A small group of diverse medical staff stand around together in the hallway of a hospital as they have a brief meeting to discuss a patient case. They are each wearing scrubs and name badges as they focus on the conversation.
(Credit: FatCamera / Getty Images)

International recruitment has been one rural community health system’s response to a shortage of nurses.

According to a case study published by the American Hospital Association, the Fisher-Titus health system in Norwalk, OH, determined that employing international workers on a full-time basis was preferable to hiring contract staff. The system includes a 69-bed skilled nursing facility, 48-unit assisted living community and a home health center in addition to a 99-bed acute care hospital.

“After the nursing shortage evaluation was completed in 2018-2019, Fisher-Titus identified PRS Global as a partner and began international recruitment. Because Fisher-Titus wanted to ensure that the new nurses felt part of the staff and the greater rural community, they chose the direct hire option as opposed to the contract staff approach,” according to the case study. 

The company also took steps to ensure that the current nurses understood that the international workers were coming to sustain members of the existing nursing staff, not to replace them. 

Fisher-Titus began the initiative before the pandemic. Initially, the health system thought it might take a year to bring immigrant workers on board. Due to complications that arose from the pandemic, however, the process took closer to 18 months.

“Once there was an arrival date for those nurses, the next step was to work with human resources to ensure a seamless onboarding process. It was only one week from the date the nurse arrives to the date they began their employment,” the case study noted. The company, therefore, completed as much paperwork as possible before the nurses’ arrival.

Community mentors worked with the new hires to find affordable rental housing for the new nurses and their families.

Identifying cultural differences played a role in transitioning international workers into Fisher-Titus. Not all of the differences were pinpointed before the first nurses arrived, but since then, “the education programs have grown, and staff incorporated the challenges into the international nurses’ monthly education so at the end of orientation they are a successful member of the Fisher-Titus nursing team.” 

Although the need for international workers was identified before the pandemic, Fisher-Titus found that the initiative brought new energy to a burned-out workforce after the pandemic, according to the case study.

“The nurses that joined Fisher-Titus staff from the Philippines were grateful to be at their facility, for the equipment, the work environment and the fact that there were other nurses working right beside them,” the AHA noted. “It gave the tired nurses a little bit of energy to be around such positivity and to see the improvement in the care they were delivering.”

International workers sign a three-year commitment to work at Fisher-Titus. 

“The goal is that the environment that they collectively build encourages the international nurses and their families to remain at Fisher-Titus and in Norwalk for many years to come,” the case study said.

See additional immigration-related news from McKnight’s here.