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Overseas nurses report ‘unequal treatment’ in US


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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Readers' comments (6)

  • I think the findings are very disturbing but not surprising. It doesn't surprise me that nurses from the 3rd world are being exploited by the agencies who recruit them to the benefit of the agencies and the profit-making health system that exploits them.

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  • Where does it say the nurses are from the third world countries?

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  • I think many overseas nurses here could probably paint a similar picture.

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  • I recently went on a cruise ship owned by an American company. I enjoyed Every thing on the cruise ship, then I learnt of the very low wages and the amount of hard work with little breaks the non americans on the ship were getting. This sadden me, I hope it is not so bad wih the nurses.

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  • This is a familiar story. Overseas nurses always get the least popular shifts, the lowest pay and zero access to training programmes in the US. They may also find that they're placed in unpopular or poorly funded units doing jobs that US staff don't want. Overseas nurses may be good at their work, or not, but they're just not 'Made in America', so they're automatically considered inferior.

    The US is not a friendly place for foreigners, but are we any better in the UK? Seems to me that a lot of migrant nurses & care staff get a similar raw deal here.

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  • Well, it's not like they're working in areas where there are strong, recognised trade unions they can join. Health care in the US is a 'for profit' business, so worker exploitation is common across all industries.

    We're only shocked by this because we're used to a system that values people as workers slightly better than as mere disposable widgets.

    We need to realise that decent, humane terms and conditions don't come free with cornflakes. They have to be fought for and whenever you stop fighting for employee rights, they are soon eroded away by unscrupulous employers.

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