Hiring internationally educated nurses in hospitals: role of competition and resource availability

Abstract

Objective: This study used Porter’s Five Forces Model and the Resource Dependence Theory (RDT) to examine the association of competition and other market factors with the hospital’s decision to hire internationally educated nurses.
Methods: A panel design was used comprising a national sample of nonfederal, acute care hospitals (n = 4,116) in the United States. Data, for the years 2008-2012, were derived from American Hospital Association’s Annual Survey and Area Health Resource File. Logistic regression with hospital random effects and state and year fixed effects was conducted to test the above mentioned association.
Results: The study findings suggest that hospitals hire internationally educated nurses as a strategy to meet their staffing needs in more competitive and diverse markets. Moreover, hospitals that hire internationally educated nurses are system-affiliated, larger, and see more Medicare patients than those that do not hire them.
Conclusions: Findings of this study could help health care managers to understand the influence of market factors on utilization of internationally educated nurses to fulfill their hospitals’ nurse staffing needs. Furthermore, the study findings can inform policymakers in crafting policies on the use of internationally educated nurses as a strategy to address nursing shortages.