She was looking for nurses. The two hospitals for which she recruits in the system — 300-bed Mesa Lutheran and 260-bed Valley Lutheran — started looking outside the United States three years ago and has hired more than 100 nurses so far. About 50 are on board already, and they come in at a rate of about two to five nurses every month. Despite a growing system and increasing number of beds, the foreign recruitment program has helped keep the vacancy rate at the two hospitals at less than 5%, Bradney says.

The first trip was to the Philippines in June of 1999. She screened about 300 nurses and hired about 100. It took about 15 months for the first group to make it to the United States. Bradney used a staffing agency, Interstaff of Houston as an agent, but Banner Health opted to select its own nurses. "We wanted to make sure the clinical skills were appropriate to our acute care institutions," she says. "We also wanted to make sure that the language skills were up to our needs and that the motivation was right." The nurses have to go through five different exams plus immigration procedures before they can come to the United States. That’s why it takes 12-24 months for the nurses to arrive after being hired. They have to pass exams from the Commission of Graduates of Foreign Nursing Schools, the TOEFL English exam, a test of written and spoken English, and a U.S. national nursing exam. "Anyone who tells you they can get them here faster than a year has nurses in the pipeline," she says. Most staffing agencies tout their Filipino nurses, but Bradney says trips to Britain have put her in touch with English-speaking nurses from India, China, and Africa as well.

Things to think about

Before embarking on a program, Bradney says there are things to consider. First, if you are using an agency, check references. "If you get the product that the staffing agencies say they have, it is cost-effective," she says. "But there are many fly-by-night operations who can hurt you or the nurses."

Interstaff doesn’t charge the nurses anything for their services, although the nurses do have to pay for their own exams in the country of origin. "I didn’t want a company that makes the nurse pay back anything," Bradney says. "I made sure we used someone who won’t cheat the nurses. After all, I’m a nurse."

Initially, Banner doesn’t employ the nurses, Interstaff does. They spend two years on a contract with the agency with a salary and benefits package similar to that offered by Banner Health. After that, they are converted to Banner employees.

Orientation often takes a little longer with foreign nurses — similar to that which you give a new graduate, she says. It lasts eight weeks at Banner, and the nurses are partnered one-on-one with a preceptor to guide them through the process. Bradney also does rounds with the new recruits and engages in a very hands-on approach to getting them settled.

Indeed, the biggest problem Bradney says she’s facing in her foreign recruitment program is that she’s not the only one in the market for foreign nurses any more. "Three years ago, you got the best of the best," she says. "But we aren’t the only company out there any more, nor are we the only country looking for nurses."


• Paula Bradney, RN, Director of Recruitment, Banner Health System, 500 W. 10th Place, Mesa, AZ 85202. Telephone: (480) 461-2776.