Friday, February 03, 2006

Global Aging report

http://www.aarp.org/research/international/gra/gra_fall_2005/index.html

Looking Abroad to Meet the Demands for Caregivers

By Ron Hoppe, COO and Co-founder of WorldWide HealthStaff Associates Ltd.
photo: Ron Hoppe

As the American population ages, the need for qualified professional caregivers is increasing as well. However, what are organizations to do that provide long-term care when their nursing workforce is also aging? Not only is the nursing workforce aging but it is doing so at twice the rate of the general working age population.

Starting in the latter 1990’s some long-term care providers in the US started to experience chronic nursing vacancies as traditional recruitment methods were no longer attracting a sufficient number of qualified nurses. Recruitment strategies were soon bolstered by expanded retention programs designed to keep existing nurses in the workforce longer and to attract those that had left the profession back to work, if only on a part-time basis.

At the beginning of the 21st century long-term care providers continued to grapple with an increasing shortage of nurses while at the same time that planning was taking place for expanded facilities and programs to meet the burgeoning demand for services. These factors, combined with workforce data that was now projecting a sharp increase in the number of nurses retiring, motivated some to seriously explore the viability of international recruitment.

Long-term care employers discovered that there was an abundant supply of highly educated and skilled nurses in a number of countries, especially those with emerging economies such as the Philippines and India. Employers also found that there were some nurses in other developed countries, albeit in relatively small numbers, such as Canada, United Kingdom and Australia who were also interested in working and living in the US.

However in order for international recruitment to be included in an employers overall staffing plans, they needed to develop strategies to meet the stringent US Registered Nurse licensure requirements and the equally stringent US immigration requirements.
"Long-term care employers discovered that there was an abundant supply of highly educated and skilled nurses in a number of countries, especially those with emerging economies such as the Philippines and India."

International recruitment efforts were focused primarily on countries where:

* education standards for nursing were recognized as being equivalent to US standards;
* there was a general level of English language proficiency;
* there was some history of immigration to the US, and;
* there was a sufficient supply of nurses that could be recruited without devastating the workforce of the nurse’s home country.

The application of these criteria resulted in the Philippines and India as being the primary countries in which international recruitment activities were undertaken.

While international recruitment was providing additional nurses to the long-term care workforce, employers realized that this strategy was not without some risks. The aftermath of the terrorist attacks on the US in 2001, changes to licensure rules and immigration regulations and sometimes lengthy immigration processing times all contributed to a process that was more complex than some employers had anticipated.

Employers who achieve the greatest success in recruiting internationally include a number of key elements in their strategies. These include:

* a strategic vision and commitment to the process;
* communication with existing staff throughout the international recruitment process to ensure organizational buy-in and support;
* contracting competent professional help to manage all aspects of the process;
* mentorship programs and structured orientations for nurses on their arrival in the US that specifically address the practice differences the nurse will encounter; and
* a clear understanding of the acculturation issues that the international nurse faces in integrating into the US long-term care workforce and into US society in general.

Concerns have been raised regarding the impact of international recruitment on the nurse’s home country. While these concerns are valid and need to be taken seriously when considering recruiting in some developing countries, countries such as the Philippines and India have a long history of purposely training nurses in numbers well beyond their domestic requirements specifically for employment abroad. Nursing curriculum in these countries has been developed with careful consideration of the US standards.
international recruitment

Also, the countries from which nurses have been recruited are receiving several significant benefits. Once nurses are employed in the US they tend to return a portion of their earnings to their home country specifically to support their extended families and some of the nurses return to their home country and are able to transfer the knowledge and skills they have gained in the US by assuming leadership positions in academia and in hospitals.

Although the nursing shortage eased slightly in 2004 as the result of domestic and international initiatives, US production of new graduates remains less than the current demand and the number of older nurses continues to increase at three times faster than younger workers.

Overall the international recruitment of nurses is having a beneficial impact on the delivery of long-term care services in the US. International nurses help to ensure that there are an appropriate number of nurses available to meet the demands of an aging population. With current US workforce and demographic studies predicting that the greatest shortage of nurses still lies ahead, international recruitment will remain as an important element of the staffing plans of many long-term care providers.

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