As many as 40% of overseas-educated nurses working in US healthcare facilities say their wages, benefits or shift assignments are inferior compared to US staff, according to researchers.
The findings, published in the American Journal of Nursing, suggest nurses recruited by staffing agencies and from poor countries are especially vulnerable to potentially discriminatory treatment.
The study authors surveyed 502 overseas nurses and said they found “troubling” evidence of widespread perceived discrimination, especially among those recruited by staffing agencies.
For example, 68% of nurses that had been recruited by such agencies reported at least one discriminatory practice, such as low wages and placement in inferior units or on undesirable shifts.
More than 27% of all registered nurses in the survey believed they did not receive pay comparable to that of US peers, rising to 47% for those hired by an agency.
About 16% of registered nurses said they did not think they were getting the same kind of benefits as their US colleagues, rising to 44% among staff recruited by agencies.
In addition, about 18% said they believed they received less desirable shifts or units – increasing to nearly 29% for nurses recruited by a staffing agency.
Overseas nurses that perceived unequal treatment were more likely to report job dissatisfaction, which the authors noted was likely to drive sickness absence and staff turnover.
Meanwhile, about a third of respondents said they did not receive sufficient orientation to life in the US or to the cultural differences they might be dealing with, potentially making it harder for them to fully acclimatise to US hospitals or nursing homes.
The study was carried out by researchers at the George Washington University School of Public Health and Health Services.
Lead author Patricia Pittman, an associate professor of health policy, said: “These findings are alarming. If confirmed by additional research, this survey raises a host of troubling ethical and practical concerns for healthcare facilities working to retain nursing staff and provide high quality care to patients.”
The researchers noted that historically the US relied on recruitment of overseas nurses to fill the gaps caused by widespread nursing shortages.
They added that many parts of the country were currently “grappling with such shortages” that were set to worsen, especially if the economy continues to improve and there are fewer US educated nurses in the “hiring pipeline”.
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